Dehydration or the start of dementia? So quick, so weird

[BreatheAndFocus]

Hi,
We’re having problems with DM (76yrs). She’s been absolutely until recently - energetic (walking for 1hr most days), always busy, chatty - but in the last two or three months there’s been a drastic change. She’s lost a lot of weight (due to not eating properly, we believe), is forgetful and sometimes disinterested in things. She can’t seem to organise tasks and got lost when driving (not driving now due to our concerns).She sits in front of the TV most of the day from what we can gather.

Recently, I stayed with her for a few days (she lives alone). One thing I noticed was that she wasn’t urinating all day (approx 12hrs). During this time she had two or three mugs of tea but didn’t pee. Isn’t that unusual? Does it mean she’s dehydrated? If so, could this prolonged dehydration be causing the forgetfulness and out of character behaviour?

She’s deteriorated physically too, apart from the weight loss. In the Summer she’d happily walk 5 miles with a stop for a packed lunch, but now she was almost shuffling and looked frail and feeble. But then, if she’s not eating, wouldn’t that be a possible cause?

At the beginning of Oct she was fine, now she’s struggling and so different 😞 Coincidently (or not), a volunteering thing she was doing ended around that time. Could that be connected? She used to have to get up to get ready and also prepared food for others and worked to a timetable. Now she lies in late and spends the day doing very little. Could she be depressed and missing the social interaction? But surely that wouldn’t make her confused?

Sorry to ramble on. It’s the speed of things that’s shocking. We’ve arranged a doctor visit for basic checks in the New Year, but I just wanted to ask if this sounds like dementia or if it’s ‘just’ a physical and mental deterioration due to lack of food and drink that can be reversed?

Any thoughts or comments welcome. I’m really worried. I spent most of Christmas looking at care options but I just wish I knew what’s causing this so I could help and could anticipate the future a bit.

UTI leapt out at me. Explains not weeing and the mental decline. Elderly people often have mental effects from UTIs.

Get her tested for a UTI. They are often silent in older folk and can result in dementia like behaviour.

UTI

I'd be looking at the possibility of a urinary tract infection. It's amazing how quickly people can go downhill when that is an issue. Getting the GP involved is a good thing, but in the meantime get a uti test kit from the chemist and see if that's a problem.

Another one suggesting a UTI. I had no idea how extreme the symptoms of confusion could be in older people until I saw it first hand with my in-laws.

Thank you both. Could she have had a UTI for weeks or would it have reached some kind of crisis before then? I’ll definitely get the doctor to test for that.

She’s not drinking enough either IMO. She turned down offers of extra drinks and also often leaves 1/3 of the mug undrunk.

Pressed too soon, there is a woman’s hour programme discussing this topic, it was on earlier this week, you can listen via the podcast

She needs to be checked for a UTI ASAP

Thank you! I didn’t know you could buy UTI test kits. I’m some distance away from her (hence me staying he few days) but I’m going to see what I can do,
possibly by speaking to her GP.

Don’t be fobbed off the by the UTI tropes. My mum was in this position, and also very fit and she was actually having a series of strokes. Her decline was shockingly fast and she had UTIs PLUS a heart problem, unknown to us. We of course just accepted the UTI explanation initially.

It may be that it hurts to pee because of a UTI, so she's trying not to drink so much and making it worse in the process. Key to avoiding UTIs is drinking plenty, so it's a bit of a vicious cycle...

Thank you everyone. I’ve just spoken to the doctor to arrange a urine test. Even if it’s not that, it looks like a sensible thing to check.

@FaiIureToLunch Mini strokes occurred to me too : / I haven’t seen any physical signs of that but I know TIAs can be symptom-free. It’s all such a worry and so sudden. She didn’t seem old at all, but now suddenly she does.

This was the story of my mum’s deterioration too, not quite as quick as yours but the same path over about 6 months.

GP referred her for tests but the waiting list was over a year (!) and about 6 months in she had a “funny turn” where she was awake but just not responding to me or DB. GP told us to take her to A&E to rule out stroke, long story short after the hospital investigated it turns out that mum has vascular changes in her brain that could be Lewy Body Dementia, could be Parkinson’s, apparently you can only tell definitively in a post mortem. She responded well to Parkinson’s meds as she’s not so stiff and shuffling in her gait but her cognitive decline has been ongoing.

