My 70 year old mum, been on antipsychotic medication for almost 30 years, became very withdrawn and vacant.
Treated in hospital for a UTI - however she remains distant, very flat mood and has no memory.
Doctor diagnosed Dementia - then took her off her antipsychotic meds ‘cold turkey’ - causing terrible withdrawals.
Weaning her back onto her medication now.
She says her mind is blank and can’t remember anything. She is very withdrawn, and SO confused, wakes up every morning not even knowing where she is.
Still in hospital and going straight into Aged Care - can’t come home as now needs 24/7 care/supervision.
What on earth is going on? Can dementia really come on this quickly?
I’m having trouble excepting this diagnosis... am I in denial?
Please tell me there’s hope for my mum :(
The other thing that strikes me is that your mother's health overall must present quite a complex picture. She isn't old, but thirty years is a long time, if she's vulnerable to a uti bad enough to require hospitalisation then clearly physical care isn't going so well, and her range of psychiatric signs could have any number of causes.
How long has this acute crisis been going on? I'm wondering if it's still early days, and the best thing might be just to take deep breaths and give it time to settle down before you try to figure out the best way forward.
To answer the first question, though: yes. Uti's can develop into severe infection just like any other, and infection is one of the (reversible) causes of dementia. But your mother's u.t.i. didn't come out of nowhere - there is just too much going on even to guess what your mother's chances of full recovery are.
What country are you in? And what doctor is leading your mother's health care? - that's the person you need to work on establishing a good relationship with.
You stated that the doctor "took her off her antipsychotic meds (that she had been taking for 30 years) ‘cold turkey’...{OH WOW!?!}...-- causing terrible withdrawals...{Of COURSE, IT WOULD!}..."Weaning her back onto her medication now." Is he weaning back on the same medications or different medications? How is she responding to the restarting of the medications other than "She says her mind is blank and can’t remember anything. She is very withdrawn, and SO confused,"?
Urinary Tract Infections (UTIs) have a nasty effect on the elderly and a person who is usually alert and oriented can become confused and disoriented and not act like themselves if they have a urinary tract infection. Sometimes it takes more than one prescription of antibiotics to treat the UTI. Did the doctor do a "Urine Culture" to see exactly what organism is causing the UTI or just a routine UA (Urine Specimen)? If the doctor did not do a Urine Culture than I think I that you need to ask that one be performed along with a Follow-up Urine Sample to check whether the UTI has be resolved. Your Mom may need to have a "straight-catheterization" done for the Urine Culture.
Has your Mum experienced any major trauma or loss (like the lost of a sibling or other close family members or lost of ability to attend activities or any other major changes in her life) other than the hospitalization the past 6-12 months?
{My Mom experienced Major Depression with Delusions after her younger brother, age 83, died in March 2017, and her older sister, age 91, died in April 2017. Their deaths were too much for her to handle along with some other major changes in our family dynamics that occurred in 2016 and 2017. Mom went from being mostly independent to not being able to do any of her ADLS within 48 hours and now resides in a Memory Care Unit. She now uses a wheelchair and has to have help with all ADLS.}
I don't know if there is another underlying cause other Dementia that might be causing your Mum to "became very withdrawn and vacant...She says her mind is blank and can’t remember anything. She is very withdrawn, and SO confused, wakes up every morning not even knowing where she is." Has she been assessed for a possible TIA or stroke? What other tests were done while she was in the hospital? Or did the doctor just "assume" that your Mum has Dementia?
We need more background information especially as to what tests the doctor did while you Mum was in the hospital.
It is 2 weeks today that she has been in hospital.
She has always had fairly good physical health- unfortunately she struggled with Mental illness though.
Being prescribed this medication decades ago she was never actually ‘labeled’ with a particular mental illness - she would always say ‘it’s anxiety medication’
Her condition was always good when medicated - a loving mother & wife, calm but low energy (wasn’t ever able to work) obsessive tendencies (highly highly religious- not in a healthy way) but could always do general home duties and had a friendly disposition.
However when she would take herself off her medication she would become very cranky and short tempered and I would even say void of emotion... so very very different when unmediated.
I am in Australia.
My mum just saw a local GP for her scripts and I don’t feel there is really a great level of care there.
It’s so strange that she now just stares and can’t answer any questions even as simple as “would you like a cup of tea”
She was at my sons birthday party just 6 weeks ago - helping me with food, walking around admiring my garden etc
And now she is sitting in a hospital bed with no memory and even wetting the bed the last 3 nights the nurse told us today...
The hospital did tell us that usually the spouse compensates for the early dementia signs and they don’t even know it...
My gut is just telling me there is more going on here...
As far as I know they just did a straight forward urine sample in a cup (I will double check with my Dad/siblings/hospital) she also had blood tests, ecg, CT scan (they said to check for haemorrhage)
The doctor gave her one dose of a new antipsychotic that has less side affects apparently but then the next day said she would put her back onto her original medication - she normally takes a tablet morning and night but the doctor is still only giving her one nightly.
There has been no trauma or loss or any event that has upset her.
Do dementia patients have that level of self awareness?
She really has not said much in the last fortnight at all - except
“My minds blank”
“I can’t reme anything”
She even said one night “I’m trying so hard to remember but I can’t, it’s all gone”
I’m very sorry to hear of your mums condition. It sounds very sudden also... it’s makes it very hard for the family to mentally process the situation.
With your mother, just reassure her. She's in a safe place, being well looked after, and it's very early days after what must have been - whatever happened - a major event of some sort.
Are you near a city of any size?
Please keep checking in to let us know what's happening, and take care of yourself, too.
Yes I will definitely keep an eye on my dad, he is so sad...
