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HIs dementia could have been getting progressively worse, just not noticeably to you, until it was.
In any case, the doctors should be figuring this out. And in his current condition, it sounds like he will be unsafe to return home. He can not stay indefinitely in rehab, but can be transferred to a skilled nursing facility for long term care, if he doesn't improve.
For instance, my Mom could no longer walk and talk. It took all her concentration to walk...she could listen, but forcing her brain to think of the words then voice them, required her to stop, voice her words, then walk again.
I'm glad you are noticing....look past the dementia to figure out what is interfering with brain concentration and try and take care of it. As you alleviate one issue after another, the brain will be less distracted and the dementia will be less noticeable. (and the lack of sleep...yes, that is an issue. However, try to find out why his sleep is interrupted. Is there pain somewhere? Does he think he has to urinate? Is he hungry? Is he thirsty?)
scans due to his age and status. We have been in facility for a year now and like many his condition has deteriorated but eats 3 meals a day and is fortunate to have private care
givers with him. Long answer but I do believe the fall speed up his overall dementia.
My dad also had Dementia, but it was a very slow decline and he fell many times too. It's difficult to know for sure, but it may be the location of a brain bleed that causes this.
My mother in law had mild dementia, injured her back, went into the hospital and was given pain meds. She hallucinated and afterwards her dementia rapidly progressed.
Does he still have a quality of life? Does it look like he will walk again? It could also be delirium from the hospital stay. The spinal fractures and obesity will be hard to heal.
One thing you can ask about is Wegovy or similar med to bring his weight down. After all he is a diabetic. My friend's sister was 350 lb. She is now in LTC but is using the med to help her move around and take pressure off staff to get her up. Another option is to also ask about a hospice consult.
Then later my Mom had another serious fall that included a second head trauma. She was sent to a rehab center where she stayed for a couple of weeks, then she moved into the center's skilled nursing facility. Within weeks of her fall, her mild dementia was now in later stage. She could no longer walk, nor recognize us on a regular basis. She now needed a village to care for her.
I, too, was amazed at how quickly everything transpired. There were times where Mom's brain would loop to understanding some things. She thought she was in a motel in a town where her parents and siblings were living. I had to think of "therapeutic fibs" any time she asked to go visit her parents or siblings. Such as asking to see her parents, I would say "they are visiting the old country" and Mom would smile saying "that's nice".
And often it is a fall that will be the demise of a person as well.
Plus if he's hit his head in his falls, that could cause a brain bleed which isn't good either.
I'm sorry that you're going through this with your dad. Just enjoy whatever time you may have left with him.
I am afraid, with dementia, you have entered a no-man's-land of very few answers and a whole lot of questions, and it seems my pounding along on my keyboard every a.m. here amounts to a "who-knows?" more than anything else. Your best answer or your best guess will come from the neurologist seeing Dad at this time.
I wish you good luck.