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Any thoughts as to why cognition can be relatively good for days and then tubes?

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It's called the "joys" of dementia. Welcome to it.
It's not unusual for someone with dementia to be able to "showtime" for a good while until they can't any longer, and then the truth comes out about how they really are.
There is nothing "normal" about dementia, and if you've met one person with dementia, you've met just one person with dementia. Everyone is different.
The best thing you can do at this point is educate yourself more about this horrific disease, so you will be better prepared for what the future holds.
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Reply to funkygrandma59
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You have posted under Alzheimer's. Is that the type of dementia your loved one is diagnosed with.
Fluctuation are more common to some types of dementia than to others. My brother suffered with Lewy's dementia, and the fluctuations were profound. One day quite out of it with many hallucinations and another day almost perfect. That is common to Lewy's I learned, it being a type of dementia in which the trajectory is up, down and sideways, whereas in Alzheimer's it tend to trend downward, sometime with stairstep of stability.

It's all quite impossible to predict, but the more information you have the more it may help you. One thing I do know, and particularly with any of the dementias that have a sort of anger or acting out component, is that anxiety is a trigger that is BOUND to worsen a day. The more calm and steady and predictable things are, the better for the person involved.

Wish I had more. I always say "expect the unexpected".
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Reply to AlvaDeer
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In particular, Lewy Body Dementia can be like that, early to mid stages .
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Reply to waytomisery
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Hi to all who have answered my question. My sis does not have Alzheimer's and most likely has vascular dementia. She has had quite a few minor strokes and a more serious one in February. As you all know, the ups and downs can be horrific. She has had palliative care since February and I can't thank them enough for all their care and concern. We thought Hospice might be in order but then my sis "perked" up even surprising the palliative care team who were impressed and surprised by the communication they had with my sis. I guess it's the extremes that are so frustrating. On her birthday (last Sunday) the family was there and sang happy birthday to her. She was in her "catatonic" phase and never acknowledged anything. Just so very sad.
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Reply to sad4sis
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My sister was very recently diagnosed with Lewy Body . Last year , they believed it was early vascular dementia , an MRI last year showed chronic moderate ischemia of white matter .

She also has been having some mild Parkinson’s like symptoms , however a Dat scan last year was normal . The past 6 or so months her cognitive symptoms were more like Lewy Body with the good and bad days and delusions .
The Dat scan last week highly suggestive of Lewy Body . Maybe my sis has both Lewy and Vascular .

When these symptoms started 2 years ago they thought maybe ALS or Parkinson’s due to her gait and at times slurred speech etc . No tests supported these guesses , nor enough symptoms . She hasn’t fit any one diagnosis well . Although the Lewy seems to be more evident now . She also had metabolic encephalopathy last year and almost died .
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Reply to waytomisery
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