Age: 70.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Hyporesponsive to stimuli, Impaired driving ability, Impaired self-care, Loss of personal independence in daily activities, Lumbar puncture
Clinical narrative: The following behaviors started in early April 2021, about two weeks after patient's second Covid-19 shot and increased in severity until her death they are not all in order. Understand that patient was extremely modest and meticulous prior to this condition. Used her cell phone less, did not return calls, still carries on a conversation. Throw items away or putting them in odd places. Could not remember how to turn on the car's windshield wipers, called me at home, could not fasten seatbelt, can no longer figure out how to drive, keys taken away. Becomes offended quickly, dressing a nightmare. Walks with rollers in her hair, no make-up, dresses inappropriately for occasions. Displayed odd behavior in restaurants (ordering too much food, starting to eat napkin or drink salad dressing, going to other people's tables, talking loudly, swirling bread in butter dish). Unable to open door locks. Let dog out of daughter's house while holding granddaughter and yelling, I've got him. Often had faraway look, could not use her credit card or calculate tips, wore chipped fingernail/toe polish, hair in disarray, said, I think I have a condition. Asks same question repeatedly. Takes 45 minutes to get a pair of mismatched shoes on, often on the wrong feet. Unable to tie shoes. Becomes manic with clothing, often manipulating the same item in her hands for up to 30 minutes. Puts several pairs of panties on, over her pants sometimes. Could not get her bra on, tried to put bra on her feet arguing that it was socks. Could not get blouses/pants on; pulls blouses on like a skirt. Unable to put pierced earrings on. Would not wear pajamas or change, wears same clothes to bed. Tears bed clothes off bed. Not accountable for wallet, keys, credit cards, handbag, and phone. Unable to remember alarm code and panicked Obsessed with the color purple, purchased odd merchandise, especially at holiday time. Unable to cook or operate oven/microwave. Put a frozen piece of pizza on a paper plate, then on a wicker plate holder, and put entire assembly in heated oven. Went to make fruit drink, stopped to clean floor with Clorox wipe, then squeezed it into the drink. Cleans shoes with sponge, then uses it to wash dishes. Lacks ability to reason, becoming extremely sensitive to sound, touch, and quick movement. Cannot find light switches, panics in dark rooms, starts grabbing/knocking over things. Hangs on to towels and tears pictures from the wall. At nail salon, put feet in soaking tub with shoes on, became upset when told not to do so. At hair salon, forgot wallet and could not pay, became very upset. Started seeing people in the house that weren't there or playing peekaboo with her granddaughter who was not present. Asked characters on TV if they wanted me to make breakfast for them. Difficulty speaking in sentences, cannot finish thoughts. When verbally profane, could often speak in full sentences. Showered with clothes on, refuses to bathe anymore; Hospice got her to bathe twice, then never again, just sponge baths. Incontinence started small and grew worse, she would urinate on the floors/rugs, sit on the toilet seat with the lid down and urinate, Depends helped. She would throw used toilet paper on the floor, in the sink, tub, and hamper, wiped herself with a towel and put it in the bowl. Put a full roll of toilet paper in the toilet. Started stuffing odd things down the bathroom sink drain. Often walked out of the bathroom with toilet paper still between her legs and trailing the entire roll behind her. She stopped brushing her teeth. Can no longer write. Once a prodigious reader she no longer reads. December 2021 (+/-): Thinner, stringy hair unkempt. Will not leave house. Walks around naked, argues she has beige pants on. Talked about past often, laughed often when speaking to visitors. Slept for extended periods of time, not eating or drinking for the entire day. Sat on couch for extended periods of time, crossing and uncrossing legs, manipulating a blanket for hours. Will attempt to twist off a non-existent bottle cap for long periods of time. Would say something, and when responding in an attempt to clarify what she wanted, she would deny saying it. Would answer 'yes' to most questions, would not ask for anything, did not talk about grandchildren, asked constantly about her dog and its location (she did not have a dog). Watched TV shows she never would have watched, and baby/puppy videos for hours on end. Smiled when grandchildren visited but did not address them by name. Sang all TV commercials and started reacting to people on TV. Became extremely empathetic, but moods changed rapidly, became verbally aggressive and profane. Resistant to taking medications. Started arguing with TV show characters, then mood would suddenly change and she would be pleasant. Polite with strangers/visitors, very oppositional, uncooperative and profane with caregivers (husband and sister). Eventually, family members witnessed mood swings and they became targets of profanity. Would repeat same thought for hours sometimes. Hearing remained excellent throughout. February 2022 on: Most of the above, plus, no longer walked around, very profane when in a mood, pleasant when not. Hands starting to shake and balance becoming unstable. Feed her and hydrate her as much as she allowed us, weight loss extreme. No longer walking. Last month of her life would not eat, last three weeks would not drink. Breathing started to change, responded less, slept more.