Cognitive Impairment Changes

darjeeling60 · August 9

Hi. This is my first post. It's been two years since I noticed significant changes with my DH. He is 79; I am 66. I am in great health. We've been together 37 years so I recognize what is normal with him. He has been diagnosed with MCI (Nov 2024 even though I noticed changes four years ago), but significant changes after his CABG surgery. Vascular dementia makes sense. The short-term memory loss is significant. We can discuss dinner for the next evening and he will have forgotten it before breakfast. How many stories can he repeat to me. I count to 10 often. My DH had MRI with loss of brain tissue and had 23/30 MoCa. He is taking Namenda and ZoLfot. He's an intelligent guy — one of the many reasons I decided to spend my life with him.

However, something has changed this week. It seems I can't do anything right and he's into name calling. I plan to contact his doctor tomorrow to report the change. My guess is we're in stage 3-4. I don't know. I need to find resources. DH is able to drive a short distance to the gym and is independent with no problem with DLA.

All legal documents are in place and I handle all finances.

Thanks. M

trottingalong · August 10

I think you are further along in this journey than you may think. I think we are in a similar place, although to date, my husbands level of irritation has been minimal. I put my husband in early stage 5 with some crossover to late stage 5. I’m sorry to say your husband should not be driving. It’s not only getting lost. It’s slow reaction time. If he were in an accident and has medical diagnosis he most likely will not be covered. My husband got into his truck one day and asked me how to roll a window down. Check out this link and see where you may fall. https://static1.squarespace.com/static/6372d16ea4e02c7ce64425b7/t/63f7b80d80d8aa3e3aa4a47d/1677178894184/DBAT.pdf
I turned 70 today. My husband is 82. Like you, I am in great health and I’m thankful I am.

trottingalong · August 10

https://alzconnected.org/discussion/76793/cognitive-impairment-changes

https://www.tamcummings.com/tools

Try this link

BPS · August 10

learn what you can and more importantly do what you can while you can. Go have fun enjoy what you still have. I am sorry to say it will only get worse so make good memories wile you can. There may come a day when you can't remember any good times but I here and hope that the good memories come back. You will get tired of living in dementia land but I believe we can all come out of this with something I just don't what right now. It sounds like you are doing the right things with you documents and care. He may go through many changes. My wife went form caring to accusing, from loving me to not loving me and back again. Come here vent ask questions and get to know some of these people they are very helpful. I have not done enough of that my self because I think my situation is different. In reality all our situations are different but the same. Learn from their experience. I don't have any good advise but I understand.

May God be with you.

Biggles · August 10

Happy birthday Trottingalong I hope it was recognised, 70 is great, same as my younger sister. I didn’t really take much notice of birthdays but now I respectfully do. I am turning 77 in November.

MariaN26 · August 10

https://alzconnected.org/discussion/comment/279519#Comment_279519

I agree with you that he should not be driving. My DH got his diagnosis of Alzheimer’s Dementia 2 years ago. He was Stage 3 and was no longer able to drive due to slow reaction time and anxiety when in the car. Places were starting to not look familiar to him.

MariaN26 · August 10

https://alzconnected.org/discussion/comment/279521#Comment_279521

https://alzconnected.org/discussion/76793/cognitive-impairment-changes

Hi. The more recent things your husband is doing sounds like my husband. He was diagnosed two years ago with Alzheimer’s Dementia. He was stage 3-4 at that time. He has moved into stage 5 and has become more agitated and argumentative. He has started calling me names and muttering meanly under his breath when I ask him to do something. He has become restless and fidgets a lot. They started him in escitalopram and donaprezil to help with his anxiety, aggressive attitude and restlessness. It has helped but we are probably going to have to up the dosage because the symptoms are starting to get worse again. He also has a lot of problems in the evening when his symptoms seem to intensify.

annie51 · August 10

I agree with what @BPS said: learn what you can and more importantly do what you can while you can. Go have fun enjoy what you still have. This is the time to do both of those things. My DH and I traveled quite a bit while it was still enjoyable for both of us and I’m so grateful we did. There will come a time where it’s more stressful than fun to do the things you like.
This is also a good time to read up. Start with 36 Hour Day if you haven’t already read it. That is the gold standard read. Other books I read were, Did I Remember to Tell You and Thoughtful Dementia Care. You won’t remember everything but I made notes or bookmarked on my Kindle certain things for later. Videos by Teepa Snow, Tam Cummings, and Careblazers are also very helpful.

