Follow
Share

Using tv remote to try and make a call. Using the phone to change channels on the tv. Does not remember how to check blood sugar or use her insilin pump.


May be medication related.


So any recommendations for how to proceed to give us the best chance for a proper diagnosis ?

I meant to say through "Her" primary care physician, but I see that your update has been posted where you called the EMS/ambulance. Good for you. I understand why Fran would be angry, but you did the right thing by calling 9-1-1 as you are not a medical professional. When the time comes for the geriatric specialist appointment, you may have to get help to get her in the auto since she won't, no doubt, listen to you. Perhaps your town's elder case worker or social worker they should have on staff can advise. Prayers ....
Helpful Answer (0)
Reply to Llamalover47
Report

I called EMS last night to take "Fran" to the ER to rule out anything physical causing her issues. She was very lethargic and refused to take care of herself : (meds, check glucose, manipulate insulin pump, eat)

Fran has had major back surgery in the past (L2 thru S1 fusion). This is why the pain meds were prescribed. She also has had a triple bypass in 2012 and then stents placed a year later.

Has been a Type 1 diabetic for 50 years and has been on a Medtronic CGM pump system for 12 years, which keeps her diabetes well controlled. Last A1C was 5.2. Better than Mine.

So now it is down to meds and/or onset of dementia or delirium. She was ver angry when I called 911, even though I explained the reasons.

Confusion, very lethargic, etc. No interest in taking care of herself. I can't even get her to get in the car to transport her to the doctor.

This morning still angry and blaming me. The geriatric specialist looks to be the way to go. Fran's neurologst referred us to a Certified Neuropsychologist, however appointment 3rd week of September. Will try to push that to an earlier date or find a geriatric specialist with an earlier time-frame. That is IF I can get her to go.

After researching the options it appears that it is not against the law to not take care of oneself. So frustrating.
Helpful Answer (1)
Reply to JMalley
Report
Ricky6 Jul 13, 2019
It might be better if you see a psychiatrist for your LO. The psychiatrist can administer drugs where as a psychologist does not.
(2)
Report
See 3 more replies
In the beginning my Alzheimer’s patient exhibited some of the same behavioral symptoms. I would start with an examination by her primary physician. I wish I could tell you that there is medication for Alzheimer’s prevention. Each person is different, but it never gets better. Sometimes slower or sometimes faster.
Helpful Answer (0)
Reply to Ricky6
Report

Ask for a specialist through his primary care physician. Start by first getting the appointment with the primary care doctor and ask him or her for the recommendation.
Helpful Answer (0)
Reply to Llamalover47
Report

Not knowing where you live, I'd say contact the primary care person if you feel good about them. If you are near a university/medical school, someone is bound to be highly regarded in the field of neurology/psychiatry or both. It is essential to not wait because you don't want your person to keep taking a medication that is causing the problem. It also sounds wacky enough that you probably want to rule on a urinary tract infection. But the memory loss, if sudden could be something you want to check on. IF the MD you find is one of the best, you may have to wait so having a primary with pull to get in may be of some help.
Helpful Answer (0)
Reply to gdaughter
Report

Although a PCP/GP may not be able to assist if this is dementia developing (this really depends on how good this PCP/GP is!), it is a good idea to start there. S/he can order blood/urine/other tests, etc, if none have been done recently, just to rule anything else out (including dementia.) It is good to have a baseline. It is also good to document the changes you have observed, to bring with you/send to doctor beforehand.

S/he should also be able to refer you to the right specialist she might need for any further evaluation. In addition to various situations that might produce some of these behaviors (medications, blood sugar, opioids, etc, even if they have been used for years), being either OVER-hydrated or under-hydrated can produce odd behavior. Many people know about being under-hydrated, but our mom was OVER-hydrating, which leads to "washing out" the electrolytes in her system - reduction in potassium left her very befuddled, really out of it, and this was well before dementia! This situation can lead to more serious medical conditions too, not just being confused. They gave her IV fluids with potassium, etc and she was to stay overnight, but restoring her electrolytes brought back the nasty crab! Even that night she was nasty to me. Plan was for her to stay overnight, go home in the morning, but oh boy was she NASTY to me! I got my SIL to pick her up and take her home as I was stuck at work.

