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Old 01-23-2013, 06:32 PM   #1
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Alzheimer's, Dementia or something else?

I'm hoping this is the right place to post this, but I really have no idea where else to turn or where to check....My uncle just turned 60 and my whole family is seriously concerned with his mental state. In the last year or so, we've noticed he has become increasingly more confused, slow moving and disorientated.

He seems to be confused most of the time (things he says or acts upon that never happened or happend differently), he seems almost "in a far away place" when you are speaking to him, he has begun to just pass out in public places and he moves as though he was just hit by a car.
Also he passed out for about an hour in a locked bathroom before we realized where he was recently.

A little background on him: he has drank pretty much every day for the last 20-30 years. He's by no means a "fall down drunk", more of a functioning mild alcoholic (if there is such a thing).

Also, he was diagnosed with Diabetes maybe two years ago and I believe he does absolutely nothing to manage the disease. I have seen his feet swell up massively however he does nothing to take care of himself.

He lives alone and refuses to acknowledge any of the above, but it's really upsetting our family. We are worried he shouldn't be driving or even out alone.

It's just such a wide range of issues that I've been having a hard time even researching anything. If you can offer any insight for me or even steering me in the right direction that would be great.

Thank you

 
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Old 01-23-2013, 08:51 PM   #2
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Re: Alzheimer's, Dementia or something else?

Dear Kheinz, Sorry to hear about your uncle. You and family are right to be seriously concerned. I will let others here with much more hands on knowledge on dementias more directly answer your question. However, I will point out that your uncle's unchecked diabetic condition is an even more serious immediate health issue. As matter of fact, unchecked diatetes, in extreme cases, can result in altered states of consciousness, cognitive disruptions, and lethargy much like as you described. Passing out for an hour in the bathroom, if it is not simple alcohol intoxication, may easily be a diabetic coma (e.g. too high or too low blood glucose). If so, these episodes are life-threatening. I am not saying this trivially.

I highly urge you and your family first attend to his diabetes. Next time you find him behaving aberrantly, do use his blood glucose monitor to take a reading. Once you can bring his blood glucose under control, and if he still exhibits the cognitive/behavioral symptoms, then you can go to the next step. My hunch is once glucose is controlled, cognition will improve. However, chronic long term runaway glucose levels will lead to vascular damage. If it happens to the blood vessels in the brain, may lead to irreversible damage and result in a form of vascular dementia.

By the way, excess alcohol consumption in an unchecked diabetic is a very nasty combination.

Last edited by Luau; 01-24-2013 at 05:33 AM.

 
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Old 01-24-2013, 07:55 AM   #3
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Re: Alzheimer's, Dementia or something else?

Thank you so much for your reply. Yes, I figured it must have more to do with the diabetes than anything else....We've begged him to do something (anything) about it, but he refuses. We all know it is extremely serious, but he just won't listen to anything said about it...

Is there some way to almost force his hand into getting help when he's an adult who doesn't think anything is wrong?

 
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Old 01-24-2013, 08:31 AM   #4
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Re: Alzheimer's, Dementia or something else?

Dear Kheintz, you are welcome, but I am afraid I am not much help in answering your real question. How to force an adult to get help when he/she doesn't believe anything is wrong is an age old question. I am battling a similar situation myself. Perhaps others can shed some light.

As for something I do know something about, there could be a dementia issue underneath the diabetes. If so, whether the cognitive impairment is secondary to the diabetes or something that occurs in parallel is a good question. Your uncles refusal to acknowledge his diabetes tells me that he is likely to have low self-esteem and refuses to face reality despite overwhelming need. On the other hand, if he does have dementia, the cognitive impairment will prevent his clear and objective thinking. You are probably well aware that diabetics tend to not drink sufficient water, leading them into a chronic high blood glucose and dehydrated state. Throw in a few daily drinks, you might end up with someone with a poor diet, and substitution of alcoholic drinks (which tend to be dehydrating to start with) for water. You then compound dietary deficiencies including critical vitamins. Deficiency of vitamins, such as thiamine and other B vitamins will lead to confusion and cognitive impairment. The good news is that if caught early, before permanent damage sets in, the mental impairment is rapidly reversible with vitamin supplement, better diet, rehydration, and stringent glucose control. The bad news is that once vascular damage occurs in the brain blood vessels, it is not easily reversible, if at all.

