Hi all, I’m here again asking another question. So many from me these days! My 79-yr old father had a severe fall about 10 days ago. We don’t know how it happened. He was alone and doesn’t remember the incident. He hit his temple area and required stitches and also fractured a number of ribs. Before this he had been suffering from UTIs for about 8 months and had lost weight / become more frail. I had noticed general forgetfulness over the last few years but it didn’t seem like anything serious. Perhaps I should have taken it more seriously as his mother had Alzheimer’s. In any case he went to the hospital after the fall for about 8 days and recovered well physically. Mentally, it was another story. It was like he went into the hospital one person and came out another. He makes up stories about things, rambles on. He also started getting up from his bed in the middle of the night, wandering in the hospital. He is now in a rehab unit getting PT. The rehab unit is also for mental care patients. I’m trying to get him a neurological evaluation. I guess my question is, can a fall really trigger dementia in this way? Can it go from 0 to 60 that fast?
UTIs can cause severe and sudden behavioral changes in elders. So can imbalanced electrolytes.
You need to make sure that the rehab docs and PAs know that this is a change in mental staus for your dad. That always needs to he investigated. Remember that they didn't know him before.
I know that my LO went downhill pretty fast after she fell and fractured her wrist. She was never able to explain how it happened and within a few weeks, her Primary diagnosed her with significant dementia. Before this, she had been maintaining her own household. I later found out that she had been having some struggles before and since the incident, but, it really got bad afterwards. Once we got more eyes on her, we were able to see that she had INCREDIBLY poor balance. She would fall down for no reason, except poor balance. It wasn't like she tripped on something. The poor balance was likely due to her dementia. Her MRI showed multiple strokes.
This is not to say your dads dementia is not caused by a TBI you do not know what happened to him this time or 5, 10, 15, 20 or more years ago.
There are some TBI's that can accelerate dementia that was in progress already.
Getting a proper diagnosis is important. And if he is a Veteran possibly get the VA involved as this also could be a result of military service.
Was he checked for a stroke that could have caused the fall. Was he checked for a concusion or brain bleed?
I decided to bring her home instead. 2 weeks after I had her home, she was basically back to herself. Chatty as always and we had to go through weeks to train her to just go in her diaper. She would hold it and yell at me to take her to the toilet.
For grandma, the problem was rehab. I don't know if it was the environment or maybe medication, but something was making her not herself. Once she was out of that environment and back on her normal meds, she was back to herself.
We hoped it was a UTI or something we could fix. But it wasn't. He's in memory care now.
If you get a choice, try to get a memory care facility that feeds into a good nursing home. Getting into a good nursing home takes some planning. Unless you have lots of money, you don't just walk in.
My own father experienced very serious hospital delirium. After that he declined slowly for years. Then he had three falls on his head in three days—he refused to drink water and the chronic dehydration left him with terrible balance. Two of those falls were serious, and he was dramatically worse afterward. He did have many other issues.
I’m so sorry you are going through this. It’s impossible to be prepared for such dramatic changes in our loved ones. I wish you wisdom and strength for the road ahead.
My only thought was to suggest double checking that he didn't start any new meds in the hospital -- perhaps the confusion could be a new side effect? Worth checking out anyway.
Best of luck, it sounds like you are suddenly deep in the midst of this harsh disease :(
People with dementia often forget to urinate and hold it until they can't hold it anymore and experience incontinence. Sometimes they don't feel the urge to urinate. Either way, retaining urine promotes UTIs.
Being outside familiar surroundings makes matters worse for those with dementia. Until your father returns home, I would not draw any conclusions by what's happening at rehab. Once he's back home hopefully he will become more lucid.
However, if he has increasing confusion, I am concerned about a contusion (brain bruise) or a subdural hematoma (slow forming pool of blood under the skull). Both can make him a bit confused. The contusion gets better with time. The subdural hematoma gets worse with time. Usually, you don't get confusion from a subdural hematoma right away but months later.
In any of these cases, a neurological evaluation is your best option. The doctor can then address treatment options for dad.
... *Treatment for NPH is simple; surgical placement of a shunt to drain build up of CSF preventing symptoms of dementia and permanent damage to areas of the brain affected by increased CSF pressure.
A fall, injuring the Temple area, however, could permanently damage the brain resulting in behavior that seems like Alzheimers or Dementia either started or was progressing.
As for him making up stories, now,.....the temple area is where the temporal lobe is located. Damage to the temporal lobe can cause hallucinations and talking too much.
Here is some info with a link:
https://www.neuroskills.com/brain-injury/temporal-lobes/
Right temporal damage can cause a loss of inhibition of talking. The temporal lobes are highly associated with memory skills. Left temporal lesions result in impaired memory for verbal material. ... Seizures of the temporal lobe can have dramatic effects on an individual's personality.
Gosh, my mom has wonderful memory. She remembers things that younger people in the family don’t. The same with my 98 year old cousin. If I have questions I ask her and she is the one to know the scoop!
After they refresh my memory, then I recall it. Some of the elderly are amazing in what they remember.
I suppose my earliest memory is my first day of kindergarten. I remember not wanting my mom to leave. In my day, preschool wasn’t common so I was dealing with separation anxiety.
I find memories fascinating. My husband is very intelligent but he doesn’t recall a lot of things in his early childhood. He says he filters out unimportant stuff! Hahaha
Yet, being an engineer he is extremely detail oriented but with the day to day stuff, not so much.