Doctor insights on:
List Of Motor Skills Dementia Patients Lose In Late Stage
Dementia: Usually rule of thirds. 3 years mild, 3 years moderate and 3 years severe. ...Read more
Patient dx'd w/non-alzheimer's dementia in mid-2010. Now in late stage. What is the rate of development of this illness on this pt?
Difficult to Say: Most people are diagnosed already in the moderate stages. From diagnosis most live about 12 years. You mention blood pressure so there may also be some vascular dementia mixed in. If health is otherwise ok, this individual could have a fair amount of time. Usually, when people stop walking & feeding them selves, they are near the end. Hope this helps. No matter what, make every day count! ...Read more
Elder male dementia patient sleeping 15+ hrs/day. What are causes? Losing weight due to missing meals though appetite remains very good generally.
In San Diego we: Have APS--Adult Protective Services. It's the adult verion of CPS (Child), and is designed to assess elders who may need assistance with hygiene, food, shelter, money management, etc. APS usually has a psychiatric component to help assess mental capacity and any needs for assistance (caregivers, medical, social programs, placement in facilities--all as needed). ...Read more
Can a md. Deny medicare-paid hospice end-stage dementia patient physical therapy if patient's family requests it to maintain movement with new law?
Hmmm. . .: Could there maybe be a disagreement between this physician and your family about what's in the patient's best interests? This is a deep discussion that involves much thought and consideration, and which deserves scheduled time with your relative's doctor to go over treatment plans, prognosis, etc. Maybe such a discussion can resolve these issues? Doctors want to help, not hurt or harm. ...Read more
What is the name of that disease where you lose all your motor skills and their hand shakes uncontrollably?
Yes but. . .: I can't diagnose any loss over the internet! My recommendation is to document your concerns w/your family physician and ask for referral to an occupational therapist for an evaluation. At the very least, you can determine your current status and use this as a baseline for repeat assessment in 6-12mo or so. If there's an obvious deficit, then your doc can initiate an evaluation and/or refer to neur. ...Read more
I have an unknown problem where I lose my motor skills. My legs become numb and in extreme pain. Any suggestions to help the pain and regain use?
Anxiety, see PCP: Anxiety symptoms are not a sign of illness, they are the mind's ability to produce the "flight or fight" response which gives rise to many physiological changes include heart palpitations, nausea, tingling, insomnia, dry mouth, speech impairment, tremor and sweating. Depending on the cause of your anxiety symptoms, your health care provider can provide you with treatment options. ...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 Tx: Tx depends on the cause of the dementia. For example, discontinuing medications that add to confusion, treating anemia or heart problems or low oxygen or infections or depression or nutritional deficits, treating the behavior problems such as psychosis or unstable moods with medications, slowing the progression with Aricept or Exelon (rivastigmine) or namenda, correcting hearing or vision problems, group activit. ...Read more
Assess and adapt: Anyone entering a long-term care situation has individual preferences and needs (food, activities, interests, etc). Which must be assessed on admission. What physical capabilities and limitations does s/he have -- and what's been meaningful to him/her before? What adaptations can the unit make so that s/he can participate and have emotional needs met? Staff must consider all these things. ...Read more
In vs out of home: Long-term care options are usually either in-home or residential treatment. In the very early stages of dementia the patient can usually get by with family support. As the patient moves into the middle stages of dementia in-home care such as home health options are usually needed. As a patient moves into the later stages of dementia, residental or even hospital care may be indicated. ...Read more
No cookbook way:
Each individual and the prior family dynamics play into this process.
"controlling" type personalities adjust less well in many cases.
The degree of impairment often plays a role as less demented often resist integration more then advanced dementias (not always though!)
lesser demented patients often transition better if preceded by day programs prior to permanent placement- sometimes. ...Read more
Supportive: Therapy helps as well as medications used for dementia. The final stages of vascular dementia is hard to distinguish with the symptoms of Alzheimer's dementia. ...Read more
Increased anxiety: Or other behavioral changes often mean that a person's environment is not supportive enough for their declining level of functioning. A geriatrric psychiatrist or geriatrician can help with an assesment. ...Read more
Probably needs help: Depending on the level of dementia, it may be impossible to get her to take care of herself with a blood glu. Someone may need to do it for her. Also, I would recommend that her diabetes treatment regimen be simplified as much as possible so that freq blood glu not necessary. Hypoglycemia may be a much greater risk than hyperglycemia. ...Read more
Could be effective if a patient initially diagnosed with vascular dementia is treated homeopathically?
