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My bedbound dad has experienced what I would consider a pretty quick recent decline. Prior to 4th of July weekend he was occasionally confused/disoriented/living in the past, but his baseline was forgetfulness and repetition. For the past month I’d say he’s disoriented/confused as baseline, with increasingly rarer periods of lucidity. He starts sentences and forgets he was talking. I have to remind him several times during a meal that he’s eating (and prior he was SHOVELING food in) and he’s increasingly unaware of my presence in the room. I know that there is a huge variation in dementia progression but does this sound within the range of typical? My brother is convinced he had a stroke or something we missed, but I’m with him so much that I don’t see how that could be. Any dementia-experienced caregivers care to weigh in? He gets severely agitated/aggressive with UTI and this is not presenting in that way, so I don’t think that is it (and surely after a month it should have gotten worse and prompted more medical needs, if that was what it was, right?)


ETA: I looked back and I posted previously about behavior change the week before the 4th of July, but right after I posted he got a NASTY upper respiratory virus, so I attributed his behavior change to getting sick. Could a virus have caused mental decline?

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Im a caregiver and work with dementia patients.. Sounds like he's having vascular strokes. Speak with the doctor and I would get palliative care involved or hospice. There are different levels of hospice. You don't have to be on your death bed. They reevaluate every 6 months. When I volunteered for a hospice organization there was a gentleman that was with hospice going on 2 years...ck it out
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When a person with dementia gets sick it can take a while to "recover" and they may never get back to what was the "baseline"
It is also possible that your dad has had mini strokes that have caused the decline. My Husband was diagnosed with Alzheimer's and I think he also had Vascular Dementia as well. There were times of a slow and steady decline then all of a sudden he would not be able to do something he had been able to do the day before.
SO it is a possibility that the 2 have caused this decline.
Is your dad on Hospice? They would be of tremendous help to you and dad.
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My dad's dementia was very stable for a long time but now changes very rapidly in weekly chunks it seems. It is possible he is having mini strokes, but it may just be the progression.

For the longest time I wanted to evaluate and understand and even diagnose from day to day... but the fact is that there were a lot of ups and downs...even hourly changes. If he doesn't have a UTI there isn't much you can do except accept what is.

I finally agreed to Hospice in May and he is in a good memory care. It has been helpful to have him around people who deal with this all the time and to stop trying to "fix" things... I highly recommend giving them a call. You don't have to commit to signing him into hospice/
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Don’t put the responsibility for making this decision on yourself- get a doctor or visiting nurse in to give you their opinion.

In some situations, previous symptoms for the same condition can be different, or symptoms that occurred for something several times can also show up in something new.

Sometimes changes can take a long time to appear, but also can appear relatively quickly.

Get another opinion. You’ll feel better for having done so.
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Carolann2244 Jul 2021
The visiting nurse clocked the change when she was here on Tuesday to change catheter (it’s been 2 months since she’s seen him, the other nurse did the end of June change) and agreed he seemed to be going downhill, but his vitals were great and she just said “That’s dementia, the only thing that’s predictable is it’s unpredictability.” I will call his doctor on Monday, he’s really great, and run everything through him and see what he wants to do. Thank you,
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I'll just add that every illness/incident contributes to a further 'step down' with dementia. A virus could indeed have helped your dad decline further with the dementia. The last bout of pneumonia caused my mother to take a huge step down with her dementia and necessitate placement into Memory Care from regular Assisted Living.

As far as strokes are concerned, he could be having them & you'd never know it. Only medical imaging would confirm that he's had strokes and not always then, either.

Best of luck with a difficult situation
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Carolann2244 Jul 2021
Thank you. I thought that strokes (other than TIA’s) were obvious, always, I didn’t realize he could have them in his sleep or without droopiness/paralysis or other outward manifestations.
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My experience is moms only signs of UTI is behavioral and cognitive decline like your explaining above - cannot focus enough to eat and swallow and a lot of almost non verbal and mute. Normally she is as you say eating way too fast - quick responses etc - she becomes severely delayed - not able to engage - eating and swallowing concentration affected as well as angry or behavioral issues and that’s it. She never has a fever - she never complains about burning pain or anything normal that a uti presents. So though I know others have said before that yes it can happen that quick - I have also experienced these similar behaviors only with UTI. It’s worth doing a urine sample as well as bloodwork/ electrolytes etc. best wishes
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Your Dad can be having mini strokes when he is sleeping.
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Carolann2244, as someone else had mentioned, it could be a Urinary Tract Infection [UTI]. It is surprising all the different reactions that a UTI can cause. This can be controlled when a doctor orders antibiotics.

If it isn't a UTI, has your Dad been placed on any new prescription meds? Could be a side effect from the med or the med is not playing well with the other meds your Dad is taking.
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There are a lot of medical reasons for a change in your father's mentation. Infection and illness do tend to top the list. Minor strokes can cause these changes. Poor oxygenation - like lung damage from smoking or COVID. There are psychological issues too like depression. The only way to know for sure is to have your dad evaluated and treated by a doctor. Many of the reasons I have stated above can be treated and improve his mental abilities. Sadly, waiting too long for some of the medical issues can lead to permanent problems.
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Carolann2244: Imho, since your father already has dementia, any additional illness is going to exacerbate his brain disease.
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