Taking medicine for hypertension, depression and dementia. Facing bowel incontinence. What's wrong?
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My 75 y.o. female friend with early dementia(?)/memory loss has pooped in the bath tub x1, & in the bed x2 in the same week. She was not feeling any distress, knew she had to use the toilet, but could not get there in time. What dies this indicate? She is up to date on her colonoscopies. She has hypertension, is taking a med for it, plus Lasix, and a memory medication, plus one for depression.
Posted Fri, 5 Apr 2013 in Depression
Answered by Dr. Payman Hajiazim 2 hours later
Hi there, thanks for asking. Fortunately it is not a sign for cancer. It shows that her dementia is progressing, as its nature. Her medication for dementia should be adjusted. Urinary or feces incontinence are the signs of dementia. Fortunately there are very good medications for dementia with very few side effects that can prevent the progression for many years. You can ask her doctor to fill the Activity Daily Living Scale for her periodically. It can show the progression of the disease even better than serial MRI. If she has fever, there is possibility of an infection which may also affect her mental function, although it is not so likely with the history you mention. Let me know if you have any question. I wish her a good health.
Follow-up: Taking medicine for hypertension, depression and dementia. Facing bowel incontinence. What's wrong? 15 hours later
Thank you for your response. That was a possibility I had in mind. I was just shocked that fecal incontinence could crop up so quickly when she is still on a very functional level. For example, on the Reisberg Functional Assessment Staging Scale, she has the forgetting, misplacing of objects of Stage #2, Repetitive question asking which I don't see on the scale; occasionally gets lost, Stage #3. She complains of having to do her own bills, Stage #4, and needs encouragement to wear adequately warm clothes, stage #5 for a year or more. But could she just suddenly skip over all the sub-stages of Stage #6 and go straight to Sub-stage 6e: Fecal incontinence? She is still living independently and has none of the other substages of Stage #6. Thank you for your insight, doctor.
Answered by Dr. Payman Hajiazim 8 hours later
Hi there, you are mostly welcome. That is true, there is no clear cut distinction between the neighbor stages. One may begin to experience some points of stage 6e before experiencing the other sub-stages of stage 6. It does not mean she is in the late stage. It is a good sign to adjust the medication and treatment to withhold the progress.