Life is cruel sometimes
Any vey serious illness can cause symptoms of dementia such as sepsis which Mum probably had. Existing dementia is often worsened by a hospitalization for anything so it is very possible that Dad has been picking up the slack for many years and no body noticed anything wrong.
This happened with my inlaws. FIL was physically ill and MIL was physically fit so she was able to carryone being a good housewife while FIL minded the shop so as to speak. Once FIL died MIL showed rapidly increasing signs of what was later diagnosed as vascular dementia and within weeks had to be institutionalized. Any oddities MIL had shown over the years were put down to a fall off the roof many many years ago.
No one is expecting a loved one to develope dementia and the early signs can be very subtle.
As far as medications are concerned obviously if new ones show undesirable effects they do need to be discontinued. Any of these antipsychotic or anti depression /anti anxiety meds do take a while to become effective, so in this case two weeks is probably too short a time to see much improvement and of course it is highly possible she will just continue to become sicker.
Read all you can about dementia, don't worry too much about the cause as symptoms will be similar so try not to be upset when she fails to recognize family, forgets names, stops eating and any other changes like the incontinence.
As mentioned it is important to find the bacteria that is causing the infection so a sensitive antibiotic can be prescribed.
This is going to be a very hard time for you all so try and concentrate on keeping everyone as healthy and stress free as possible.
I hate to say this but good luck....i had the WORST experience with doctors/hospitals and any care in Brisbane. I had to do all my own research and tell THEM what to do. I was more than vigilant to the point we couldnt leave my mother without a family member with her at all times. My sister and i started to clean her or be there when the nurses were as they did not do it proparely....it got to the stage when i knew a uti was on its way...if you want to help your mother unfortunately you have to do most the work.
In my opinion the only way to know is to watch her and listen to her because people with dementia arent always speaking 'rubbish' you need to see through it and try and work out what is really going on. There is a fantastic lady called Teeba Snow ...look her up ... i wish you luck
The other challenge to your mom's mental health is the hospitalization itself. The combination of unfamiliar surroundings, intrusive strangers, noise and light interfering with sleep ... all of that can bring on delirium, which can progress to dementia fairly quickly, alas.
Any chance of getting her home even while her meds are being rearranged?
Yes, a UTI can create havoc. Poor lady. Can you seek another dr. opinion?
*Kept a record of her (Altered Mental Status fluctuations.
* I got REALLY connected to mom's primary care physician.
* for a time, we had her catheterized to measure intake and outflow of fluids.
*also have an excellent relationship with pharmacist--they understand drug interactions.
*Never allow a doctor cut off her meds cold turkey..they don't even do that to hard-core addicts and jailed criminals...why in the world this is common with our tax paying elders, I have no idea...but the coma it triggered in my mom almost killed her.
Good luck--do something nice for yourself!
A UTI generally can't cause dementia but easily can cause delirium, and delirium can take a very long time to resolve, especially in people who have dementia or whose brains are otherwise vulnerable. We do see a certain number of people who are not diagnosed with dementia prior to hospitalization (although if we dig into the history and prior symptoms, we almost always find evidence that the person was not entirely normal before hospitalization) but then the dementia gets "unmasked" during or after hospitalization. People with all forms of cognitive impairment are at higher risk for developing delirium, and it's associated with acceleration of cognitive decline too.
Being inattentive or spaced out is a cardinal feature of delirium.
Many of us in geriatrics would say it's not really appropriate to definitively diagnose someone with dementia during hospitalization...technically one should wait until delirium has had a chance to resolve.
Now is the UTI the only thing going on, that's a good question to consider. Sounds like there is a comprehensive evaluation going on.
I must say I'm surprised they would stop antipsychotics cold-turkey like that...someone who has been taking them for 30 years presumably has a significant mental health condition that would predate any dementia.
Eeebee, hope your mom gets better soon.
I'm sure 99.9% of these posts are affirmative which is very true.
UTIs also effect men!
Once the onset of either dementia or Alzheimer's kicks in, the issues then become hygiene and eating habits. If one is not getting the hydration needed, then they don't urinate, toxins effect the kidneys, the blood which effects the brain.
The longer the infection goes without treatment the more recurrent it becomes. There will never be a complete recovery from this as antibiotics will no longer help due to their system no longer reacting to treatment.
This will cause extreme mood changes, more toward anger, agitation to physical combativeness.
I learned this very quickly this past month with my Mother. I had to learn and experience via on the job training. I live out of State and things being what they were for the past few years; I was never informed about the situation until it was all dropped into my lap.
I went home the 1st week of April thinking Mom had dementia only to find out she has Diabetes 3 Alzheimer's....a new and improved catagory!
The first week of May, me and my husband went back to deal with issues only to have an episode I truly had not expected or experienced with Mom.
I knew about the UTIs, but I didn't know the signs to look for when the onset of the infection would be noticeable. Had to call 911, get Mom to the hospital where they had to treat her for no less than 2 infections because the panels were not revealing the exact cause. Mom did physically attack me while I was helping the EMTs, but rather me than them and just part of the course.
Come to find out from my sister these UTIs were happening very frequently and I was experiencing what she had with Mom.
EeeBee, there are so many things that affect dementia/Alzheimer's that it's like reading a menu at a Chinese restaurant. Choose from column(s) A, B, C.
Talk with the doctor. Set an appointment for just you to have a lengthy discussion about everything that can possibly cause issues...it can be good too.
When we were with Mom last month, she played her last hand her doctor gave her and I had to place Mom/stepfather in an assisted group home...stepfather has progressive dementia.
Science doesn't know 100% what causes these conditions. What they do know is that they are not caused by metallic exposure as was claimed about 4-5 decades ago.