Doctor insights on:
Dementia Stages Timeline
My Grandmother has been diagnosed with the early stages of Dementia. Is this disease hereditary and if not, what can I do to prevent it?
Incomplete data: Research seems to suggest a genetic contribution but it is of uncertain strength and not to a single or even simple set of genes. Living longer has increased the numbers of people who decline cognitively but causes differ. Some are gradual and easier to deal w/. Some rapid and frightening. Healthy living in all respects is the best prevention-like strategy, but no one knows. If we did, Wow! ...Read more
Depends: End stage dementia usually means the individual can no longer nourish them selves by mouth and are completely dependent on others for care. Most people with end stage dementia die lf illness related to infection or complications associated with immobility or swallowing difficulties. If one can no longer eat or drink and there is no artificial nutrition or hydration, death usually occurs within 2 wk. ...Read more
When a dementia pt is transferred to another facility, how much time should be given for the pt to settle in before resuming visits?
Depends: For some people visiting soon can be reassuring while other people may need weeks before a visit is a good idea. Past experiences are often the best predictor of future actions. Talk with the persons doctor and the staff at the facility. ...Read more
My grandma is 85 with dementia and for the last week every time she finishes eating she moans like if something hurts what can it be?
Needs evaluation: Unfortunately sometimes with dementia, there is a loss of ability to explain or communicate well. This is often due to loss of language functioning. Thus the groans and moans signal something wrong. Medical examination will be needed. Perhaps as simple as indigestion or possibly constipation or some other GI or bowel problems. ...Read more
Question or query repeatition very often in short time - what kind of dementia and remedy if any for.
88 year old with dementia started having body spasms, she is sitting in a chair with sides and starts yelling I'm falling. Lasts under 30 seconds time?
Dementia: You're describing part of dementia process whereby the body misinterprets sensations. Some people w/dementia are constantly eating b/c they can't remember that they just ate. Others refuse to eat b/c they feel full all the time. While you can't argue or use logic, you can try to reassure or distract. Ask pt's Family Doc or Geriatrician to evaluate for other/correctable causes of hallucinations. ...Read more
Fish Oil: The dementia that is reversible is vitamin B12 or Folic Acid defiency dementia, . Vascular dementia is irreversible. I know for sure that there are a lot of good tangible results about fish oil being very helpful to improve cognition, sleep, anxiety, depression. These are all associated common symptoms of dementia too. It also reduces clotting, which is common with vasuclar dementia. ...Read more
Depends: Patients with brain damage from any cause can have drops in their mental status. .. delirium, which can be from any number of reversible causes. If the cause of delirium is treated there can be a sudden improvement as well, relatively speaking. As an example, urinary tract infections can cause a sudden drop. With treatment of the underlying infection the mental status should improve over time. ...Read more
Why is the clock drawing test a test for dementia when most of my teenage friends can't even tell the time on an analog clock?
Are there any other conditions that can cause fluctuating cognition besides dementia with LB? I've been to a few doctors and no conclusions were ever made but my symptoms just keep worsoning with time
How to address: Cognition normally fluctuates on a day to day basis, and can change secondary to sleep patterns, emotional stresses, contact with infections or allergies, side effects from medication, use of alcohol or recreational drugs, and even reactions to foods. I seriously doubt you have any issues with Lewy Body Dementia, and suggest some counseling to deal with this pre-occupation. ...Read more
I'm 3 mos s/p c6-7 acdfp. When can I return to work full-time as pt in nursing home? I do have to transfer and lift patients frail w/ and w/o dementia
Ask your doctors: The doctors who've been following your progress are much better equipped to answer your question than doctors who've never met you. Returning to work after such procedures depends on how you were before surgery, and how you're recovering. If you're working with a physical medicine ; rehab physician along with the surgeons who operated, those would be the ideal doctors to ask. ...Read more
Dementia pt. On DNR, only IV of morphin, no V/S, just palliative care, no nutrients. What is happening to body and is this a slow painful death? Time?
Palliative care.: Palliative care is employed for relief of symptoms and optimization of quality of life for patients who have terminal or incurable illnesses. Their timelines vary. We would assume that with adequate palliative care that patients are kept comfortable and relatively free of pain. ...Read more
Dementia pt now sits and stares into space, response time very slow. What is happening in the brain to cause these behaviors?
What would cause my dementia patient to have a bm in her sleep everynight at almost the same time and she is totally unaware. No accidents while awake?
