My fil has recently seen a neurologist. Mil was concerned that he had Parkinson’s. He has no tremor, but does have a shuffling gait and a terrible time getting up and down from sitting to standing. Lots of leg weakness. He is 82.
He has an MRI and is going back for a follow up on Monday. MRI showed no tumors or lesions, but he does have fluid. Some googling around has led me to believe (via Dr. Google) they are probably going to to tell him he has Normal Pressure Hyrdocepahlus - NPH. They have not yet told him a diagnosis - just that he had “fluid” show up on the MRI. They are supposed to discuss follow up treatment. Mil believes this is simply going to be PT to increase his leg strength. From what I have read the only treatment is to have a shunt placed. I don’t think they have any expectation of surgery, and I think they will be rather shocked. I’ve discussed with sil who plans to go to the appointment with them (we are several states away). I expect there may be PT afterwards, but that is not the primary treatment. I also anticipate (hope for) a spinal tap before they install the shunt.
I’m not a doctor (and don’t even play one on TV), but this is my best guess. So, I’m a bit ahead of myself. However, I just wondered if anyone has had experience with NPH and a shunt. It sounds like a straightforward procedure, but I do wonder/worry about is age of 82 and recovery. I also worry about the efficacy of the procedure, since he waited such a long time to see the neurologist. That’s why I’m hoping they do a spinal first, but that is yet another procedure.
Any experience with this, good or bad for someone his age? He is otherwise in good health, through I do know he unilaterally decided to stop taking his cholesterol medicine because he didn’t like how it made him feel.
Call me Dr. Google, as my research led to a correct diagnosis.
Fil will have a spinal tap next week to help determine if a shunt will be beneficial. He’ll have to lie completely still on for four hours after it’s over.
As I suspected, the Director of the assisted living and nursing director met with me today and want my mother hospitalized to stabilize and then she will go to a special unit for those with rapid cognitive decline for work up and detox. The AL will not allow any alcohol at all in her room. She fell again and when they got there she said she had gotten up herself, proudly, but she was still on the floor!
She had the runs today and wasn’t cleaning herself properly. She refuses help but I put her in the shower and soaped her myself. The aides are afraid of her. She is formidable!
Not sure I trust that the AL is going to let her back in. Her memory has gone SO fast, she falls, her hygiene is terrible and her heart failure test was not good.
I feel oddly guilty. I have been cooperating with the wishes of the AL and communicating with them and may have given them ammunition, so to speak, though honestly everyone in the place is aware of the situation. And this unit might give us some answers and a trajectory of sorts.
Want to know more about “board and care” homes. Can’t find any in my area.
Sorry you need to deal with this change @compmom. From what you say, I don’t think the AL is able to meet her needs. What they are suggesting sounds reasonable and a good next step. It seems what she needs so don’t feel guilty. After a hospitalization, Medicare typically pays for up to 3 months in a rehab facility. I found our board and care home by googling “family care home” or “personal care home.”
@compmom My dad was sent to a psych facility that specialized in geriatrics. The social worker at the facility hooked me up with a lady that showed me different Memory Care options (no charge to the client, evidently they get their payment from the facilities). Evidently they do the same thing for Board and Care homes. Maybe there is a social worker at the hospital or psych facility that can refer you.
We are on the ER going through medical and psychiatric clearance and the Senior Adult Unit is saving a bed. My mother is not happy but I am trying to use humor. We have had the same conversation 25 times!!! Thank you for the encouragement and ideas. I honestly appreciate the possibility of having a social worker and care manager for a few days! I hope my mother Ian completely disoriented but we have no choice. Your posts help me feel we can make the best of it.
While there is always a risk of any surgery, as @GTalum said, if your dad has NPH, the shunt insertion is not that bad of a surgery, and the benefits on balance, ambulation, cognition and toileting (NPH patients can have urinary incontinence) can be life-changing.
For those with difficulty getting to the bathroom in time, the advantage men have is they can use a urinal bottle, so some can avoid wearing ‘briefs’ i.e. diapers during the day. However the pull up briefs are helpful to mimic more of the underwear/panty.
I was just talking about my former boss yesterday to a resident who had worked on the gov’t base he use to be in charge of (he was a Ret Major General; I worked for him at the University where he was Director of a Dept and I was Assoc Director) - and it turns out he died yesterday! He was 92 and had dementia for many years - at his wife’s funeral, he remembered me but he was pretty debilitated even then. Since I work 2nd shift, I can get to his funeral…
Best wishes on a good outcome for your dad @Hoggirl - interested to hear how things come out.
I am sure I will have a few stories to share with FIL/MIL (both 88 and not great health) make the trip from WI to CO by car in May for their grandson’s wedding…MIL is determined and somehow they rise to the occasion…
@jym626 - yes, that seems to be the case. I wish he (it’s my father-in-law, not my dad) would have gone a year ago, He simply attributed his issues to aging. I do hope he gets some relief. I fear he is going to start having falls soon if something doesn’t change. He refuses to use a cane.
What is your FIL’s age @Hoggirl and what are the reasons he doesn’t want to use a cane?
MIL had been resisting using a cane, but always holding on to things as she walked…then she started using the cane and then used it regularly. FIL is TERRIFIED of falling and always uses his rolling walker. However FIL doesn’t do an more walking than needed, and he could be doing more as PT.
I am hopeful that a shunt will provide enough improvement in his mobility that he wouldn’t need a cane. His biggest challenge right now is getting up and down from a seated position. He can do it, but he often has to push up with his hands, and he relies on using whatever is nearby. Fine at home where the stability of the furniture is known. I worry he will push off of something rickety. He doesn’t have a lot of leg strength. Very shuffle-y with his gait.
Still waiting on the spinal to be scheduled. I’m frustrated with mil. They could and would have done it this week, but she, one of her sisters, and my sil had a little trip planned. I think they should have canceled it. Instead of it being scheduled while they were in the neurologist’s office, now they have to wait for a call. Mil is much more active and outgoing than fil, just by her personality. She is fretting about having to rearrange her schedule, get subs for bridge, etc. I don’t know if it’s denial or selfishness.
Just fyi for others out there: the geriatric psych. unit is fantastic. *Though of course I have gotten the daily call from my mother to come get her out." I have visited twice a day and love the staff. The residents are supposed to stay out of their rooms and there is a cozy room where they color, do puzzles, and have activities in art, music, flower arranging etc. Dinner is cozy. The staff and MD are all focused on the patients and they ask one family member to call each day after 11 to get an update (but they do talk freely if I spend enough time on the ward and wait for them to come to me).
This is really making me think about the board and care model some of you have described.
They have my mother on Ativan so she doesn’t miss her alcohol and nicotine for now.
@compmom, since you have your mom at a place that seems to meet her (& your needs), sounds like a great place. Moving them from one place to another is disruptive and hard for them.
Yes, my parents stay out of their room and spend time in the living room and dining room. They do spend the day on puzzles, coloring, and music. But, they also spend a lot of the day not doing much because the staff is also cleaning, meal prepping, and attending to one-on-one needs if called for. Therefore, the structure wouldn’t be the same as a memory care or especially a psych unit. I am confident my parents get much more personal attention at their current board and care.
Mil is much more active and outgoing than fil, just by her personality. She is fretting about having to rearrange her schedule, get subs for bridge, etc. I don’t know if it’s denial or selfishness.