Tuesday, January 8, 2013

What chemical causes dementia in patients with end stage liver disease?

Q. My friends mom has it and we are trying to figure out what the chemical was that causes it. The doctors said it but we don't remember. Real medical answers from people who actually know would be greatly appreciated.

A. High ammonia levels can cause confusion, forgetfulness, hallucinations, and can cause a person to even become belligerant and violent. They are just not themselves. This is a condition called encephalopathy.

The common drug used to treat this condition is Lactulose.

How many forms of Dementia are there and what might the causes be?
Q. We have an 87 grandmother that seems senile. She can be sweet to outsiders but acts like a 2 year old brat around us. She won't accept outside help and she has almost caused a house fire.

A. Early dementia

Often this phase is only apparent in hindsight. At the time it may be missed, or put down to old age or overwork. The onset of dementia is very gradual, and it is often impossible to identify the exact time it began. During the early phase of dementia, the person may:

Appear more apathetic, with less sparkle.
Lose interest in hobbies or activities.
Be unwilling to try new things.
Be unable to adapt to change.
Show poor judgement and make poor decisions.
Be slower to grasp complex ideas and take longer with routine jobs.
Blame others for âstealingâ lost items.
Become more self-centred and less concerned with others and their feelings.
Become more forgetful of details of recent events.
Be more likely to repeat themselves or lose the thread of their conversation.
Be more irritable or upset if they fail at something.
Have difficulty handling money.

Moderate dementia
During the âmoderateâ phase, the personâs problems are more apparent and disabling. They may:
Be very forgetful of recent events. Memory for the distant past seems better, but some details may be forgotten or confused.
Be confused regarding time and place.
Become lost if away from familiar surroundings.
Forget names of family or friends, or confuse one family member with another.
Forget saucepans and kettles on the stove. May leave gas unlit.
Wander around streets, perhaps at night, sometimes becoming lost.
Behave inappropriately - for example, going outdoors in their nightwear.
See or hear things that are not there.
Become very repetitive.
Be neglectful of hygiene or eating.
Become angry, upset or distressed through frustration.

Severe dementia
During this later stage of dementia, the person is severely disabled and needs total care. At this stage, the person may:
Be unable to remember - for even a few minutes - that they have had, for example, a meal.
Lose their ability to understand or use speech.
Be incontinent.
Show no recognition of friends and family.
Need help with eating, washing, bathing, using the toilet or dressing.
Fail to recognise everyday objects.
Be disturbed at night.
Be restless, perhaps looking for a long dead relative.
Be aggressive, especially when feeling threatened or closed in.
Have difficulty walking, eventually perhaps becoming confined to a wheelchair.
Have uncontrolled movements.
Immobility will become permanent and, in the final weeks or months, the person will be bedridden.

Remember
Some abilities remain, although many are lost, as the disease progresses. The person still keeps their sense of touch and hearing, and their ability to respond to emotion.

What can I do to with a dementia senior become more active instead of sitting around all day?
Q. She enjoys doing puzzles and on occassion we will do a puzzle. They family would like her to become more active instead of sitting on the couch watching TV all day. I am not good at coming up with clever ideas that would fit her needs. Any brainstroms on some activites would be most helpful.

A. Activities for Seniors with Memory Loss

Memory loss is a common problem that senior citizens suffer from. This is a very serious condition, and also painful for loved ones around the patient, as they tend to forget their family and friends. Alzheimer's disease and dementia are the extreme conditions of memory loss. Usually, doctors and caretakers focus on the basic necessities of senior citizens suffering from memory loss. However, many do not know that there are certain activities for seniors with Alzheimer's disease and dementia which may help them.

Scrapbook: Family members or caretakers of senior citizens suffering from memory loss should make a scrapbook by including several photographs of the person's life. One will have to go through the album regularly, talking about the story behind every picture, like where and when it was taken, etc. This may help the person in remembering past events, thus improving his/her memory.

Roll the Ball: One of the activities for seniors with dementia is to play ball roll. This can be played at a hospital which houses many dementia senior patients. Make all the senior people sit around a large table and ask them to roll the ball to each other. A caretaker can volunteer in this where when he says a name. That person gets the chance to roll the ball to someone else. This game helps in improving coordination in people who have dementia.

How can i compose a research problem -dementia patients having UTI which causes behavioral changes?
Q. Is this a correct research problem? - Is there a relationship between UTI of elderly patients with dementia and their behavioral changes such as agitation?

A. Nice choice (you can thank me later!). That is correct, dementia is a chronic problem. The occurrence in further agitation (if there is agitation present in the first place) at the time of UTI would be the study. You will need a certain number of agitated and nonagitated patients diagnosed with dementia for the study to be appropriate.

How do I get a person with dementia to agree to accept outside help?
Q. This person is my spouse. I can be available if I leave my job, but he will need to support me financially. Or I can keep working, but he will need to hire caregivers while I am out of the house. His doctors tell me I can no longer leave him home alone. His Power of attorney requires me to involve him in decision making as long as he is conscious.

A. You will just have to do what is best for him. He will never accept help on his own. Been there. As far as him being involved in decision making process there is no way. As this progress's he will not know where he is at and will have no Ideal how to make a decision. So sorry this is a terrible disease.




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