We believe my father suffered a mini-stroke on Wednesday. My husband found him on his carpetted hallway. He initially had trouble moving his right leg, and walking. He has been diagnosed with the Early stage of Altzheimers by his Pyschiatrist. Dad will not leave his house so we don't have a thorough understanding of whether he had a stroke or not, but he has been improving since Wednesday; though he is now very weak.

When he eats, he seems to become more disoriented afterwards, and my husband has noticed increased confusion and lack of vocabulary afterwards. Is this part of the Altzheimers? Or, could it be something else? He has been on Aricept, which the doctor instructed us to take him off of because dad is now incontinent.

Any information would be appreciated.

You need to have your Father diagnosed by a "Nuerologist" for an accurate testing and diagonsis of alzheimers.

And it sounds as if your dad "may have" had a stroke,,,it also sounds as if he's diabetic. ....which a phyciatrist isn't competant enough to do such a diagnosis and treatment of.

I would urge you to please get your Dad into the hospital or to his primary care Dr and have him thoroughly tested for many things physically ,,and get him to a good nuerologist that is experienced with Alzheimers.

One you get this done,,please come back and let us know what the diagnosis is. Best of luck to you,,,you're in my thoughts and prayers. Peace

Raven,

Thank you for your response. This is very hard as my father, who is now 90 years old, will not leave his home. His doctor has done everything he could to help us. He is an amazing doctor who is not just a Physchiatrist, but also a Pharmacologist, and Researcher who specializes with dealing with Elderly issues (such as Altz./Dementia). He has come to our house--how may doctors do that these days? He had blood drawn, and did what he could to get it analyzed. I will let him know about the eating issue.

Unfortunately, dad will no longer leave his home; so we are impaired by the inability to get further information about his situation. My father has stopped leaving his home in the past few years. At his age, I am just trying to allow him to live his time the way he wants to. I believe he deserves to have his life as close to what he wants as possible.

With bringing in a woman to live with him, this is potentially a changing situation that may from this point on always be difficult.

I have done the best I can to help him, but with having a child with Autism, it is very hard to do as much as I would like.

Wendy

If your Dad appears to have another stroke in the future, you could call 911. In some cases, early intervention can make a huge impact on recovery.
Perhaps you could utilize physical therapy at home as well as a visiting doctor/visiting nurse. I don't know if the visiting doctors exist all over the country, but in my area, they're popping up quite a bit.

Is your father a veteran? If so , he is eligible to receive healthcare from the VA. They have many homebound services available at little to n o cost, bsed on your level of income.

My Dad has been receivieng his healthcare from the VA for about 5 or 6 years now and has received excellent care both in Florida and now in PA.

They did a full geriatric assessment on him recently which resulted in the following home serivces being set up for him: PT once a week, visiting nurse once a week, social worker/therapist once a week, homemaker services 3 times per week, and a physician who came to his home to evaluate his living situation in his home. She returns as needed, manages his med perscriptions and will answer her cellphone any time of day or night and responds to issues immediately.

He had all of these services come to his home.

Each visit, regardless of duration, cost us a $15 copay. This was their most expensive rate since Dad did not qualify for any fee reductions due to his income level and lack of a service-connected disability.

It may be that your Dad's issues are caused by a physical condition that can be treated. There are many causes of symptoms of dementia, and some of them are stoppable or even reversable. A psychaiatrist, no matter how well-intentioned, is not able to make a determination on his own about all of the possible physical causes of dementia. In order to properly deal with whatever is going on with your Dad, you must first know what is truly going on.

He needs an assessment by a medical doctor, not a psychiatrist. If he won't leave the house voluntarily, perhaps the psychiatrist could prescribe a sedative or anti-anxiety medication to calm him enough to get him into a car to go for a doctor's exam.

Another way to go is to call 911 the next time he falls. They will take him to the ER and from there you can have him evaluated. This is a less preferable way to get him examined though, because you must wait for womething bad to happen to him before action is taken. Still, it's an option.

quote:

Originally posted by Gidget P
It may be that your Dad's issues are caused by a physical condition that can be treated. There are many causes of symptoms of dementia, and some of them are stoppable or even reversable. A psychaiatrist, no matter how well-intentioned, is not able to make a determination on his own about all of the possible physical causes of dementia. In order to properly deal with whatever is going on with your Dad, you must first know what is truly going on.

I agree with all of what you said except the above. Assuming that some sort of neuroimaging was done at some point, psychiatrists can and do accurately diagnose AD and other forms of dementia.

quote:

He has come to our house--how may doctors do that these days? He had blood drawn, and did what he could to get it analyzed.

Based on the above, I assumed that neuroimaging was not part of the diagnostic effort. Not disparaging psychiatry, just trying to make the point that a proper medical assessment needs to be done. "he had blood drawn and did what he could to get it analyzed" is not a very complete assessment.

Redondo-- I am amazed at all you've been able to do while caring for your child with autism. Always remember that your father has led a long life and that YOUR needs have to come before his.

When you call 911, two trained workers will get on him on a stretcher and carry him out of the house and take him to the ER. If it's not a life or death emergency, they will take him to the hospital you request.

I didn't like the ambulance workers who came from our 911 so the last 3 times I needed to get my mother to the hospital, I called the ambulance company with the best reputation and asked for someone who has experience with frail and demented elderly.