So, a GOOD checkup, including lab work, would be the best place to start. Document the changes you observe and provide those. Hope for the best, but plan for the not so best...
Helpful Answer (0)
Reply to disgustedtoo
Report

Hi! In our experience with my gramma, seeing a geriatric specialist made all the difference in the world! She diagnosed moderate to severe dementia, did a complete medication review, made a bunch of changes to the meds and equipped us with the information we needed to make decisions regarding Gramma's care. The result is that Gramma's cognitive and motor functioning are much improved, I'm happy to say. Clearly they can't stop the progression of her aging or dementia, but if she gets more hours each day where she can converse with people and find enjoyment, YAY!
Helpful Answer (3)
Reply to gmadorisylove
Report

Start with your Primary Physician - he/she will refer you to the proper specialists.
Helpful Answer (0)
Reply to RayLinStephens
Report

Hopefully she had a primary dr. If not find one that specializes in geriatrics. I would start there and the see a neurologist. Once a diagnosis is made you will be better equipped to help her. The more you know on dementia the better it will be. There is a lot on line. This forum is good but I would search the Internet. Contact your local Council on Aging. They can be a real help and a real resource. It is a tough road but the more you know and understand the better it will be
blessings to you both.
Helpful Answer (1)
Reply to Eloise1943
Report

You are correct that something is wrong and being proactive.Maka sure you speak to her specialst about the pump. This is now dangerous. Sliding scale may be necessary but she will need supervision. You will either have to take over the medication or put her in a nursing home. This higher level of care is not available in assisted livings. While you wait for these appointments, start planning ahead for all scenarios.
Helpful Answer (0)
Reply to MACinCT
Report
Judysai422 Jul 11, 2019
I totally disagree. My mom has dementia and is in AL. They administer her meds and help my dad, they live there together, with his diabetic needs. A nursing home, now called skilled nursing facility, is likely overkill at this point. Even Memory Care facilities are considered a level of Assisted Living.
(2)
Report
See 1 more reply
Any kind of psychotropic or narcotic medication can impair judgement and memory. There is research that indicates they can predispose to dementias. A neurologist may perhaps give more insight to this.

If she also drinks alcohol the risk is over 10 times worse because alcoholic beverages...is a legal narcotic and interacts with medications.
Helpful Answer (0)
Reply to cetude
Report

I went to major hospital with Neuroscience department for diagnosis, then a neurologist on their recommendation. Now into moderate to advanced Alzheimer’s with my wife, on meds. Situation stable, all things considered.
Helpful Answer (2)
Reply to Papafio
Report

A neuropsychologist might also be able to help with a dx
Helpful Answer (1)
Reply to SofiaAmirpoor
Report

Hey Joe. You are good hubby. Talk to PRIMARY CARE PHYSICIAN then see a geriatric psychiatrist. Don't let that scare you. That's who will test the missus for cognitive impairment. Good on you Joe, for being the good hubby and caring person.

Hope your eye surgery went well and got you the results you wanted.
Helpful Answer (1)
Reply to Segoline
Report