If you know the name of your uncle's primary physician, you should make an appointment to consult with him. Immediate questions are 1) how bad is his diabetes; 2) how much is he drinking; and 3) his liver and renal functions and cardiac functions. Forcing him to control his diabetes is a question that perhaps his doctor can address.

As for any underlying permanent brain damage, only a physical test, such as an MRI or PET scans can perhaps reveal. Because we suspect his confusion is at least partly secondary to his lifestyle and uncontrolled diabetes, any mental status tests will not reveal whether he has permanent brain damage.

I am sorry I cannot be more precise or of more help. -L

 
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Old 01-24-2013, 11:50 AM   #5
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Re: Alzheimer's, Dementia or something else?

Liquid has pretty well nailed it. It is a triple whammy of diabetes,cognitive issues, and alcohol allnaking the other two worse. The best thing you can do for your uncle is to get him to a doctor. You can nit ask him to go as you have found out. You have to take him.

Love. Deb

 
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Old 01-24-2013, 02:22 PM   #6
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Re: Alzheimer's, Dementia or something else?

Thank you both very much for your insight, very helpful. I wondered too about calling his GP however when I tried to find out who his GP was, I learned he does not even have a family doctor. Apparently, he had gone to the hospital (for an unrelated issue) when the doctor discovered he had diabetes and informed him. So I guess there is no GP to even call.

It's too bad there's just no reasoning with him... Kind of at a loss I guess. I will do some more research to see if anything else can be done for him.

 
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Old 01-24-2013, 05:13 PM   #7
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Re: Alzheimer's, Dementia or something else?

Hi Kheintz,

As you know, Canada has a shortage of GPs, and it is probably worse in Quebec. In Ontario, it may be the same situation. Perhaps somehow your uncle lost his GP along the way and didn't get another one. He can either try to get another GP via referral or go to the walk-in clinic and ask for referral of a specialist and GP. A specialist can diagnose dementia and a GP can tell you what is wrong in general.
We have changed a few GPs here as some GPS came and left. My husband just got a new GP with luck.
ER takes a long time. So try to get a physician and if there is no GP available (some GPS are booked full), try the walk-in clinic and get a specialist by referral.

Hugs,
Nina

Last edited by ninamarc; 01-24-2013 at 05:16 PM.

 
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Old 02-13-2013, 01:28 AM   #8
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Re: Alzheimer's, Dementia or something else?

Hi

In my opinion we have to give more care towards to that patients.And also make them in very happy mood always.

Thanks.

 
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Old 02-13-2013, 03:56 AM   #9
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Re: Alzheimer's, Dementia or something else?

I don't know about the laws in Canada. Here in the US you almost cannot force him to do anything. The law will tell you that it is his choice to ignore his health issues, continue to drink, etc. Have very recent experience with a friend who a bad alcoholic, stated she wanted to drink herself to death. After many, many incidents her husband tried to get a judge to commit her and couldn't because it was her right to drink herself to a stupor, regardless of the consequences to her health. She finally died last fall after being found unconscious for four days after going on a drunk. She was seriously debilitated and never able to care for herself again. Very sad but what she wanted and the rest of us wanted just were not the same things.

 
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Old 02-13-2013, 03:07 PM   #10
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Re: Alzheimer's, Dementia or something else?

Titchou is right. It is almost impossible to do anything regarding the health of another person as long as they are considered competent and do not break the law. We do fall on the side of protecting person choices and freedoms... even if that includes behavior detrimental to their own health.

The best we can do is encourage, beg, or use trickery if necessary.