Counting to 10, deep breaths, leaving the room, all help you to keep your cool, so keep doing what you’re doing. You’re doing a lot of the right things. One more thing to add about the sudden change you noticed - UTI might be a possible cause. They often have none of the normal symptoms we think of with a UTI but can cause sudden personality and behavior changes. If you’re talking with the doctor you might mention this.

Come back here often as this site was my saving grace while I went through this. We’re pulling for you!

MariaN26 · August 10

https://alzconnected.org/discussion/comment/279521#Comment_279521

I agree with you. No one has all the answers or advice but just being able to share what we are feeling helps. This is not an easy journey for anyone and I too try to hang on to the good memories. My family and I try to make more memories with my DH but some times it is more difficult than others. This journey is a long one and groups like this will help us all get through it. I think one of the hardest things so far for me has been my once loving, kind husband have moments were he is calling me names and yelling at me for things I didn’t even do. Then moments later he is calm and does not remember any of it. Sometimes just having someone acknowledge what you are going through and understanding your pain helps.

MariaN26 · August 10

Everything you said is great advice. I have read 36 Hour Day and it has helped me a lot. My DH is in stage 5 and we are still able to travel and do things with our grandkids but it is starting to get harder. I think one of the hardest things is having patience when you are exhausted. I too try to count to 10 and just breathe. One of the things I have trouble with is feeling responsible when he upsets others in the family. I know I can’t control his words or actions but I can’t help feeling responsible to make it better. I keep thinking I should be able to see it coming and should be able to stop it before it happens. I know that isn’t always possible and I know they need to adjust to the changes like I have to. But still when they get upset with him I think it is my responsibility to make it alright.

harshedbuzz · August 10

@darjeeling60

Hi and welcome. I am very sorry for your reason to be here but pleased you found this place. My guess would be that your DH has a foot in early stage 5— it's where you would expect to see an uptick in accusations and irritability (often symptoms of anxiety/depression). So called "catastrophic reactions" start to be seen in mid-stage 5. He likely needs a medication adjustment.

FWIW, neurologists use a 3-stage model for dementia that is based off of available treatments. Here, we use a 7-stage model that focuses on aspects of behaviors, care needs and safety.

DBAT (1).pdf

It's likely that you have a much more accurate assessment of your DH current state of progression than any of his doctors for a number of reasons.

Doctors tend to see patients at their very best time of day whereas you see your LO's mood and abilities across a 24-hour/7 day period and would see things like sundowning and/or disordered sleep.

PWD, especially in the middle and early late-stages tend to showtime. This is when a PWD can temporarily get their act together and appear to be functioning at a significantly higher level than is their true baseline. My dad could showtime like there was an Oscar to be won.

MoCA is a quick and dirty instrument. A full neuropsych assessment, usually given over 2 days by a psychologist, would tease out a more accurate picture of what kind of dementia your DH has and stage of progression.

A very intelligent/well-educated person will come to dementia with a considerable amount of cognitive reserve. This likely showed up in the MoCA testing. My own dad was very bright and had a Masters. I was in the room when he had a MoCA given by his geriatric psychiatrist (I highly recommend for meds management) about 6 months before he died from complications of aspiration pneumonia. Dad showtimed unashamedly at this appointment— trading punchlines in Yiddish with his Israeli-born doctor. Dad was a lapsed Catholic so I was somewhat surprised. At the time dad was far enough along to be having falls and being unreliably continent. Dad scored a 24, as I recall. He had issues with word recall but zipped through serial subtraction by 7s at least as quickly as I can. He bragged the whole way back to the valet stand about how smart he was and how he was "off-the-charts". Then I turned my back to turn in my ticket and dad climbed into some random lady's car in the drop-off lane.

HB

brupt30 · August 10

https://alzconnected.org/discussion/comment/279541#Comment_279541

That's exactly the issue that I deal with all the time! I know that it is not my fault, but I am constantly trying to protect others from my DH's rants and mean-spirited comments.

LearningCurve · August 10

Whew. I can relate. My husband has been more highly agitated lately. He is outside working on a project today cursing VERY loudly, often. He is red faced stormy and just downright scary. I worry that the agitation will morph into something much bigger. I try to make myself scarce on his especially moody days. Today's outburst is primarily outside and has gone on for a few hours. I contemplated dialing 911 but we live in a fairly small town. My dogs and I really get shook up by all of this. Thankfully we are (dogs & I) using an Rx/OTC which seems to help a little. He is 73 (I'm a few years older). We have been married over 10 years. I have thought about leaving but my heart says no. He has Dr.'s appt in 2 weeks.

Cognitive Impairment Changes

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