stage and progression

bahurff

My first time here. My DH (87) was recently diagnosed with ALZ…no surprise. His memory has been off for a few years now, surprised I didn't realized something was wrong earlier….well, that's in the past. Doctor seem very vague, I guess everyone progressed differently with this. To me its seems his mind/memory is somewhat stable. It's his physical, that has me hoping for more clarity. Physically things have been going downhill quickly this last month, his loss of bowel and urine control and now difficulty swallowing water….because of this he is not eating much, weight loss, doesn't want to leave the house and is mentally down. Obviously, he is tired and weak.

Some questions:

Is this normal to be somewhat mentally stable but physically fall apart so quickly?

Is there anything they can do to help the bowel and swallowing situation?

I have to ask….this physical disconnect, when does this normally happen in the course of the disease?

Any experience or advise with this would help.

Thank you

jfkoc

Unfortunately all possible symptoms are normal and there is not rule about when they occur or which ones our loved ones will have.

All a caregiver can do is make certain the diagnosis follows current protocol, all things treatable are ruled out. Additionally that legal and financial matters are seen to.

After all of that the caregivers job is to educate themselves….dementia 101. It is that education that can make "the journey" smoother.

There is a lot of 101 on line..many books and we are here 24/7 to lean on.

-Judith

M1

Welcome to the forum. Incontinence and swallowing problems are late stage symptoms- 6 edging into 7. The weight loss is worrisome and very hard to reverse.

He would probably qualify for hospice, have you thought about asking for an evaluation? You don't need a doctor's order and can call yourself. They can provide quite a bit of help and make things easier for both of you-

midge333

I agree that hospice is very reasonable at this point. However, given his age and sudden physical decline, I wonder if he has another undiagnosed disease such as cancer. He should be seen by his PCP as soon as possible.

Quilting brings calm

If he can swallow other items, there is a thickener that you can buy for water. Ask a pharmacist where they keep it. If he can’t swallow other items, then you need to find out why. Some things can be fixed, but others can’t. Even if it CAN be fixed, it might be too hard on him to do so. Even the simplest fix ( stretching the esophagus) involves an endoscopy and twilight sedation.

harshedbuzz

Hi and welcome. I am sorry for your reason to be here but pleased you found this place.

Most forms of dementia follow a fairly standard progression in terms cognitive and physical symptoms but there is some variation. Sometimes a PWD will straddle stages having symptoms for 2 or even 3 stages at once. But this seems extreme; if he hasn't had a full workup for dementia, that may be a prudent if possible.

Bowel incontinence is typically a later stage symptom, unless caused by something like prostate issues, by which time the PWD would present as quite confused. Swallowing difficulties are an emergency and should be investigated on an urgent basis. It would be highly unusual for a PWD to seem OK at this point. When you say his memory is "somewhat stable" does this apply to short term memory or just from his distant past. Memory seems to be LIFO, so in dementia folks tend to recall childhood better than yesterday.

This is a staging tool—
https://static1.squarespace.com/static/6372d16ea4e02c7ce64425b7/t/63f7b80d80d8aa3e3aa4a47d/1677178894184/DBAT.pdf