JMalley...
rather than hit "reply" to your last post I will respond this way.
You want to know what treatment options there are...
For dementia there really is no "treatment" that will make her "better"
There are medications that are supposed to slow the decline but the decline will continue.
So bottom line it is up to you to determine :
If you can safely care for her at home by yourself. I will tell you right now you can not do this alone. Hiring caregivers is an option. Do not rely completely on family and or friends. It is not fair to them.
I made the cut off for me Safety. As long as it was safe for my Husband to remain at home...as long as it was safe for me for my Husband to remain at home he would stay. But as soon as I could no longer safely care for him I would have had to make the decision to place him. Luckily he was compliant and he remained at home until the day he died.
I did have help from Hospice the last 3 years of his life. I had the help of the VA as well. I could not have done it without both.
So do not let anyone tell you that you should do this..or you should do that...
Only YOU know what is right for you and for your wife.
As the facilitator of a Support Group I go to says..."Don't should on yourself"
As this disease changes her it will change you and it will change your decisions.
If you have ever "promised" each other that you would never put the other in a "Nursing home" remember that that person you made the promise to no longer exists.
One other thing to consider..a trip to a lawyer that specializes in Elder Law. Get POA for Health and Finances in order. Do what you need to do to protect yourself and make things easier financially.
Might be a bit early but consider End of Life decisions What measures do you want to take. Check out a document called a POLST much more detailed than a DNR.
Take care of yourself.
This is a difficult Journey you both are on.
Helpful Answer (6)
Reply to Grandma1954
Report
MaryKathleen Jul 11, 2019
Grandma1954. You are not only right on the mark but stated it in a very coherent way.
(0)
Report
Thanks for your input folks. I have recently had eye surgery and could not get back to the site right away.

My wife has been a type 1 diabetic for over 50 years. Her diabetes is well controlled, due to using an insulin pump along with a cgm sensor.

She is 75 , has had major lumbar surgery in the past, and is on opioids to control the pain. She has tolerated her meds for quite while now. We have seen a Neurologist and was diagnosed with metabolic encephalopathy, among other issues.

It is to the point where I think I need to force the issue by having her admitted to the hospital by a doctors order for observation. She is not very mobile and going from doctor to doctor is not an option. You know the drill, labs, scans etc.

Her medical condition is very complicated and would be difficult for her PCP to manage this aspect of her care.

There are too many possible dangerous situations, such as the pills, the insulin pump, fall risk etc. I cannot watch her 24/7. I do control her meds right now.

I have not done the research yet, but if it gets to the point of a dementia diagnosis, what could the treatment options be?

Thanks,


Joe
Helpful Answer (0)
Reply to JMalley
Report

Ask her PCP to refer her to a Neurologist. Cognitive dysfunction can stem from a multitude of illnesses and it may not be related to aging. A Neurologist can analyze her brain for activities and trauma. Then, you can talk about geriatric care if it’s indeed related to aging.
Helpful Answer (1)
Reply to allisonlei
Report

I would start with your primary doctor. You are correct that this could be actually related to something such as medication reaction; that would be the doctor who would know. There are also a few things that should be done. There can be confusion with high and low blood sugars, which I am sure you are aware of. Is the confusion ALWAYS there no matter what the blood sugar numbers are? Keep as good a diary as you are able for one week. Do some simple tests of your own, like naming our last two Presidents other than the one we have. Or asking "Who was married to Bill Clinton". Or giving some simple words that you tell her you will ask her later. Then talk a minute. Then ask her for the words. Whatever you can give the doctor as far as symptoms, when they occur, time of day, blood sugar at the time, what she does. Just a really GOOD diary. Then you and the doctor will work on followup from there. Wishing you good luck.
Helpful Answer (4)
Reply to AlvaDeer
Report

Who’s doing her ongoing management of the diabetes? If that physician knows her and is familiar with her past issues, I think I might start there, and ask THAT PERSON about some of your concerns, and also if THAT PHYSICIAN could recommend where you should go next.

I am not on insulin, but I do the TV remote/telephone/cell phone/iPad switch up once in a while (all the time) and so does DH. Since we live in a very high pressure environment just at present, we laugh it off.

Before you see her doctor, make a list of any changes, good or bad, that she’s experienced recently, and a separate list of things you’ve observed that you think indicate out of the ordinary in her day to day activities.

Also, jot down how she reacts to these missteps.

Before you go to her doctor together, make a copy of these lists and mail them to the doctor’s office. They can be useful to the doctor if you find any additional quirks showing up in the future.

Medications, change of sleep habits, blood sugar levels, thyroid status, happy AND unhappy stressors- all of these and a whole bunch more stuff can cause this kind of result. I speak from experience.
Helpful Answer (3)
Reply to AnnReid
Report

Ask a Question

Subscribe to
Our Newsletter