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My 59yo husband with early onset Alzheimer's came down with a bad cold six days ago. He developed a cough; I contacted his doctor who had him tested; it was positive for covid. DH is on both covid and cough medications, along with his other meds that he takes for Alzheimer's. I have seen a significant decline in the past five days including but not limited to speech, hallucinations, and ADLs. His speech is now mostly gibberish, and his hallucinations are fully visible, i.e. stomping on non-existent bugs in front of me. I know that his sleep is disrupted, as mine is too, by the coughing (the cough meds don't seem to work as well as I had hoped for). While I have helped with most ADLs by now, toileting was not one that seemed to be an issue. However, I am finding used TP in the trash and there have been several accidents in the past few days.
While our conversations were not deep or plentiful, we could converse. I cannot understand most of what he says now and his actions have less reason than usual. An example, I laid his breakfast in front of him this morning and he handed it back to me and stood up. I asked what he needed and he said he wanted some food. I can put a drink by him and show him where it is and he will still get up to get a drink, leaving the refrigerator door open and the water running.
I know the decline will continue but this is so rapid I am hoping that he will regain most of what has been lost once he gets over this illness.

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I think you can't know the answer to this at this time.
Covid is infamous for brain fog, and should a person descend into long-covid then that fog can remain. And it seems to hit hard in the area of the brain that allows one to concentrate or focus on tasks with the mind wandering off in all directions, even on simple tasks. It takes focus away.
They are currently doing experimental studies now with some who are affected with ongoing "brain fog" that involves actually playing computer games, and with mindfulness training, to regain the ability to focus on things.
As with all things medical, any one person's reactions to these things is individual to that person as his own fingerprint. I think also that we know little about the new drug paxlovid, and whether it can/may react or interact with other medications. It simply hasn't been used long enough for any studies about interactions and reaction.
I assume you are measuring O2 saturation with the little finger monitor, so you are assured there is good oxygenation to the brain.
I am sorry to say I think this cannot be predicted. I wish you good luck and I hope you will update us and stay in close touch with the doctor regarding symptoms. Daily if you can.
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MarleysMom Feb 2023
Thank you, that is an excellent point about oxygen levels. His has been in a good range but I have not discussed with his neurologist. If brain fog is present then she may have other ideas about what we can do. The paxlovid seems to be working but I agree that the interactions could have issues, hoping the doctor would make that decision as he knows his meds. All the covid reactions seem very much an individual situation. I probably have it but for me it is a cold that is going away.
I don't have a lot of hope about returning to pre-covid levels since there are multiple things starting to happen and now seem accelerated. Eating is minimal and I am doing as much as I can to supplement. I just was hoping I was wrong.
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After an illness or any setback a person with dementia can decline. Sometimes there is a return to the pre incident baseline sometimes not. It is a wait and see what happens "game". Whenever my Husband got sick I would hope for the best but would be prepared for no return to his previous cognition.
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MarleysMom Feb 2023
Thank you. Not what I wanted to hear but what I expected. I think I asked because I was feeling a bit down and was hopeful for something different. I am trying to adjust my thoughts but it is hard. I get to a point of some acceptance and then this disease makes another change, requiring another adjustment. The plateaus are more like ledges at this point.
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Weirdly, my mother gained more clarity while she had Covid, but that didn't last.

I found that every medical or emotional crisis led to a noticable decline in Mom's cognition from which she recovered only partially or not at all. Her decline was not a gradual slope downward but rather a series of step-downs, then a levelling out until the next crisis.
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bluebell19 Feb 2023
When we had covid (and I think my MIL did too but the hospital never tested - she had a fall and broke a verterbra), she was the most alert and aware in the hospital than we had seen in years. She knew she wasn't going home and told us to find her somewhere good and asked about the finances. That was over 2 months ago and now she just repeats the same old phrases and some gibberish.
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You seem to be telling us of delerium which happens with acute illness. It increases mortality and yet it can slowly return to normal. However, with every illness, every hospitalization, and with reduction in ability to get out of bed and move, it is harsher on the elderly to recover. The classic graphic on chronic conditions and acute hospitalizations looks like a roller coaster with the peak never being able to be reached but enough recovery to gain some bodily abilities back...just not to normal. I hope this answers your question but you also need to look at how the future may be.
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MarleysMom Feb 2023
Thank you. I actually started getting MC options at the beginning of January because I figured it would be a little over a year before needed. Now I am concerned it may be sooner.
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I have not seen that happen, once on that downward slippery slope it seems to escalate quickly.

Hopefully your husband will be the exception.