You can ask for a social care assessment from her local authority if she needs help at home - mums was done as part of her hospital assessment and she’s at home with carers visiting 4x a day. She has to pay as her savings are over the limit, but as it’s care commissioned by the council it keeps them involved and ensures we get assessments from them. I found being “in the system” a help as at the start I was flailing about a bit not knowing where to turn.

Hopefully there’s a relatively simple explanation for your mums change but I’m afraid to say she’ll probably need you/family members to advocate for her and it can be a long and ongoing battle to get the treatment and/or support she may need. Has she done a Power of Attorney at all?

My mum was a bit like this, but slower decline. It was parkinsons. She seemed to morph into a frail old lady overnight

the history doesn’t fit with a UTI. This has been going on for months you’ve said. The weight loss is also concerning. I think a GP check and go from there, perhaps they’ll suggest some bloods/imaging

The Surgery phoned her but she didn’t answer her phone - despite me phoning her earlier and telling her she’d be getting a call and to keep her phone with her. I know it’s not her fault but it’s frustrating, especially as she sounded ok on the phone to me compared to previous days. They’re going to try to phone her again tomorrow.

Thank you for the further posts. I’m not sure about the weight loss but I think it’s a mix of confusion and that she can’t be bothered, rather than anything sinister. That is, her weight loss marries up with her reduced eating and drinking. I also think she’s lost organisational abilities so can’t plan meals or think ahead about what food to buy. She seems to have lost her appetite a bit too, but if she’s not eating well, then presumably her stomach has shrunk. Sometimes she seems to be able to think about food and plan a little, but other times not.

Having looked on here, Power of Attorney is top of my list of things to do, after I’ve got some initial medical input. Dementia is my fear 😔

My Mum has Parkinson's. With hindsight she'd had it for some time before diagnosis but the thing that the GP noticed was when shuffled rather than walked into the surgery - I noticed that you described your Mum as shuffling in your OP. She got back to her old self quite well, and had 8 or 10 good years on medication before declining again.

Thank you to the people who’ve mentioned Parkinson’s. That hadn’t occurred to me. I did know a relative with it but that was years ago and I don’t remember much about it, so I’m off to google.

Yes it was the weight loss that got me to take mum to the GP, she went from about 11 stone to 8 in a few months and it was because she wasn’t eating. A mixture of loss of appetite and cognitive changes meaning she’d forgotten how to work her microwave and oven. I’d been doing online shopping for her for months but she kept saying “yes” when I asked if she needed X and her cupboards were over full of tins and packets and expired food in the fridge, she just wasn’t managing it at all. The GP said to me quietly that mums stiffness and shuffling were making her think Parkinson’s, but as I said the waiting list for the consultant was over a year, which is ridiculous when you’re 82!

She doesn’t drink enough either, even with the carers making her drinks and that’s a lack of thirst and also slight incontinence issues meaning she wants to avoid accidents. We thought she had a UTI last month but it was clear but very concentrated, which was probably the cause of the smell and the increase in confusion due to dehydration.

@BreatheAndFocus i agree that getting PoA in place asap while she has capacity is your priority. I’d also get her to sign a letter to her GP saying she agrees to you speaking to any and all doctors on her behalf, because you may need that before PoA is done - others are reporting that it’s taking 6 months or so to get it registered.

OP Mumsnet is obsessed with UTIs being the cause of everything in the elderly.

Your mum needs to see her GP ASAP. It's not clear what is wrong but very clear that something is wrong.

Thank you very much for that advice @funnelfan I’ll get mum to sign a letter for the GP.

I think not knowing what’s causing this is most worrying. At least if we knew, we’d have something to work with, something to research. I’m hoping that my contact with the GP will start the ball rolling a bit.

Thank you @AnnaMagnani I’m keeping a totally open mind and just want to find the answer. Not knowing is stressful. If a UTI is ruled out then I’ll ask for further tests.

We had similar and it turned out to be a brain tumour - i sincerely hope that's not the case, but we all thought UTI and were so very wrong.

yes knowing what you’re up against is half the battle. This board is a gold mine of wisdom, I’m just paying forward the help I’ve had. Good luck to you and your mum.

Definitely get her checked for a UTI. My elderly Mum went quite doolally every time she got one. But once the anti-biotics kicked in she became lucid again.