Collaborative Care: Vascular dementia can bring with it many behavioral issues, such as irritability, depression, sleeplessness, etc. Classical homeopathy can help these things, even if the complete dementia is not cured. The case needs to be taken thoroughly by an experienced homeopath, and the closest single remedy given out of hundreds possible. Collaborate w/neurologist. I've also seen dementia itself improve. ...Read more
Would it be possible for a patient initially diagnosed with vascular dementia to be treated homeopathically?
Would NOT risk it: Vascular dementia arises from strokes, and since risk of large stroke could be deadly, would choose a stroke specialist to prevent future events. Am unaware of any homeopathic remedy which could supplant standard medical prevention in this category. ...Read more
How beneficial are visits to a dementia patient, what should frequency be and any reason to limit visits to the "occasional"?
Visiting dementia Pt: I agree with dr. Baker. Many dementia patients enjoy visits from others, yet may not retain what happens from one visit to the next. I recall one woman with alzheimer's dementia, whose husband visited daily despite the severity of her cognitive decline. A nurse asked him, "why do you keep coming when she doesn't know who you are? " he replied, "because I know who she is." a very wise man. ...Read more
What kind of facility would a dementia patient at the moderate to severe stage be put in, and who pays if not medicaid eliglble?
Each state different: Memory care units are appropriate for those with moderate or severe dementia. The right level of care will decrease the stress for the person with dementia. In the United States, we are all responsible for paying for our living place and that includes those with dementia. Medicaid is available to help those who cannot afford it. Contact your local govt or estate planning attorney for specific into. ...Read more
Dementia patient at a SNF usually found semi-asleep when visited at different times of the day/evening. Reasons? Could she be drugged?
Concerned?: Especially if you are a closely involved person, but in any case, you can politely but firmly ask to speak to a responsible staff member about what you observe and your concerns. There are indeed many medications that make the elderly overly groggy as a side effect. Hopefully, they can help you understand her condition which may be the cause directly. Caring makes SNF care better! Thanks! ...Read more
Why would the location of a dementia patient now be suddenly considered confidential, with visitors now needing to call the fiduciary's office first?
Depends on details: Privacy and concerns regarding potential exploitation often are key to these types of decisions. However, most states have ombudsmen who work at facilities. You can contact them if you have concerns. ...Read more
Will a psychiatrist be willing to meet with a spouse for a consult before seeing the proposed patient. My husband of 28 years suffers from dementia but can't or won't admit he has a problem. On the rare occasions when he will admit something is wrong, wit
Depends: Ask the patients primary care provider to relay your concerns to a new doctor. Many will meet with you separately but contact them first to se. ...Read more
Geriatric issues: It sounds like these issues are best approached by a geriatric psychologist, and a geriatric psychiatrist. Which is to say, you're looking for a psychologist and a psychiatrist both of whom specialize in geriatric issues, like the ones that you have described. State psychology and psychiatric organizations can help you find the best practitioners for these issues. ...Read more
This is hard: The american acadmeny of neurology has developed guidelines on this which are available online. Anyone with dementia is at higher risk of being in an accident then those without dementia. If someone can pass a road driving test, they are more likely to be safe driving. Most people and those who care about them underestimate the danger. ...Read more
Yes: Aging wins in the end but in the meantime regular exercise, weight bearing exercise, and fun group activities can keep the demented elderly moving. Keep the medicine list as short as possible. Provide a well lit, safe environment with no loose items on the floor. ...Read more
Pretty much like all: That being said, there are some distinctions. People with dementia need calm, patient, balanced assistance with good attention to their communication of needs. Avoid abrupt, sharp interactions - clear & firm is fine but no confrontations, challenges or arguing. Offer your interpretations & seek agreement, then go on. Give simple, congruent positive feedback as much as possible. Follow their lead! ...Read more
A balanced diet with plenty of protein, dark leafy vegetables, and variety the loved one prefers.
Keep in mind the signalling center of the brain may also be effected by the same pathology thus reducing the hunger/thirst drive. It's often subtle.
More stimulating food smells (fresh baked bread?) and tastier foods are often better.
Watch for choking. This may represent a need for a swallowing study. ...Read more