Expert: Michalene Peticca - 9/22/2009

Question
I am the caregiver for a 81 year old friend, I am also the poa. he has been in and out of the hospital for the last two months and has been home with us for the last three weeks, before all of the hospitalization I cared for him for three years. The problem is for the last three weeks I have noticed a big change in him, he is often confusion or has hallucinations. I have had his doctors check his meds several times and they are not the cause. I have taken him to the er twice in the last three weeks and they can find nothing wrong with him.
I have searched the web and to me it seems like he has Alzheimer's or Dementia. did I mention he has parkinsons.
Do they normally check for Alzheimers or Dementia at the er or do i have to insist on the test?  

Answer
Hi Bonnie,

Thank you for writing.  I am sure this is a very challenging time.  I am so glad your friend has you to help him!

The key to your friend's recent decline is his diagnosis of Parkinson's disease.
Parkinson's disease is a Form of Dementia.  Dementia is a Broad category that also includes Alzheimer's disease.  (much like there are different forms of Cancer)

The doctors have been trying to determine his levels of brain chemicals and were wondering if his medications were causing these changes.  It sounds like it is not his medications.

Therefore, it perhaps can be a few other things:  a urinary tract infection (did they test his urine?), low potassium or dehydration.....or, unfortunately, a sharp decline from the Parkinson's disease.   It is not uncommon for a person afflicted with this disease to suddenly
decline.   

If you do not have it already, i would strongly encourage a daily multi-vitamin and LOTS of water to begin with over the next few days.   Of course, check with your friend's doctor to see if this is alright.  

Then, if no improvement occurs over the next week...i would strongly request an MRI or CT scan
(if your friend is able to be still for either) to determine if there has been any extensive brain changes (stroke, etc.)

I know you will help your friend the best you can.

Best Regards,
Michalene Peticca, MA