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All of a sudden his appetite is diminishing. Cannot tell if he is hungry or not and eats much less than usually. He is losing his sense of direction, does not know which way to turn with the walker to get from the bathroom to the living room or bedroom. Looking at recent pictures he does not recognize himself and cannot associate his name with himself. Has constant very loose bowel movements in spite of the Immodium I give him. Has diabetes 2, high blood pressure, takes a lot of pills every day, which may be part of the cause. He is tired all day. What can I do?

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Has he seen his doctor recently? A bladder infection or medication reaction could be causing the confusion, but it also might be the progression of the disease. I would check to see and to get some advice on his diet. Has he lost much weight? How is his hydration?

I usually look at the Stages that are listed for Alzheimers to see what types of things my loved one is exhibiting to give me an idea of where she is. My loved one has all the signs of Stage 6 or Severe Stage, but she still has good verbal skills and can feed herself, so I don't know how far away from the Final Stage or Stage 7 she is.

Signs of the stage can also fluctuate, so you may not know how close they are to the Final Stage. I think that knowing when the final phase is near might be difficult, unless it's very clear and they have stopped walking, talking, eating and staying awake.

I bet you will get some good advice here though, as others have gone through this.
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It sounds as though our loved ones are at about the same stage. My husband has stopped eating, has lost his voice and has trouble finding his way around our home. He is very unstable when trying to walk with his cane. For any distances outside, I have to push him in the wheelchair. He is now having problems swallowing his medications. He needs help dressing and undressing and also bathing. We see his doctor every week because he is diabetic, has congestive heart failure and has had a quadruple bypass.
I had to make the difficult decision this week to put him in a home as I am unable to do it all alone anymore. I do not want to bring anyone new into our home to help because he gets uncomfortable with others in the home. It is also more expensive than memory care facilities in our area.
It is hard to say how long your husband has left to live because the progression of the disease is unpredictable. My husband was doing pretty good until about a month ago and now his disease is moving very rapidly. It could slow down with his move into the home or accelerate. We just have to make decisions that are difficult but also keep in mind what is best for both of you. Prayers and hugs sent to you.
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Not all kinds of dementia follow the stages identified for Alzheimer's and some do not progress in stages at all. And even when it is possible to say what stage someone is in, it is seldom possible to say how long they will stay there before progressing to the next stage.

As Diana says, the disease is unpredictable. We'd all like a little more guidelines in what to expect, but as in so many things, we don't always get what we'd like.

I agree with Sunnygirl that it would be appropriate to consult with his doctor at this time. If your doctor thinks it is time for hospice, consider that seriously.
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On a comfort level, could the constant very loose bowels make one not feel like eating? The bowel issue could be from a number of things, for my Dad we found out he was dairy intolerant.... for others, some artificial sweeteners act like a laxative.
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I have just been advised that the Stevia sugar replacement I have been giving him may be the cause of the diarrhea. Will cut that down as much as possible. It is hard for a diabetic who loves sweets to lose these last pleasures of life.
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I drank two stevia-sweetened soft drinks and had explosive diarrhea the next day. And I usually have an iron gut. Could eat the Olestra potato chips without any issues and just about anything else. But stevia really set my body off! And I talked to a girlfriend who had the same reaction. So definitely try cutting that out to see if it helps!

One thing you might try to add some sweet treats for your husband is dates. They are considered a fruit by the American Diabetic Association. They're SO sweet you can eat one and be pretty satisfied. They have a lot of fiber, which helps with their absorption.

http://www.diabetes.org/food-and-fitness/food/what-can-i-eat/making-healthy-food-choices/fruits.html
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One date is the same number of carbs as one Lindt chocolate truffle ball. I love dates, but, frankly, sometimes I'd rather have a truffle. :) Neither a date nor a truffle would satisfy the desire to have sweetened coffee or tea.

But what if you just reverted back to sugar? You say your husband is not eating much. Would he really consume so much sugar that it would be a problem? There is nothing, including sugar, that a diabetic can't eat, given reasonable portion control.

At this point, in my philosophy anyway, the main purpose of food is to give pleasure. I'm not saying to give up on nutritious food entirely, but I wouldn't (and didn't) deprive my husband of treats as he nears the final stage of his life.

Dementia is a terminal disease. No amount of spinach and kale and avocado is going to reverse it. A cup of hot tea with honey or slice of pound cake at least gives pleasure.
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I agree with Jean. I'm no expert, but I am a Type I diabetic. Blood sugar control is complex and granted, I have the benefit of being able to take an extra dose of insulin if I eat a lot of carbs, but my endocrinologist has always encouraged me to not deprive myself. Just use moderation. After years of sugar substitutes, I stopped them and just use regular everything with limits. Its works better for me.

If you husband is taking pills for Type II diabetes, she still should be able to handle some small amounts of treats. My cousin, takes pills for hers and she has some small treats everyday. She just got her A!C and it's excellent!

And if he's taking Metformin, that could also cause loose stools. Many people can't tolerate it. There are substitutes. My cousin was switched to substitutes and now has no intestinal distress.
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Yes, he is taking Metformin, 1500 mg per day. I have not given him any stevia last night or today. Had to go on a lengthy drive this morning and packed everything for the eventuality and gave him some Immodium - it is now 7 hrs later and still no bowel movement. I am perplexed. This does not happen usually. Will see how it works now without the Immodium.
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The geriatrician suggested Immodium as a preventative, on days hubby had activities, such as his bowling day. So I see no harm and a lot of benefit to that when not being home near a bathroom.
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