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My twin sister has had mild dementia for a few years. Within a 2-3 week period she suffered a severe decline in her mental function. She is not able to process what she hears, she forgets what she wanted to say, some slurred speech, falling due to balance issues without dizziness or lightheadedness, some paranoia. She has congestive heart failure with her heart function now at 20%. Her doctor asked her to live with me, is making arrangements for a visiting nurse to do some evaluations, scheduling app'ts with both a neuropsychologist and a neurologist. He has asked me to take total control of her medications and she now has to use her wheelchair all the time. She also has lupus and fibromyalgia.
The recent cat scan showed no stroke, brain bleed or clot but did show full blockage of several vessels and partial blockage of others and shrinkage of brain matter. Is this common for a sudden decline? She is frustrated, afraid, and doesn't want to go into a nursing home. I am more than willing and able at this point to care for her.

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Thank you Pam. Oddly her O2 levels are in the high 90's which surprises her doctors and well as the family. Doctors say her sudden decline in mental function has nothing to do with her 02 levels, that it's all neurological. I guess at this point is really is a wait and see situation until she has seen the two specialists they want her to see and the visiting nurse does her evaluations. I thought it curious that they would say completely blocked vessels but no stroke. Her heart rate has dropped into the 40's and stays there consistently while awake. I would imagine as with my own bradycardia her heart rate is dropping lower in sleep? Thank you for your response.
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"did show full blockage of several vessels (STROKE) and partial blockage of others and shrinkage of brain matter (ENCEPHALOPATHY)." If the ejection fraction is only 20%, what is her O2 saturation? Below 90% is not good. Her prognosis is probably "Limited" or "Guarded" and you might want to ask for Hospice, if only to get coverage for in home aides. This is not something you can tackle without some additional help. Nobody can do 24/7 care alone without killing themselves.
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My mother experienced a similar "sudden onset" of dementia last summer. She is 85; and had been mentally fine - then suddenly couldn't remember the names of her sons-in-law, her daughters, granddaughters etc. She would look at my dad and ask "Who are you? Where's Bob?" The neuropsychologist diagnosed her with an "Alzheimers-type dementia" which he said had been developing for "years." He said it just sometimes isn't apparent because people learn to cope with it in the earlier years. Her family doctor was also shocked by how quickly it is progressing. He ordered an MRI, which showed absolutely NO signs of stroke, blockages, bleeds, or any other brain issues. She was having hallucinations, seeing people who weren't there, children playing in the house and "living" with her. Aricept made her very nauseous. The doctor started her on Namenda which has been a big help. The hallucinations stopped, she stopped seeing people who didn't exist. She now recognizes her children and husband. But we understand that the decline will continue over time.
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Hospice is an amazing organization and I will contact them as soon as we get the word that she would qualify for their services. She also has an enlarged heart which she was born with. She suffered major heart damage to the front of her heart 15 years ago and the already enlarged heart has only gotten more enlarged and muscle weaker so what you said makes perfect sense. I just expected her dementia to continue on a slow decline rather than the "falling off the cliff" as the doctor said. Thank you for responding.
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After re reading your post I noticed that you said her heart function is at 20%... perhaps the stroke like symptoms are related to that. As the heart loses the ability to pump circulation slows and the brain is deprived of enough blood to function properly. Perhaps it is time to contact hospice? They could be a wonderful support for both of you.
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She was seen in the emergency room 4 days ago. They did a cat scan of her brain. No stroke, brain bleed, or clots. However, there are several blocked vessels and some partial blocks. Family doctor examined her in his office 2 days ago and recommended she come home with me. He is sending a visiting nurse to do some evaluations and setting up appointment with both a neuropsychologist and a neurologist for testing. Every thing I have read regarding a rapid decline such as hers was caused by stroke, clot. or brain bleed. Since none of those things appeared on the scan I just wondered if anyone had a family member experience the same rapid decline without the usual causes. She realizes at times there has been a severe decline and she cries and states she is so afraid. I am afraid for her.
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I am not sure by your post if your sister had seen a doctor within the past 2-3 weeks. Some of those symptoms sound like a stroke.
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