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Q: disoriented and confused
asked by: Cutwolf on February 18th, 2007
New User
Today I found out some worrying news about my 74 year old grandmother. She lives in a rest home and is pretty active, extremely intelligent, has never shown any serious symptoms of any major disease (she does monitor her blood sugar, but I do not think she is diabetic). She also has relatively poor vision.



However, over the past 12 hours or so:

- the home staff found her in the dining room (the dining room is closed today) sitting for 4-5 hours. She said she had thought there was a valentine's day party (the party was wednesday)

- when my uncle went to visit her, she was sitting in just her shirt and depends. Thats not something my grandma typically does.



- she said she going to see a play tonight at 7. My mom called her 10 minutes later and my grandmother said it was at 4. Then a few minutes later she said she wasn't really sure but thinks it was at 7 (it turned out to be 4). Keep in mind my grandmother is the most punctual and organized person I know. I've never seen her late for anything.



- she talks to us on aol instant messenger. She was talking to my mom on there and she was understanding the convo, as her responses made sense and she did make a joke of the sort we've become accustomed to from her (my mom said she thought my grandmother should be checked and my grandmother responded, "like plaid?"). However, her typing was very poor (strange variations of capital and lowercase) and her spelling was off too. Some words almost looked as if she was spelling phonetically as opposed to the real way. This is uncharacteristic as friday (the last time I talked to her on aim) her typing was perfect and her spelling was as well. She also used words shes always used (for example, she always says noshed instead of nibbled). When my mom asked her if she had any of her vd candy left, she said "i noshed on 95" (we're pretty sure she meant 95%). She also mentioned that vince (my uncle) stopped by, so she is aware and understanding of things.



- when my mom called her, my mom said she sounded pretty bad (slurred speech, one word answers). However, she did say that she wasn't having trouble moving and didn't have a headache or anything.



- when my uncle came to take her to the hospital, she didn't let him in. He got security to let him in and she claimed that she had asked repeatedly "who is it?" and no one answered. She is very disoriented.



- sometime either during the trip to the hospital or at the hospital (not sure), she soiled herself.




Shes in the hospital having tests run, but i'm just trying to get a feel for what else it could be besides a stroke.

Any ideas? Am I off on the stroke diagnosis? Whats throwing me off is the fact she has no headaches or weakness or paralysis.



I know I know let the doctors run their tests but i'd like some hypothesis as well.
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Cutwolf
replied on February 18th, 2007
New User
A couple new things:

- the doctors asked her for a urine sample and gave her the container. She went into the bathroom, came out, and said she did it. The doctors went into the bathroom to retrieve the bottle and it was still closed and everything. When the doctors mentioned this to her, my grandmother said "it must have been a different bottle" but there were no other bottles.

- my grandmother asked the nurse "when are you springin' me outta here?" (as I said before, shes still herself but not herself...Its very hard to describe. Thats a joke shed normally make). Then she somehow brought up that they'd been there for an hour already, but in reality they've been there 3.5 hours.

Its really strange because her mind seems fine. Shes aware and responsive. She responds to requests, can carry on normal conversations, and has no paralysis.

Yet, it is almost as if shes going through actions in her head that she means to go through with in person (like when she claimed she said "who is it?" at the door but never did) but actually doesn't. However, her mind tells her that she did go through them. Does that make sense?
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Cutwolf
replied on February 19th, 2007
New User
The doctor said a bunch of things wrong with her but he went so fast my uncle only had time to catch a few.

- dehydration
- low electrolytes
- something was 400 that was supposed to be 200 but he didn't catch what it was (any idea?)


also, they kept having her take a urine sample and she kept going in and coming out with no sample. Then she went in there and stayed in for like 25 minutes and wouldn't let the doctors in. They let themselves in and she had went all over herself.

Can severe dehydration do all this to an elderly woman?
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Cutwolf
replied on February 19th, 2007
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The Drs first said they thought it was a mini stroke and were going to do another EKG. Then they found bacteria in her blood from a urinary tract infection that spread. They're treating that and said that should fix everything.
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mominashoe
replied on March 25th, 2008
Moderator
It seems like your grandmother is showing signs of dementia/Alzheimer's so I am copying the topic over there in case you need more support.
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CarolDiane
replied on March 29th, 2008
Extremely eHealthy
You last question you posted was: "Can severe dehydration do all this to an elderly woman? " The answer would have to be yes. When your electrolytes are low and off balance it affects everything going on inside you brain. Your hindsight, memory, hillusinations and much more. After reading both your posts, it's sound like she has alot going one. The "rule out" phase can be long and tormenting. It can take days, months and sometimes years. Did you know that the only real way to diagnose Alzhiemers Desease is after death. It can not be anything performed while the brain is still functioning. The medical proffession has to be very careful when diagnosing Alzhiemers. That is why you hear so much more about "Dementia". Dementia is so much more common in the elderly and is more or less an every day thing. There are three stages of Alzhiemers. Begining is the slight memory loss. Second stage is complete memory loss not ever recognizing your own son or daughter. Third stage is when the anger and combativeness comes to play. The patient actually looses their sense of any reality to the point of total aggressiveness. Third stage patients are capable of harm.
All three stages need to come into play when diagnosing the patient. This could take years.
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jcottle11
replied on May 31st, 2008
New User
To Cutwolf
Okay, acute changes in cognition in the elderly are most often attributed to a urinary tract infection. By contrast, Alzheimer's disease and similar neurodegenerative diseases that affect cognition have an insidious onset and it takes several years for symptoms to become pronounced.

She will be fine once the UTI is resolved.

Best regards,

J Cottle, MD
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