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We are taking care of my mother in law; but it seems that it is moving way too fast. One month ago she was going through the sun downers stage; but now she can hardly walk without assistance and we are having her use depends because she can not control her bladder. She also will not eat and drink as much as she should. Her Neurologist appointment is this Monday. Two months ago she was fine. This seemed like it came out of nowhere. How fast can the progression be with this disease?

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I'm watching my mother go slowly into "that goodnight" of dementia. She will be stable for a while, then I'll notice some new deficit. She does have UTI's a LOT, but she is very on top of getting those dealt with. Honestly, she doesn't go "crazy" with them , she'd miserable, but still acts "normal"--normal for her.

The dementia is slow and steady, occasionally, as I said, she will be a bit worse in one area. Like, suddenly she can't remember how to use her phone--- My 3 sibs are all MIA and don't see this. The brother she lives with and I take care of her, so we notice this.

It's sad to watch her "lose it" and repeat herself 5-6 times in an hour. She is obsessed with watching the neighbors, and they know it, and are sweet about her nosiness--something she never would have done "pre dementia". She's also a lot sweeter, so I am personally enjoying THAT.

I have to say that every surgery she has had (A LOT!!!) she would have a long road to shake off the anesthesia. At this point, she is barred from any "elective surgeries" for life. So, unless she falls and must have something repaired, she cannot have surgery. She was kind of a surgery junkie and has had everything replaced or removed. She still has her gallbladder, but doesn't remember that she does, so we NEVER say anything about it, b/c she has faked her way into surgeries before.

She's mostly just really forgetful and that's easily dealt with right now. She doesn't wander, doesn't even walk down a step w/o someone strong by her side. I know she'll get worse, but I'm not looking for trouble. Just taking it one day at a time.
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Hi Banty...just want to thank you for your input. Also, to let you know we have put Mom on Iron supplement for over 3 weeks now. Of course, now is that "thin line" to keep her continence regular. Iron and Miralax.
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I totally agree with Nightmare on this we know our loved ones better then any doctor will even through exams. My mom went into the hospital last December I had to call 911 they checked her and she had COPD with being a CO2 retainer, which for those who don't know it acts like it's Dementia but it's not. But I swore up and down something more was wrong they treated the CO2 put her on a Cpap for 3 days got that down and it was send her home I begged them to test for a UTI and they did the 1st night it showed negative so I was considered the "crazy" daughter. She was home 12 hours from the time I brought her home and within that time she fell out of bed could hardly talk she was a wreck I called 911 again scared out of my mind and I begged them to test her when she got to the hospital for a UTI AGAIN! The paramedics listened to me this time and when she got there they had her tested. Guess what it was a borderline septic UTI the first test they did 4 days prior showed negative. I knew my mom so well I always knew when it was more then her CO2 even she didn't know herself as well as I did. I lost her sadly in March to the CO2. But I know I saved her life on several occasions knowing when she had a CO2 fit and when it was a UTI. You can buy at home UTI tests that's what I did from that day on her nurses hated me I would call all hours of the night saying "I tested my mom, you were just out here she has a UTI" Some would say no she doesn't the lab tested it this morning. I would make them come over and get a sample some would say I couldn't test her because it was from her urine bag and that was always carrying bacteria, so they would take the foley out and test and sure enough a UTI. Doctors and nurses can only do so much but they are only human. Listen to your gut if something seems really off something is really off.
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Definitely get her seen now. Don't wait until Monday.
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Just wanted to add that low blood sodium makes them almost catatonic (happened to my mother) along with dehydration, low potassium, low magnesium, just to list a few. It's such a hard balancing act as they age and their bodies don't get the nutrients from their food, or they are simply not eating or drinking enough. My mom has had 3 trips to the hospital for these types of imbalances. Once they get that sorted out, she goes back to what her baseline was when the incident occurred.
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I have 2 elderly people in my family who have Alzheimer's. One is my grandmother, the other is my grandmother's cousin. We immediately put my grandmother on Axona (a very high concentration of Coconut Oil), and have moved onto Fuel for Thought, since getting Axona has become such a pain. I have noticed my grandmother has had a very slow decline. While my grandmother's cousin was told to try Aricept and a few other medicines. Her decline was very fast, she has now been put on Axona/Fuel for Thought and we have noticed that her decline has slowed down. Hope this can help someone. But as we all know everyone is different and not everything works for everybody.
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Whoever checked urine sample, that was negative, should have followed up with other tests and an exam to find source of her symptoms.
1) She needs blood work that shows if has infection in any part of her body + another UA. I would recommend this done by different doctor than used last. A general practice/family physician or Internal Medicine doctor would be most appropriate for this however, since seeing Neurologist in few days that would probably be fastest appointment.
2) Today, check number of her medications...to see if she could be overdosing on any of her meds, or is taking someone else's meds (family/friends..). Also determine if she is taking alcohol or illegal drugs.
3) If all of the above check out negative: She needs full physical exam, preferably by an Internal Medicine doctor, to check for cancer,...