Dementia patient question should a 86 year old dementia patient be on both rispeadal and depakok at the same time? What are the side effects and how long for them to show up? -
Risperdal: Risperdal is indicated to treat a disease called schizophrenia. Depakote can be used for treatment of seizures or bipolar illness. Unless your patient has been diagnosed with any of these diseases, using Risperdal or Depakote to treat dementia or complications arising from dementia would be considered what is often called the "off-label" use. While doctors are essentially free to prescribe any medication they consider necessary to treat any particular patient, as long as the treatment benefits are greater than risks, there are caveats to this approach. Risperdal and other medications of this class (collectively known as "atypical antipsychotics" have been deemed by the us food and drug administration (fda) as dangerous and causing increased mortality when they are being used off-label - for treatment of dementia. The fda warning of this side effect is known as a "black-box warning" and is a boxed statement found prominently displayed on the Risperdal prescribing information brochure that typically accompanies the packaged drug or promotional materials. Depakote does not have this warning, however, absent symptoms of bipolar illness or seizure disorder, there are no clinical trial data convincingly showing that the drug helps to reduce symptoms of dementia or its complications (such as agitation). There are numerous other side effects of these medications, the most common of which, is muscle stiffness and falls. Ankle swelling was the earliest and most common side effect in some clinical trials of Risperdal in dementia. Since both medications can cause muscle stiffness, it is likely that taking both at the same time will enhance this effect. How rapidly the side effects appear depends on the type of dementia and other health issues that the person might be having. However, most side effects become apparent within 1 to 15 days of using the medication. The prescribing physician should be very explicit about the black-box warning when recommending Risperdal and should very clearly communicate to the person who is making treatment decisions, all relevant information about side effects and expected benefits, if any, of these medications. Please do not hesitate to contact my office at (877) 483-2071 if you have more questions. ...Read more
Would you say my mom is in stage 5 of renal failure? She is 84 with dementia and dr say dialysis is not an option. How much time does she have?
Depends: If she was told that she has end stage renal disease, then she is in kidney failure. How functional the individual is is a better reflection on whether the person should recieve dialysis. In older adults, if there are no dangerous urgent symproms, then dialysis is delayed until absolutely needed. If mom is having these symptoms and not to be dialyzed, she may have only a few weeks. ...Read more
My friend's mother has dementia, is it compulsory for patient to take it's medicine life time and is it inheriting disease, from parent to child?
Good questions: You may not mean "compulsory", but it might be advised that an elder with dementia take effective medication until they die. The selection of drugs may change over time, but they are intended to delay disease progress and relieve some behavioral symptoms. As there is no cure, this is the best that can be done. Causation is complex, but heredity appears to play a role in the risk. ...Read more
My mom just prescribed Namenda (memantine) for the 1st time for her dementia, the confusion and forgetfulness began about 3-4 months ago. Will this help?
Namenda (memantine) is one of several drugs used for dementia, and is reasonable to use. I assume her doctor did a thorough work up to assess thyroid function, B vitamin deficiencies, depression, other brain dysfunction, or a chemical reaction to other meds she was taking first.
Should this fail, other meds should be tried. You mentioned her age, but it should not be assumed this is just old age. ...Read more
My 65y old mom died, had dementia & taking its meds since 2010.Dr told now she's facing brain stroke, at the time of death she felt chill then sweat.
Question: I am sorry to hear this. Please re-submit so that we know what your question is. ...Read more
Multi infarct stroke dementia patient, will stopping ssri antidepressant have a negative impact after some time and patient has shown improvement? Is it addictive or have a downer. Any ALT antidep's?
Vascular dementia: These days multi infarct dementia is referred to as vascular dementia. After a stroke there is evidence that ssri antidepressants help prevent post stroke depression. There is a little but not a lot of evidence that ssris help those with vascular dementia. Ssris are not addictive. For specific advice about using any antidepressant it would be best to see a mental health expert. ...Read more
My mom has dementia. She is on celexa, aricept, namenda (memantine) and risperdal. She takes low to normal doses. She has gained 70 lbs in 18 months and feels tired all the time. Is it expected? Suggestions?
MEDICATION EFFECTS: Do not recommend use of Risperdal in this situation, as there is a substantial risk of stroke or death, in those elderly folks who have dementia. Of course, I fully agree that the weight gain and fatigue is also due to this drug. Is there are major issue with stopping it in view of all the potential problems? Is her diagnosis confirmed, such as alzheimer's? Should you get a second opinion? ...Read more
When do you know its time for a dementia patient to go to a nursing home? Mother is 85 years old. Lives alone in apartment. Forgetful, but otherwise good health. Apartment is extremely clean and tidy, makes her own meals, walks independently. Siblings w
The basic reason for a person to live permanently at a nursing home is if they can not function without assistance. Can the person handle every day tasks of living such as brushing their teeth, washing themself, dressing themself? Does the person engage in unsafe behaviors such as forgetting to turn off the oven? Does the person have a medical condition that would make it unsafe to live alone such as falling often or seizures? Is the person depressed and isolating themself? I think that it is excellent that your mother continues to interact with others and that she maintains her own home and makes her own meals. Many elderly people who have difficulty with some of those activities of daily living, may still elect to live independently in their own home but might have some meals delivered or might have maid service.
Sometimes relatives want their elders to be placed in nursing homes so that they will not worry about them. I think it is very important to ask the person what their desire is. ...Read more
Many factors: Such as inherited predisposition as in Alzheimer's Dementia, Vascular Dementia is caused by hardening of the arteries with decreased blood flow to the brain causing microvascular changes as in strokes, repeated blows to the brain as in those incurred in sports, boxing, football. Accidents causing concussions or traumatic brain injuries like explosions in war. Diseases like Parkinson's Disease ...Read more
Yes and no: If there is an illness that runs in your family you should speak to your doctor about it. There are many many types of dementia. Some of them are genetically passed on while others aren't. The most common type of dementia is alzheimers disease and there are 2 forms. The early onset form is highly heritable. Alcoholic dementia is not inherited though a propensity for alcohol dependence can be. ...Read more
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