Need Insight--Sudden Progressive Dementia Symptoms

kg2021

Hi Everyone,

I am new to this message board have been reading all the posts for the last couple days. My family has been suddenly thrust into the dementia world with my grandmother.

My grandmother has a history of mini-strokes, or TIAs. In the last 12 months, she has had at least 3 TIA episodes. Over the last couple years, she has slowly lost vision in one eye, hearing in one ear, and more trouble with balance. However, after he last TIA in April, in what almost seems like overnight, my grandmother is completely not herself. She lives with my parents. She no longer really knows where she is, she wants to go home, is very combative, talks in nonsense, and can no longer wash herself. Each day seems to get worse. She has no formal diagnosis of dementia yet, despite my parents telling her doctor these worsening symptoms. I suspect she has Vascular Dementia. 

Last week, she broke a window in the middle of the night, and my father called 911, he had no idea what to do. She can not be left alone, my parents are stuck in the house with her. She has been to the ER 3 times in the last 2 weeks, they've checked for UTI, done cat scans and MRIs. My parents are completely overwhelmed with this sudden change. They are so busy taking care of her, they don't know what options they have. I now worry for the health of my parents. 

What can I do to help my parents in caring for my grandmother? I feel my grandmother needs to go to MC or AL sooner rather than later. Does Medicare help with this? My parents feel like she can't go to AL because its not something that we can afford, but there has to be options. My heart breaks for my family and I want to find resources for them and offer them hope. 

Thank you!

star26

Your parents sure do have their hands full and it’s a good thing they have you to help and look out for them. Here are few ideas: 

 

If you haven’t already, see if your grandmother qualifies for Medicaid. Specifically, Medicaid for institutional care, not just health insurance. (This is different from Medicare.) If she qualifies, Medicaid will pay for her care in a facility.  Medicaid will assess your grandmother’s income and assets to determine if she qualifies. Sometimes, assets (such as from the sale of a home) need to be spent on care before someone will qualify for Medicaid. If her income is too high to qualify, there are sometimes clever ways to get around that. An elder law attorney can help with that

 

Combativeness can often be helped with medication. A geriatric psychiatrist is the best doctor to handle this. Give the doctor all of the records: MRI, CT scans, lab work etc as these will help with diagnosis and treatment. Whether she stays at home or goes to MC, the combativeness will need to be treated. 

 

The local “Office on Aging” can also give you information on various community resources that may be available to help. For instance, bringing her to adult day care could give your parents a break and some daycares can also do showering.  

 

But even with resources and help, caring for a PWD at home is still a very big job and very stressful.  I’m glad you found this forum because there is a lot of help here for you and your family.  Keep an eye on this thread, as others will respond but it may take a few days.  

towhee

Type of Facility- It sounds like she needs memory care and not assisted living

How to Pay-Medicare does not pay for long term care. Medicaid pays for skilled care (nursing home) and sometimes AL and MC, it depends on the state. You have to meet eligibility requirements related to income, assets, and transfer of assets, but these requirements relate to your grandmother and not your parents. For a general overview you can google your state name with the tags- medicaid eligibility memory care gov- to find a state website with information. You can also google- state name medicaid memory care nolo- for a commercial legal site. It is very general info but a starting place.  

Diagnosis--Many MCs do not want to accept a person who is combative. Even if the doctor has not made a formal diagnosis has he prescribed dementia medications? She will probably need some medication for behavior, and if you cannot work with this doctor you need a specialist, a neurologist or geriatric psychiatrist, and probably a new PCP. Write down the behaviors and give the list to the doctor before the exam.

Approach-sometimes a different approach is helpful in behavior. Try reading article available for free online called "Understanding the Dementia Experience".