Rapid Decline w/out diagnosis

hiitsjenna

Rapid Decline w/no diagnosis (prior TBI)

Hi, all-

Approximately 5 years ago, my (now) 63 year old father was involved in a car accident and suffered a TBI and spinal injury. He underwent surgery for the spinal injury, and the TBI did not immediately seem to cause any significant cognitive issues. He was able to return to work (as an independent owner/operator of a box truck, working alongside my husband) after a few months, and up until 6 months ago, he had continued to work without issues or concern.

About 9 months ago, he started to present differently - slight confusion (he would order food at a takeout counter and stand there afterwards, rather than move to the pick up spot), some impulsive/erratic behavior driving (which led to us taking his vehicle away), an almost obsessive fixation with being near my mom at all times (he would follow her around the backyard, or from room to room), OCD-like behavior (insisting on taking a half-full trash bag outside to the barrel). 

Over the past 4 or so months he has very rapidly declined. He will ask the same questions 10+ times although he recognizes that he already asked you the question; it's almost OCD-like where he can't help himself from asking, although he knows he already did. He has started to constantly try and leave the house, even in the middle of the night; it's almost like he gets obsessed with going somewhere (yesterday was a nearby donut shop) and can't get it out of his head until he gets it done. The way he walks has changed: hunched over slightly and always reaching out to hold onto something along the way. 

He does not seem to have any true memory loss, and does well on cognitive testing. He can still do math equations in his head that I would need a calculator for. He has had multiple MRI's and other tests and, 9 months later, we still have no official diagnosis of anything other than blaming the TBI. His doctors have mentioned possible dementia, but nothing official has been recorded at this point.

I am struggling, along with my siblings, and my mother, with the fact that this has so rapidly progressed to the point where we can't leave him home alone, and we are searching for ways to prevent him from escaping. In a matter of months, he went from working a full time physically demanding job to requiring a full time babysitter (for lack of a better word). Does anyone have experience with such a rapid progression, without any official diagnosis?

Marta

I’m sorry for what is happening to your father and your family. 

I want to encourage you to look at the situation differently. Your father does have a diagnosis-it is TBI.  TBI is the best established environmental risk factor for subsequent dementia. 

Have you let his physicians know about his rapid decline?  Whenever there is rapid decline it is recommended that the individual be examined for occult infection (eg UTI) or other treatable conditions. 

It sounds as though he may be headed for placement sooner rather than later, unless a treatable condition is responsible for this rapid decline. 

Marigold Starcrown

Get a brain scan or a brain x-ray.
Because that's probably going to be the only way that you can tell for sure what it really is.
Sorry to hear about your troubles.