Doublecheck with your insurance but my experience is that with a 90 year old, all trips to the hospital are covered... Impossible to get them there ourselves.

Would your dad be eligible for hospice? A nurse would come to house weekly (or more if needed) and they would provide an aide to help him bathe, etc.

Gidget's -- I hope you'll post the great information information about services available for Veterans themselves through the VA(as opposed to A&A which is for widows).

Dad is not eligible for Hospice at least according to his doctor. While I agree with what was mentioned above, this doctor is no ordinary Psych. He also is a researcher (dealing with Altzheimers/Dem. clinical trials), and Pharmacologist.

I cannot make my dad's time here miserable by insisting on him going to a doctor. While it is definitely preferable, I believe at 90 he has the right to not leave his home if he chooses. He would have to be incoherent and further along with this disease before I could take charge in getting him to a doctor's office. At that point, is it really in his best interests? I may be missing the whole point here, but he has lived a very long life. He wishes it to end in his home. He could spend his remaining time in a hospital with much done to try to keep him alive. Would that be in his best interests when quality of life would most likely be very poor? If it comes to a situation where he is not managable at home, we definitely will have to do something else. For now, I have chosen to get an inhome caregiver to be with my father. It seems like the best decision.

I know I am new to this disease and all of its issues. Dad's wishes have been to not spend all of his resources on his own care. He wants my daughter to be taken care of in case she has the good fortune to live to 90 also. For most of his life, he has had a wonderful one. I guess I am not ready to force him to do what I want. He is not wealthy in material positions, though he owns his own home. I know that it is always best to visit doctor's, but wonder what most people do when they are 90 years old, incontinent to some extent, proud, and not able to feel comfortable leaving their home.

Of course, if he has a significant stroke, it will be necessary to call 911; and have him taken to a hospital. Can I require that the hospital be somewhere near my own home? Dad lives about 1/2 hour away from me.

Wendy

quote:

Originally posted by brightwings:
Redondo-- I am amazed at all you've been able to do while caring for your child with autism. Always remember that your father has led a long life and that YOUR needs have to come before his.

When you call 911, two trained workers will get on him on a stretcher and carry him out of the house and take him to the ER. If it's not a life or death emergency, they will take him to the hospital you request.

I didn't like the ambulance workers who came from our 911 so the last 3 times I needed to get my mother to the hospital, I called the ambulance company with the best reputation and asked for someone who has experience with frail and demented elderly.

Doublecheck with your insurance but my experience is that with a 90 year old, all trips to the hospital are covered... Impossible to get them there ourselves.

Would your dad be eligible for hospice? A nurse would come to house weekly (or more if needed) and they would provide an aide to help him bathe, etc.

Gidget's -- I hope you'll post the great information information about services available for Veterans themselves through the VA(as opposed to A&A which is for widows).

Information on teh VA's Medical Benefits program can be found here:

http://www4.va.gov/healtheligibility/

My Dad is enrolled in Priority Group 8, which pays the maximum deductible amounts. It used to be that any veteran, regardless of income, could apply and receive this level of benefits. This past summer, however, the VA has restricted access to Group 8 based on income. Medical expenses are deducted form income to determine income level for eligibility. There are a lot of different priority groups, having to do with service-related issues and I am not familiar with all of them.

Now that Dad is in Assited Living, his medical expenses have become significant enough that his income will be reduced and he'll be eligible for a higher priority group with little to no copays for his care. I'm pulling the paperwork together now so we can apply come Jan.1.

Redondo
I agree that you don't want to take him to the hospital unless very very necessary. My understanding is that having a stroke is one of those times when the sooner the help, the less debilitating the results...

Also, I suspect you already know much about the following, but just in case:
There's a wonderful elder lawyer in Boston named Harry Margolis. His web site has recently also had information about setting up trusts for special needs children.
There's a huge issue in that if they inherit money directly they may become ineligible for much needed government services. If you called his office (Margolis and Bloom), I'm certain he could connect you with a skilled special needs lawyer in your area.

Has his psychiatrist considered that anxiety or depression may be the reason he doesn't want to leave his house? That's pretty common in AD. A lot of people with AD say that they don't want to leave their homes, but end up loving adult daycare.

I don't know how far along your Dad is, but is he legally competent to be making these medical decisions? I can understand not wanting to have him spend his last years in a hospital, but that's quite different than taking him to the ER for a stroke or to a primary care doctor a few times a year.
Depending on the type of stoke he has, if treatment is given soon enough, he could be spared from the debilitating effects of a stroke, making it more of a quality of life issue than a life-prolonging measure. Strokes evolve, so the picture you see when he is first on the ground really can't be the determining factor of whether it's a major stroke or not.

Just my two cents

redondo, I'd contact a couple of hospice providers directly, if I were you, and ask them to do an assessment. Most doctors are not aware that the "rules" for accepting AD patients are different from those for patients suffering from other disorders. And different hospice providers have different rules, too. It couldn't hurt to ask.

It is strange that your dad is worse after eating. Do talk with the doctor about that.

Aid &Attendance is for veterans as well as surviving spouses. For information on finding financial assistance -- Federal, State and local -- for which your loved one may be eligible, see:

http://alzheimers.boomja.com/F...-Patients-27301.html