So sorry that you are having to face this decline, keep posting it will help.
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MarleysMom Feb 2023
Thank you for your reply. I wish it was different, but doesn't everyone that gets in this situation?
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My 90 yo MIL had COVID in October. We too saw a clear and frightening decline in cognition, including mild hallucinations.

Four months later and she's recovered quite a bit. Not everything but maybe that would have been part of the natural decline anyway? I don't know.

Physical stress, whether from infection or emotional (death of a close friend) definitely impacts her cognitively. Keeping life as stress free as possible works best in our situation.
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MarleysMom Feb 2023
I am trying to be stress free for him. But I may have not done a good job with this situation due to lack of sleep. The cough is getting better so maybe we can get back to a better level. Just hard.
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I know personally of people who experienced cognitive decline after Covid. One was sharp as a tack, had no cognitive decline, and was managing various ventures very well including the home care of a spouse with physical issues. Had a mild case of Covid, and six weeks or a month afterward, brain fog set in. He has been studied for this and has now moved to assisted living due to cognitive issues. Another has migraines and has trouble focusing. Another says she feels well but she is exhausted most of the time though she led an active life before Covid. I know some people with dementia who died of Covid. And on and on. This is why we need to protect our LOs and ourselves the best we can during this pandemic. Which is still a pandemic, no matter who is trying to tell you it's just a cold.
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MarleysMom Feb 2023
I hear you. We are vaxed and boosted and are not out and about in large groups. But I don't think that matters anymore. I truly cannot figure out where we could have picked it up since we go out so rarely. We walk the dogs or take them to the dog park.
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MarleysMom;

Have you talked to his doctor about the fact that he's still coughing and the hallucinations?

Has he been tested for a UTI?

My mom had Vascular Dementia. But every infection, and illness set her back a bit.

I would get on the phone to the doc right now.

At some point, we made a decision to do only palliative care with my mom, no hospitals or ERs. But she was already in a NH, so there was lots of staff with medical training around, not at home.

Does your doc come to the home, or can he send a Nurse Practitioner?
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MarleysMom Feb 2023
I will talk with the doc about a UTI...it has crossed my mind. We went to his internist for the covid meds, so I may check with the neurologist for other considerations. Thank you.
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Does your husband have to take the medicine for COVID? I'm wondering if there is an interaction between the medicine he's taking for COVID with all the other medication.

Last year in May, my mother, nearly 100 years old, had covid. She has mild to moderate dementia. They moved her into isolation per protocol at the time. We did not do drugs. She couldn't understand why she was in isolation. Yes, she coughed more often. Her case was so mild that she just thought she came down with the flu. I didn't notice a change at all in her behavior, other than coughing and sleeping more.

Since you posted, 7 days have past. Hopefully, your husband is better or past the worst now.
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asfastas1can Feb 2023
I know that many people are afraid of the Covid vaccine and medications that help with Covid symptoms, for some reason Covid medications have,in this day and age, been a flash point for fear; but it is best to listen to and trust your doctors. I would hope that most doctors, like the ones we have for ourselves and for my 94-year-old mother, know the medications that we are on, and take their medicines and their physical and mental conditions into consideration when prescribing the medicines that help our loved ones, especially those that cannot help themselves.
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My husband had a brain tumor and my dad had vascular dementia. When my dad had yet to be diagnosed (but we knew he was in decline) he had to be hospitalized for an emergency surgery. He was not at all himself and it took weeks for him to recover mentally from the anesthesia. My husband had 2 different surgeries as his brain tumor progressed. After one surgery he developed a septic infection and was very ill. During that time he was hallucinating and couldn’t speak coherently. His neurosurgeon explained that his fever had “exposed”
the tumor. In other words, the part of his brain that normally compensated for his tumor was unable to function normally due to the fever. Once he recovered he was able to function again mentally. Have you been talking to your husband’s doctor about this? I would at least have a phone call and get some advice. Perhaps there is something they can do to help. Depending on the type of dementia it can progress fast. My father’s was vascular dementia and his would progressed in steps where he’d suddenly be worse. God bless you as you care for your husband. I understand what a hard job that is.
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MarleysMom Feb 2023
Thank you for your response. Delayed response due to my health (bronchitis that wore me down). I understand a bit of what you have dealt with. My 65yo sister has a brain tumor and I am her only support. Last year I moved her from out of state to my city when it was clear she could no longer be on her own or rely on friends that lived 20 min away. She is in IL which gives her autonomy but support. I still need to see her weekly but I see her decline as well, i.e. aphasia and maybe some dementia, FTD?
I talked with both neurologist and PCP and it was wait and see. Frankly I don't see doctors the same way, i.e. they can help with issues that are definitive but not much with ones that are different for each person. It is called a practice for a reason!
God bless you in your journey.
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