Steep cognitive decline after loss of son

[MathsMum3]

My mother is 88 and has lived alone since my father died 30 years ago. She has never been interested in forming another relationship. My brother and I have always had a good relationship with her, visiting regularly and helping out as and when necessary.

She coped really well throughout her 60's and 70's, had a reasonable social life, got on with neighbours, and continued to drive. Her physical health has always been good for her age, but I noticed a cognitive decline starting about 5 years ago. She became more anxious and less decisive about things, and generally required more support, but was still living completely independently.

I've become concerned more recently (last 1-2 years) because of her loss of vocabulary. She absolutley knows what she wants to say, but can't remember the word for something, so she'll say for example "I've got to go to that big place (supermarket) tomorrow", or "I can't find the red thing (phone)". She also has a very short supply of adjectives - she uses "heavy" a lot to mean big, serious, bad, long etc., and "quiet" to mean small, good, and short. It's usually possible to work out what she means from context, and I've taken comfort from the fact that her memory for names and past events has been very good.

However, there has been a massive decline over the past 2 weeks since my brother sadly passed after being diagnosed with cancer a year ago. Her conversation is now almost impossible to decipher. For example, she'll say something like "The heavy thing behind the frame doesn't have light anymore" to mean "The TV isn't working". I can't really do it justice, but it's very disturbing as it goes on and on. Plus, I was talking to her the other day about my father's sister who she hasn't seen for about 4 years, but who she was extremely close to when Dad was alive, but she had no idea who I was talking about! She just couldn't remember her at all. Very concerning.

So, I have 2 questions I hope you Mumsnet guys can help with.

1. What do you think of the general loss of vocabulary, with no other obvious cognitive decline? Is it a sign of dementia? Has anyone else observed this in their parents?
2. Do you think the very recent worsening of the situation is due to the stress and emotional trauma caused by her son passing, in which case might it improve as things settle? Or do you think it's a more fundamental decline?

Many thanks for any advice or shared experiences.

I'm afraid it it does sounds very much like dementia, OP. Regarding your second question, I have only limited direct experience and am not qualified to comment, but my impression is that cognitive decline in old age tends to get worse rather than better. She may well need more support in the near future and as time goes on.

Speak to her GP and ask for a referral to memory clinic and blood tests , recently gone through similar with my mum and part of the issue was very low Vitamin B12 - she had that stabilised and then a memory nurse came to assess at home and she scored ok but they have arranged for her to have a brain scan to reassure nothing sinister going on and just normal age related decline

I’m so sorry for your loss.
Yes this can be a sign of dementia in some cases. The deterioration could well be grief but it might be unsure how much she can bounce back. Has she seen her GP?

Sorry to hear about your mum op.

i think a bereavement can have serious cognitive effects. Whilst my own mum is not at the same stage as yours, and is much younger at 73, she has definitely had memory issues over the past year since my dad died very unexpectedly. She will freely admit it herself.

She said she’d googled as she was worried she was getting dementia but found info talking about ‘widow brain’, which seemed to reassure her. It’s not as bad as you describe but it’s almost like her brain can’t hold too much info at once. She forgets things like appointments, or made a mix up with some banking stuff. Nothing major but a definite change, things she wouldn’t have made mistakes with before. She is hopeful that it will settle.

So in your case unfortunately it does sound more like dementia but I’m sure a bereavement can make it worse.

This is precisely how my grandma's (vascular) dementia presented - including going sharply downhill quickly after a loss (in her case, her sister). The losing words (and using words in odd, adjacent ways) is called aphasia, and can be a symptom of various things, so not just dementia. In the case of my grandma, she did not get better or 'go back' to her previous state, but I'm not a doctor and that's not to say your mum won't. But you should absolutely be getting her to a doctor for a referral to the memory clinic as soon as you can - if it is dementia, then you'll want a diagnosis to allow you to sort things out a bit easier. Another thing to check is that she's otherwise well - UTIs can do some crazy things to the brain.

Do you have power of attorney for her? It sounds like perhaps you might struggle to get a solicitor to agree she has the capacity to give it you now, but it's worth looking at just in case - will make things a lot easier for you if she does have dementia.

Sorry for your loss OP. I'm sadly in a similar situation. We lost my sister, quite traumatically, and a year later, dad's cognitive decline took a turn. He had some very strange experiences when he had a UTI (hearing things, strange behaviour etc) and after getting checked out in a&e and a CT scan, he was referred to memory clinc. He was diagnosed with early stage vascular dementia. He also had a lot of the symptoms you describe so I'd def encourage you to arrange an appt with your Mum's gp and request a referral to memory clinic. There are some can be done to help slow the decline, but if it is dementia, it's inevitable I'm afraid that she'll will.

So sorry you're dealing with this on top of your grief, it's really not easy but your mum will very likely need some extra support going forwards, and the earlier you have it place the better. It hit me really hard, so please look after yourself and find some support for yourself too. Dementia UK and Altzeimers Society are very good sources of info and support.

Thank you. Not seen the doctor recently. I was planning to go with her in a couple of weeks when things are more settled after the funeral. Hopefully they will do some tests as another PP suggested.

I would say she has quite severe dementia and has done for a long time - she needs to see a GP asap.

I agree it’s likely worsened by the stress and things like UTIs also impact people quite severely as they age. Is she still cooking etc at home?? I’m wondering if she’s safe to do so. Is there any risk of her leaving gas on for example? Lots of Luck to you. So sorry for your loss xx

This is helpful, thank you.
I will get a GP appointment as soon as I can, and ask about memory and other tests. Luckily, we got a PoA sorted a few years ago, so that's sorted.

I guess it's taken me suprise because in many ways she's so capable. She's fully mobile, cooks, cleans, and her personal care is excellent.

Thank you.
Yes, she cooks and cleans at home, and her personal care is excellent. I'm pretty sure she's safe with gas etc. She's always been a bit OCD so checks things like that.

The trouble is if her memory stops her from remembering to check. If it's been a rapid decline over the last couple of weeks, it might be that she needs someone staying with her or a needs assessment at home.

It is really hard to see it sometimes when you're really close and they've always been so capable. I was putting some window film up for dad, using a hairdryer to make it taut, and before I knew, he'd gone and got a hot air gun (400 degrees hot!) and started to "help me". It was quite a wake up call, but I soon did a clean sweep of the house for any dangerous tools.

Please do speak to a gp as soon as you can, incase things carry on in the same trajectory. It may also be a uti or something, so important to check that out too.

And I hope you've got lots of support around you too. It's still early days really of your brother passing, so take good care of yourself.

A occupational therapist can do a home assessment to gauge any degree of risk. I would think she would need an urgent assessment.
So worrying. Take care

I am sorry to hear about your brother. It must have been a shock for both you and your mother.

It does sound like dementia, and dementia only tends to go one way unfortunately, so I would expect your mother to decline further.

My mother had Alzheimers and she exhibited the form of speech you mention when she moved to a care home. She would say something like "there's a thing in my room where I can see another thing I like" (view, from the window). Her speech was only intelligible because I could guess what she meant. My mother was at this point fully mobile, but she was no longer capable of living independently.

You say she can still cook, do housework, have a bath/shower - have seen her doing all this yourself recently? My mother believed she was still doing all her daily tasks successfully, but she wasn't. But that was only apparent when her neighbours found her setting fire to food under the grill. So if you can, I'd do some covert supervision.

Just to let you know that in terms of a diagnosis, the process (if you're in England) goes - GP, memory clinic, MRI scan. Do you think she would tolerate that?