Uncertainty of Mixed Dementia

ShanaL

I live in Atlanta Ga caring for my mother with severe late stage ALZ. But I am concerned she may have Parkinson's Dementia and/or Lewy Body Dementia. Her anti depressant, anti psychiatric and mood stabilizer is still not lessening the physical aggression, paranoia, delusions and hallucinations. I'm being pushy with her healthcare provider to get a blood test, imaging scan done to better address the pin rolling tremor she's had in left hand since 2024, PT said her left arm/hand has decreased strength, her handwriting has turned into scribble scrabble more oval loops, she has hiccup like body jerks when she talks, the words try so hard to come out right and she's aware of it etc. How did you know your loved one didn't just have ALZ and what did you do about it?

persevere

Do you have hospice involved? If not you should seriously consider it. They have the ability to act quickly with meds and most of their patients have dementia so they see it more in my opinion.

H1235

Welcome. I’m not sure a more specific diagnosis is going to do anything to help. I think all the symptoms you are describing are listed in dbat for Alzheimer’s. Finding the right medication can be very difficult. If what she is on isn’t working I would push for different medication or an increase. I agree that it might be worth calling hospice. There are different rules for qualifying when dementia is involved.

DBAT.pdf

understanding-the-dementia-experience.pdf

April23

I agree, I don’t really see the advantage of a specific diagnosis, as in late stages, it’s not uncommon to have mixed dementia and the symptoms of each tend to look the same anyway. No medication will slow progression at this point. My dad has LBD but luckily he doesn’t suffer with any movement disorders or agitation. The diagnosis didn't change anything in terms of his care but did explain his extreme sensitivity to medication (among other things) and provided me with the knowledge on which ones to avoid.

I would not put her through additional testing but instead focus on adjusting her medication to make her comfortable. It can be tricky to get the medication just right and it often takes time for it to work. If she does have LBD, certain anti-psychotics are to be avoided.

harshedbuzz

Normally I wouldn't push for a specific diagnosis this late in the game, but there are meds specifically for LBD which might be appropriate here.

Another concern I would have would be the "hiccup movement" you are describing. Does it sound like tardive dyskinesia to you? She might need to come off the atypical antipsychotic.

https://my.clevelandclinic.org/health/diseases/6125-tardive-dyskinesia

If you're not seeing a geriatric psychiatrist, it might be a good option in your mom's situation.

HB