4) If she does have physical issue, then let them treat that however, if shes to have same symptoms even if somewhat better, then I'd still take her to Psychiatrist for senior population.
5) If all test for physical illness are negative: Take her to Psychiatrist that specializes in elderly population. Seniors can not tolerate the same doses of meds that they could when younger & can easily be overdosed even if taking same meds they did when younger.
IF she refuses to see a Psychiatrist, then have her admitted to a hospital "Senior Care" Psychiatric Unit. There they will have a medical doctor & a psychiatrist reviewing her meds, symptoms, history,.... to problem solve and find the cause of her behavior plus find correct medications for her. (she may agree to go to this due to she will technically just being admitted to a regular hospital & she may never know she was in a "special" unit).
Not all hospitals have these units so may need to ask your doctor, a nursing home/assisted living... These units are NOT for permanent placement. Patients stay until doctors are sure they found the correct meds & doses to help her. This usually takes a stay of 1-5 weeks & Medicare should pay on this. Make sure the unit is for Senior Citizens only.
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Everyone here had such great answers. I guess we just don't know because everyone is different. My best girlfriend's husband seemed to be fine on Thanksgiving, no one knew he had dementia. The next week he got lost going to Home Depot. He was dead by the middle of January. Another friend's husband took 5 or 6 years to die. All you can do is be sure they don't have any of the problems mentioned above and take life one day at a time.
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My Nurses used to call these sudden changes "episodes". Something just happens. Mom could have had a stroke. Low potassium does a number on people too. Dehydration too.
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Dementia is sure scary. Another thing I have heard over the years is a number of people with UTI's fall....backwards. And just to say I have a friend whose husband's behavior seemed eccentric...annoying...reclusive...but it was all the dementia brewing. Then hallucinations, bladder control issues. It was a fall and her being unable to get him up that led to his being hospitalized with some physical issues, and some hesitancy on the part of some to confirm her suspicions, that it was LBD. He is in his 2nd much better nursing home, and somewhat suddenly is now using a wheelchair. And within a week of that they approached my friend to consider hospice.
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Does she have Alzheimer's? Is she on medication? Aricept can slow the progression of an Alzheimer's decline. It did for my mom, who was on it from 2010 to 2016 or so. When she was temporarily removed from the medication, she very quickly got profound aphasia. When the medication was respored after a couple of months, everyone at her nursing home marveled that her speech was back. That's all I needed to see. Ask your neurologist if she can at least *try Aricept and Namenda and see if it helps stabilize your mom.
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My mother-in-law passed away from septice when the hospital was unable to detect the infection. I repeatedly told them something was not right and they repeatedly told me there was no sign of infection. She returned home and within 2 days a ambulance was called and she was brought to the hospital again and put in ICU and died 5 days later. She was completely septic. It seems when I researched it that the elderly often do not have elevated white blood count cells present during an infection because their immune system is compromised from years of antibiotics . Just wanted to put that out there that the hospitals and doctors don't know our loved ones Behavior as well as we do a sudden decline is very often infection that goes undetected .
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Alzheimer's is just 1 type of dementia.
With a very fast decline like this it is possible that you are dealing with a Vascular Dementia not Alzheimer's or it might possibly be both.
Slow and steady is usually the decline of Alzheimer's. Like walking down a ramp.
Vascular Dementia is a more rapid decline. Like walking down stairs.
I described my Husbands decline like walking down a ramp then going down a few stairs to landing with another ramp.
He was walking one day and literally the next day he could not/would not walk.
He was able to support his weight while I used the Sit to Stand and almost over night he was unable to support himself. Resulting in having to go to a Hoyer.
He was eating and drinking one day and the next day refused all food and water.
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My mother,97, recently gave us a scare. She could not walk, seemed way off. I made same day appointment with her doctor. After most of the day getting tests, we found the beta blocker had dropped her too low, her hemoglobin(needed iron supplements), and she was treated for pneumonia. This has taken over a month to get her navigating again. I am amazed that these took her down so quickly. Please, do not wait for Monday appointment, I am not sure our outcome would have been so good had we waited.
Bless you and your MIL
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Check for UTI. FYI, when Mom was diagnosed ,7 years ago with Lewy Body Dementia , she was given meds that seemed to advance her decline and give her horrible hallucinations. My family and I opted to now given her any meds. She did quite well for 5 years progressively getting worse a the disease progressed. She was able to use her walker w/assist and we could get her to the bathroom and to her lift chair. Was speaking her normal gibberish every day. Laughed a lot too. Two months ago her hemoglobin dropped to 4.3, she had a UTI and she was impacted. Loooong story but I can assure you it wasn't due to neglect. 7 days in the hospital. When she returned home she was completely bedridden, and didn't sat a word for almost a month. She's still bedridden but has started her gibberish again😊. We're so happy to just hear her voice. Sadly, she is not able to get out of bed😔.
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KathyMarie, on a December evening of last year, my MIL went to bed able to walk with a cane and get up & down with some assistance. When she woke up the next morning she was unable to get out of bed without full assistance and was unable to walk without a walker. She had also lost her appetite, wouldn't eat much and had gone from moderate bladder leakage to complete incontinence. That is how fast it can happen. No UTI, no other illnesses. I would heed the advice of others, though, and have her checked out. We took my MIL to the ER just to be on the safe side.
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"Sun downers stage"? My mom was diagnosed in 2008 with Alzheimer's but can be counted on to sundown almost daily/nightly, lol. I can tell by looks from staff as I'm on my way down the hall daily in the NH around 4:30 p.m. what kind of dinner hour I'll be having with her. There are good afternoons when she's smiling, pleasant, relatively quiet and eats her dinner well, but far more often is her constant muttering and negative behavior. Meds don't seem to help a great deal. She's consolable most of the time, but I'd sure like to see the unhappy/angry stage end, if it ever will.
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Spitting a lot occurs often in some kinds of dementia. One cause can be excessive saliva because they forget to swallow. It will be interesting to hear what her doctor says!
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Thank you all so much for this great advise. We have already had her tested for a UTI and she doesn't have one. The results of her CT scan came back today and the result was Chronic Ischemic changes of the white matter. I am glad the neuro appointment is Monday so we know what the next step is. Does anyone know why she would constantly need to spit? I will let you all know what the doctor says.
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Sudden declines can be caused by
1) An acute illness, such as a uti or other infection. When the illness is cleared up, the person will often return to baseline.
2) A reaction to a medication. Again, when the medication is discontinued, with a few exceptions, the person can return to baseline. (One of the exceptions is Haldol, if given to persons with LBD. It can cause permanent damage.)
3) Progression of the dementia itself. This is permanent. There may continue to be good periods and not-so-good periods. Some forms of dementia decline in a steady, gradual manner, but others "step down" in plateaus, with stable periods between changes that seem very sudden.

