Possible Dementia-First Steps

[Anonymous]

A family member is exhibiting some signs of cognitive decline (awaking in the middle of the night and escaping, unable to follow tv or use electronics etc) We have a neurologist appointment scheduled, and there is a mostly capable spouse and a caregiver who comes a few times a week to assist. What should we have ready for the appointment and potential next steps?

[Anonymous]

Taking this a lot more seriously would be the first step. Get proper locks for your doors and a door alarm.

[Anonymous]

Believe it or not, test for a UTI.

[Anonymous]

Anonymous wrote:Believe it or not, test for a UTI.

Yes, if this is recent onset and symptoms are that advanced already - elopement is usually fairly far along the dementia path- it could be that your loved one has a persistent low grade UTI that has caused cognitive impairment, a fairly common occurrence in elders.

Also should get sodium levels checked. I’m a professional caregiver and once worked with an elder who went from sharp and sassy to spaced out and falling down in a few days time - at the hospital after I had to have EMTs get her off the floor for me, doctors tried to discharge her because they assumed her behaviors were normal. I’m a former attorney and demanded that they keep her for observation, because I know it was a dramatic change of behavior in a short period which is not typical dementia onset. They kept her reluctantly after I asked whose fault it would be if she fell again and cracked her skull - and it turned out her sodium levels were totally off which caused substantial cognitive and motor dysfunction. She went right back to baseline once they got it sorted.

Dementia is far too common but there are also organic bases for some fairly sudden onset cognitive decline in elders that should always be ruled out.

[Anonymous]

Get paperwork in order, trusts, wills, durable
Power of attorney, etc. early

[Anonymous]

Know how much money they have. Know what the living facility options are.

[Anonymous]

Anonymous wrote:Taking this a lot more seriously would be the first step. Get proper locks for your doors and a door alarm.

Door alarms are installed, we are taking it seriously and getting their spouse on board. There’s a lot of denial

[Anonymous]

That's full-blown dementia, OP. They need a memory care unit. They cannot stay home, unless you really hate your relatives who will need to be caregivers, or they have enough money to hire aides 24/7.

[Anonymous]

Yeah, that’s definitely not early stages unfortunately.

I agree to always check for a UTI any time there’s a steep step down.

Get all the account information and all insurance policies gathered in one place.

Buckle up.

[Anonymous]

Anonymous wrote:That's full-blown dementia, OP. They need a memory care unit. They cannot stay home, unless you really hate your relatives who will need to be caregivers, or they have enough money to hire aides 24/7.

+1
A competent spouse and a caregiver a few hours a week is not enough. She needs someone awake and focused 100% on her 24/7, or placed in a memory care unit.
My mom was like this, and if my dad left the room even for 10 minutes to brush his teeth and get dressed, she would be out the door.

For 24/7 awake caregivers, expect to pay $30-40k per month.

[Anonymous]

Anonymous wrote:Yeah, that’s definitely not early stages unfortunately.

I agree to always check for a UTI any time there’s a steep step down.

Get all the account information and all insurance policies gathered in one place.

Buckle up.

Yes, I know that is probably true. He recently had a hospital stay which included a UTI, and is why there is part time help. We’re having a conversation this weekend in part to gather this information and hopefully really get the spouse on board. Residential care will be an extremely hard sell but might be able to convince full time in home care

[Anonymous]

Anonymous wrote:

Anonymous wrote:Yeah, that’s definitely not early stages unfortunately.

I agree to always check for a UTI any time there’s a steep step down.

Get all the account information and all insurance policies gathered in one place.

Buckle up.

Yes, I know that is probably true. He recently had a hospital stay which included a UTI, and is why there is part time help. We’re having a conversation this weekend in part to gather this information and hopefully really get the spouse on board. Residential care will be an extremely hard sell but might be able to convince full time in home care

Why is the spouse not on board? Are they afraid it will drain their savings?

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Yeah, that’s definitely not early stages unfortunately.

I agree to always check for a UTI any time there’s a steep step down.

Get all the account information and all insurance policies gathered in one place.

Buckle up.

Yes, I know that is probably true. He recently had a hospital stay which included a UTI, and is why there is part time help. We’re having a conversation this weekend in part to gather this information and hopefully really get the spouse on board. Residential care will be an extremely hard sell but might be able to convince full time in home care

Why is the spouse not on board? Are they afraid it will drain their savings?

I think that’s part of it, but more denial, afraid of their own mortality, loss of quality of life. Wife is nearly a decade younger. There are significant assets including 2 paid off properties and lots of cash/investments

[Anonymous]

Make sure they can’t operate the stove. Disable it sometime. Make sure smoke detectors are everywhere. As others have noted, if this is not UTI related, then it is not early stages. This is a dangerous situation.

[Anonymous]

Anonymous wrote:Make sure they can’t operate the stove. Disable it sometime. Make sure smoke detectors are everywhere. As others have noted, if this is not UTI related, then it is not early stages. This is a dangerous situation.

Good point, while he’s never used the stove (not an exaggeration) I know that all bets are off now