Expert: Paula Damgaard - 12/28/2004

Question
My dad who is 80 years old has multi - infarct. He's awaiting a place in a nursing home but will end up in the pysch ward due to unstability of his mental state. He's almost 6 years into the disease but it's been over the past 2 months that his aggression has esculated. Upon speaking with is doctor, he finally admited that dad is not following "the pattern" and he's one of those rare cases. I tried telling them all this but they would never listen to me. I spend alot of time with dad in the hospital since Aug of this year when I had to commit him, knowing this man back to front and never having any issues with him. Why I don't know, it's a gift they say because I also deal with some of the other patients on dad's floor that the nurses can't. Can someone out there telling me about my dad's future since we are on this journey together and I'm the one who picks up the peices whenever there's a crisis. My mom is not much help because she can't cope with dad's illness so I've been doing all of the caring duties that can't be done by the nurses due to dad's untimely moods. They are playing with different types of drugs at this point in time but dad has some nasty side effects with loxipene and serequel but these seem to be the only ones that control dad if need be.

Thank you,

his daughter, Teresa

Answer
Dear Teresa,  I am not sure what your question is exactly, but I am guessing that you are wanting to know your father's prognosis.  

Multi infarct dementia is caused by little strokes occurring in the brain.  Sometimes they are restricted to one area and other times they are all over the brain.  The strokes cause the blood supply to be cut off to the area it hits.  This causes the brain cells in that area to die.  The best example of this is a person who has a big stroke on their left side of their brain then they are paralyzed on their whole right side, you see the people who can't use their arm or leg or both after a stroke.  With your dad, the strokes are hitting lots of areas, mostly in the memory and behavior areas.  Unfortunately, he is not alone in being unable to use the medications which we typically order for people with schizophrenia or other mental diseases.  They have a "mis wiring affect" where your dad has complete shut down of the wiring in that area.  The drugs help with the the people with mental illnesses straighten out the mis wiring, but they can't help with damage done by stroke.  

Your dad may continue along with this stage as is until he has a major stroke or if he also has Alzheimer's with his multi infarct dementia, he could continue with his Alzheimer's  and become totally demented, becoming infantile. Totally dependent for all his care.  

If you are able to redirect him and get him involved in other things it can help to change his moods.  I know this is hard but it is easier sometimes than putting up with side effects from drugs.  

His life span will depend on how aggressively you treat him for all diseases he can get.  For years pneumonia was the "old people's friend" but now with all the high powered antiboitics we have we keep people alive longer, which isn't necessarily a good thing when some one is dementing.  Your goal should be to give your father the best quality of life available.  Not necessiarily quantity of life.  So whenever you take your dad to the doctor ask him if this is for quality or quantity.  That is the best gift you can give your dad.

I hope this answers your question.  If not please feel free to ask again.  Good luck.  My thoughts are with you.  Paula