Expert: Mary Gordon - 4/15/2009

Question
Good morning Mary, My father-in-law is in Stage 7 of Alzheimers Disease. He is still able to feed himself and swallowing is not a problem.  We had to call 911 twice in the past week as he had recurring fevers of 103 degrees. On both occasions, he was admitted, no infection was found, fever disappated and he was discharged within 2 days. Could these fevers be related to the progression of this disease?  He often complains of abdominal pain with these fevers, yet the C.T.'s, blood work, etc. show no obstructions, contusions, etc.  Would appreciate any cognitive advice u may have...Thanks, Mary & have a nice day!  Regards, Debbie

Answer
Hi Debbie,

Here is a good article on abdominal pain in the elderly
http://emedicine.medscape.com/article/776663-overview
The real problem is, the elderly just don't always display the symptoms or test results you'd expect, just as they react differently to medications than younger people. It can be very hard to diagnose just what the root cause is. A person with dementia has the added problem of not necessarily feeling sensations the way a normal person would, due to the neurological damage. They can't help you by accurately describing the pain, how long its been going on, what seems to make it better or worse etc. I'm surprised he can communicate enough to tell you his abdomen hurts - by the time my mother in law got to Stage 7, all we had to go on was behavior and external signs of illness. It was a lot of guesswork

What he is going through is not associated with his dementia - although the dementia certainly doesn't help when they are trying to figure out what is wrong with him. Fevers and abdominal pain are not part of AD.

Hope this helps. I know you and your family must be struggling to come to terms with the many issues that come with seeing a loved approaching the end of life. At what point do you consider palliative care, and call off the emergency trips to hospital ? If he did have some serious ailment, what would you want done about it? Very tough questions for anyone dealing with a loved one in later dementia.

Thinking of you.

Mary G.