Questions in the Mental Health Forum have been answered by Roger L. Gould, M.D., affiliated with U.C.L.A. and by doctors from Henry Ford Health System.

Question Title: Multi-infarct Dementia

Forum: The Mental Health Forum
Topic: Dementia


My father is a 74-y-o white male diagnosed with multi-farct dimentia caused by aterial fibrilation. He received a left artifical heart valve about 8 years ago, and has been on cumadin to prevent blood clots. His condition is complicated by congestive heart failure, and type II diabetes.

Dementia symptoms are evidenced by very eratic sleep patterns (nods off in the middle of conversations but then wakes at 3 AM and gets up and gets dressed). He has lost all sense of judgement and reasoning. For instance if he gets cold, you don't know if he'll adjust the thermostat, put on four shirts or set a fire in the livingroom. He has severe disnomia and can hardly say a sentence w/o substituting sounds for words he's lost.

He can still walk, and still talk so he is not elligible for any kind of nursing care. I'm concerned he will become the next little old guy on the news that is lost. We don't have a large family or much in the way of financial resources. I'm scared he'll decided to "go to work" or take a drive (yikes!) or take a walk when his wife is attempting to sleep (she exhausted). Can you give us any terminology that can help us with the insurance companies to convince them he is better off in a nursing facility, or do they really see it as a cost saving measure if he get's himself killed walking along the road? We're at our wits end but have been told that as long as he can shower on his own, he's not eligible for nursing care. Our family is overwhelmed with his care and despite the serious nature of all his diagnoses, he seems to be recovering from every crisis and still has a strong will to live.


Joann,

Your father has been diagnosed with multi-infarct dementia which has been
characterized by impaired judgement and reasoning, language problems,
impulse control issues and sleep disturbances. You relate that your
family is burned out as result of trying to care for your father and are having
dificulty placing him in a nursing facility. It is quite clear to me that
your father requires 24 hour attention/supervision which may be impossible
for your family to provide at this time. Fortunately there are various
settings such as nursing homes and assisted living centers that span the
spectrum and intensity of care that one would require in various stages
of dementia. The bottom line is that your father's safety is the main
priority and this should be emphasized when attempting placement. Sad
but true, insurance generally will not cover all of the costs. I recommend
that you discuss these issues further with your father's physician who
can also attest to and document his current condition and need for placement.
Good luck.

Sincerely,

HFHS MD-JM

Keywords: Dementia and placement issues



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