My SIL went to see her father, my FIL, yesterday and is shocked by the changes in him since Christmas. At Christmas he came to our house, ate everything in sight and appeared healthy physically. As some of you may remember, he started becoming agitated and violent in January. He is now on four different medications aimed at keeping him calm.

However, in the past month he appears to be fading fast. He moves extremely slowly, shuffling his feet. He has to think for a long time before answering you when you make a comment and he appears to have lost weight. He seems to be getting frailer and more disoriented in a short period of time. He has become totally incontinent. When my husband visited him a few days ago he told him that his father wants him to go home and he tried to open the door of his lockdown unit.

I know deterioration is naturally a part of this disease, but do changes occur this quickly? I had noticed his increasing frailness the past month, but my SIL was really shocked at the difference in three months. I am wondering if we should check out his medications more thoroughly to determine if there is a problem in that area or just accept that deterioration can occur quickly.

Jane

Hi Jane,

It's difficult to know if this is just the rapid decline that often follows a "plateau" period of time.

It would probably be wise to check his medicines as the doses may be too high since he's lost weight. His shuffling gait, the slowness in thought and answers, and even the disorientation may be just too much medicine. Perhaps there is a blood test to check medication levels. If he's past the violent stage, he may not need the medicines at all now, but that's tricky to test!!

The other two things that come to mind that need to be checked:
* He might have a urinary tract infection causing the incontinence. It could be that he's just at the stage of being incontinent. My mom was incontinent for the last 18 months of her life.
* His weight loss means you need to check if he's eating enough. At some point in the AD decline, folks lose the understanding of use of knife, fork, and spoon. They can eat finger foods, but will need someone to cut their meat and perhaps feed them, too. Someone in the family should pop in for a visit during mealtime and quietly watch to see how your FIL manages by himself or if he's getting the assistance he needs. Ask the staff what help he needs.

My mother also went through as stage when she worried that her mother didn't know where she was and sometimes cried to go home to her mother. This happened about 20 months before she died.

Hope there's a fixable reason for this troublesome decline.

((((hugs)))) Barbara :)

Hi Jane,

I am with Barbara on this. Sometime deterioration can happen quickly. But, he could also be over medicated! It is hard to tell. Maybe one of yall could make an appt. with his dr./nurse and discuss the meds being given to him and what the reasons are for them. Sometimes I think that my dad is over medicated, and he is still at home. He takes 9 pills at night, but that includes vitamin, stool softener and meds by other drs. for other reasons. And then he takes 4 pills in the am. So, yall might want to check out that area.

Shuffling the feet, is a parkinsons trait. The rest of his new symptoms seem either UTI, like Barbara said, or just alzheimers. My dad thinks a while, before he says anything. And he hardly says anything, when there are too many people around!

Plus ad patients do have their ups and downs. Does someone in your family see him every week? That is the person that would know if it is a fast descent.

Hope yall can get it checked out and get a semi-final answer to your questions.

Love, Wannabe

Thanks, ladies. He is checked for UT infection all of the time, but does not have one. The staff at his unit do check to make sure he is eating or they did when we visited him during lunch. We have talked with his doctor about his meds a few times. He did not get along well on Seroquel and this was changed, but two other meds were added. I don't feel qualified to ask which meds could be safely dropped since we only see him two times a week and the staff naturally is around him all the time.

I will research the drugs he is taking to see if any one of them could be causing this fast decline. Thanks, again.

Jane

Hi Jane,

Be sure to also ask that the dose for each medicine be checked to make sure it is appropriate for your FIL's current weight. My MIL lost weight and suddenly had bad symptoms from her thyroid medicine. When the doctor lowered her dose to match her new lower weight, all was well.

Cheers! Barbara :)

Oh, good thought, Barbara. I will see about his medications in relation to his weight. My FIL also takes meds for his blood pressure, atenolol and lisinopril and a few other related ones. I am finding it odd that he is taking Zoloft, buspirone, temazepam, depakote and lorazepam for his depression and agitation. Of course, I am only looking at his pharmacy bill so it is possible the depakote or one the others was dropped in favor of the new one, lorazepam. I did read up on this one after reading on this board about becoming addicted to it. Apparently, there are withdrawl problems when it is stopped so I will check on that as well with his doctor.

I thank God everyday that my parents, 85 and 93, still have their health and sound minds. I don't think I could go on this rollercoaster again.

Jane