Love, deb

 
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Old 02-14-2013, 12:54 AM   #11
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Re: Alzheimer's, Dementia or something else?

hi my mom is 66 she drinks almost 5 days a week she recently fell broke her hip and she had the surgery and now shes very very confused she know certain things but she dont know where shes at whos the strang drs in her house she loves her beer but i feel the beer is affecting her memory dr.s say its the surgery med but its been over a week going on 2 and she still confused lost.

 
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Old 02-14-2013, 06:01 AM   #12
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Re: Alzheimer's, Dementia or something else?

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Originally Posted by coreyharris View Post
hi my mom is 66 she drinks almost 5 days a week she recently fell broke her hip and she had the surgery and now shes very very confused she know certain things but she dont know where shes at whos the strang drs in her house she loves her beer but i feel the beer is affecting her memory dr.s say its the surgery med but its been over a week going on 2 and she still confused lost.
Sorry to hear that, Corey. A couple of questions. How much did she consume daily, on the average? Secondly, is she still drinking since her surgery, and how much? Third, how long was she in the hospital before discharge. I am assuming she is home now.

If she had hip surgery, I suspect she is on some fairly strong pain medications. Many of these pain meds do not interact well with alcohol. Her continued confusion may be because of the pain meds, either alone or exacerbated by alcohol intake. Anesthetics administered for her surgery and the stress of the trauma from both injury and surgery may sometimes precipitate a bout of confusion, referred to sometimes as hospital delirium. This should transient, unless other factors take over during her convalescing from the surgery, such as pain meds with alcohol. I am not implying that I think that is what she is doing right now, but it is something you should make sure she does not do.

 
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Old 02-14-2013, 08:03 AM   #13
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Re: Alzheimer's, Dementia or something else?

Corey, I am so sorry you are having to go through this but welcome to the board. What you are experiencing is probably a combination of both.

Yes, there are pain medications given that affect the cognition. Anything that will take away pain sensations will also take away other cognitive abilities as well. Then you have the anesthesia. It is a known fact that the anesthesia puts the brain to sleep. Especially in the elderly and those predisposed to dementia, the effects can cause a decrease in the cognition that does not return quickly... or at all. It may be weeks before they come back to normal, if at all. Then there is the Hospital delirium that can affect anybody but particularly those elderly patients predisposed to dementia. The alcohol does not help. It also affects the cognition, as we all know. So whatever effects she has from the anesthesia and pain medications is only made worse by the alcohol. So Luau is absolutely right here It will take time and patience to know if this is going to continue or go away It could be temporary (taking weeks to get better if it is related to the pain medications she is taking or the anesthesia) or it could be the beginning of a long journey into dementia.

If Mom was showing any early dementia symptoms before the surgery, a trauma such as this can cause her cognitive decline to accelerate. I hope for you that it is a temporary situation that will correct itself in time

Love, deb

 
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Old 02-14-2013, 10:03 AM   #14
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Re: Alzheimer's, Dementia or something else?

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Originally Posted by Titchou View Post
I don't know about the laws in Canada. Here in the US you almost cannot force him to do anything. The law will tell you that it is his choice to ignore his health issues, continue to drink, etc. Have very recent experience with a friend who a bad alcoholic, stated she wanted to drink herself to death. After many, many incidents her husband tried to get a judge to commit her and couldn't because it was her right to drink herself to a stupor, regardless of the consequences to her health. She finally died last fall after being found unconscious for four days after going on a drunk. She was seriously debilitated and never able to care for herself again. Very sad but what she wanted and the rest of us wanted just were not the same things.
It is the same thing in Canada. Everyone has a right not to see a doctor. Given the fact that health care in Canada has too many patients, I am sure some people choose not to see any doctor at all. Many people here don't have any GP at all. They go to the walk-in clinic or ER for sickness.
It is sad that this husband could not make her see a doctor. Also, being an alcoholic makes the person less willing to see any doctor. The person can always say he is not sick. Sometimes one needs to make some excuse so the person can see the doctor.
Sometimes some people are just passive and waiting for the relative to get a doctor. So try everything. Don't give up.

Last edited by ninamarc; 02-14-2013 at 10:05 AM.

 
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