Sudden drastic deterioration

[Rattysparklebum]

DF 83 has Lewy Body dementia, probably in the moderate phase, still living at home with DM, can eat and use bathroom independently, meds have reduced the hallucinations and paranoia so although still confused some of the time is pretty calm and happy.

DF had a fall on Wednesday, got himself up and seemed ok but Thursday morning had a lot of lower back pain and couldn’t get up from an upright chair because of the pain, 111 sent an ambulance.

X-rays showed no fracture but DF was admitted due to no mobility and was seen next day (Friday) by mobility team who got him up and managed to walk nearly a metre, he was kept in another night so mobility team could continue to help him.

I have seen him today and it is like he has aged 20 years, cannot sit up in bed, cannot feed himself, hallucinating, shouting, aggressive to staff, refusing meds, he has no idea where he is and cannot recognise us.

Is this deterioration just down to not taking his meds or could there be something else causing this?

I”m going to ask for his meds to be given IV, is there anything else I can ask to be checked?

Insist they check for a urine infection. Very common cause of rapid deterioration.

My DF had Lewy Bodies so I know all the stages and how quick deterioration can happen. I also thought about a UTI as they had this effect on Dad. However we did notice that after each of these and other events he would improve relatively quickly but never quite get back to where he was. My heart goes out to you and your family as LBD is very difficult to deal with 💕

I would wonder if he is suffering from delirium? My mum who has an undiagnosed (appointment soon) form of dementia suffered really badly with delirium in a recent hospital stay for pneumonia. It really aged her and she went down hill very quickly. The good news is three months on she has improved a HUGE amount which initially didn't seem possible. I think it affects 50% of people who already have an underlying memory condition as opposed to 20% of the general older population who are hospitalised.

I second the uti test. Not an expert but have some experience, but maybe the lower back pain could be kidney pain if it is a uti? The physical deterioration is concerning, but if not uti the deterioration of symptoms is more likely to be from missing meds surely? If there was a gap between his meds at home and the ones administered in hospital/if timings changed he may need a couple of days to settle down

THIS!! 3 weeks ago I'd have to leave meetings to hear my dad say "i'm not going to make it this time" to now, asking if I can get him to Twickenham to watch the rugby... he's got quite advanced Parkinson's but UTI with constipation absolutely rinsed him.

Thanks everyone, they were going to do a urine test and a chest x-ray but because he wouldn’t cooperate neither has been done.

Delirium screen.