So, yes, dementia decline can be sudden. Or it can be caused by illness or medications. You have received some good advice on what kinds of things to check.

I'd like to share one other thought about declines. You may hear, even from medical professionals, that there is no recovery from declines. The decline is the new normal. In my experience that simply isn't true, as katiekay describes. If the decline is the result of illness or medication side effects the person is very likely to return to their previous level of functioning.

After each of his hospitalizations my husband (LBD) had home visits from therapists for a few weeks. Each therapist told me to except the decline to be permanent. They were wrong, but they weren't around long enough to see the recovery, so I'm sure they went about continuing to spread this false message. Hospitalization is NOT GOOD for anyone with dementia, although sometimes it is necessary under the circumstances. In our experience it took maybe a week or two to complete the healing process from whatever sent him to the hospital in the first place, and another few weeks to recover from the hospital experience. Home therapists were long gone at that point.

KathyMarie, please let us know how this works out for your MIL. We learn from each other.
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That's too quick of a decline. She has to have more fluids. Get a urine test for a possible UTI. Get her to her dr asap. Not sure I'd go to ER. could pick up germs there.
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in addition to UTIs ..other infections can also cause a sharp drop in mental status. My mom had bronchitis and forgot how to eat..and speak...once it was cleared up she was back to her baseline mental abilities.

Same with my dad who had an infected gall bladder at one time.
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Kathymarie
I have read where Alzheimer's symptoms can come very fast but Jjariz makes a good point about UTIs. You can take her to ER or urgent care for a test and meds if positive or you can pick up a self test at the drug store. You would still need to see a dr for an antibiotic if the self test is positive.
If you haven't had experience with UTI in the elderly just know that it can be life threatening and the normal symptoms of burning etcetera will probably not be experienced. Use the search portion on this site and look for threads on UTI. Your MIL should be checked for one anytime you notice drastic change.
Talkey, my DIL father died of PD. He had those moments as well of clarity. Fleeting but treasured.
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We just went thru this. No UTI or infection. The change was dramatic with hallucinations galore! (He has PD.) But ...today we were at a speech pathology appt, and he was almost back to normal. I don't understand this at all.
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She should be tested immediately for a UTI. Don't wait until Monday.
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