Middle Stage Archives - Alzheimers Support

Alzheimer’s and Dementia can Cause Sundowners and Frightening Nights

If you have a family member with Alzheimer’s or Dementia, you have probably experienced

==> some nights that are more than fitful <==

Severe mood swings can occur during the evening hours that are often referred to as Sundowning or Sundowners. My Mom would often awake from a sound sleep, crying and moaning as though she’d suffered a horrible trauma.

Bouts with Sundowners or Sundowning seem to spin the patient into a torrent of intense feelings of agony where they often groan and wail, longing for their mother or father or the “home” of their childhood.

My Mom would cry-out for her own mother and demand that they come and get her. She would beg to go home, as though I was holding her hostage. Mom’s weeping and wailing would be inconsolable no matter how much I tried to soothe her. She would be agitated and anxious and cry for long hours while I could only stand by and watch her emotional pain.

==> These behaviors can be quite confusing if you have never lived with someone who has demenia <==

In the beginning, I was baffled and tried to help Mom sleep by saying soft, soothing words as the moaning began. But as the moods grew worse and occurred again and again, I took a more aggressive view of these fitful nights and made a more concentrated effort to slow their occurrence.

==> A few resolutions <==

~One way I found to insure that Mom had more peaceful nights was to make certain her evening hours before bedtime were more harmonious. I always tried to coax Mom into some light, physical activity in late afternoon. Mom loved to sweep the porch or rake the yard. She’d always been an “outside” person, so this was a treat for her. It doesn’t have to be anything strenuous, but enough activity to make rest and sleep a welcome end to a long day.

~I tried to make certain Mom never went to bed hungry or thirsty, offering a glass of water or juice shortly before bed time. On the other hand, she wouldn’t go to bed immediately after a meal, either. In fact, we tried to have dinner a little earlier than most, since a person with later stage Alzheimer’s can be confused by something as slight as indigestion.

~When Mom lived with us, we had “lazy time” in early evening. A couple hours before bedtime, everyone in the house settled down to the television, a movie, music or a book. Mom had a large recliner and she’d kick-back with the rest of us. Once the bouts with Sundowners began, I extended her “lazy time,” having her settle-down and rest several hours before bedtime.

==>The person effected by Sundowners seldom remembers what they’ve endured during the night.

And it could be quite frightening to tell them later <==

When the Sundowners symptoms occured, I never tried to argue or explain what was happening. In the beginning, I tried to soothe Mom but she always refused comfort. And most often, if I spoke or said anything during the fitful times, she didn’t appear to hear me or understand that I offered help.

So I made certain she was comfortable and offered her radio and head-set. Sometimes the music would circumvent the entire event and Mom would fall asleep, peacefully, before the Sundowning could occur. And on those nights we were happy that we all had a good and peaceful night’s sleep.

At this stage of Alzheimer’s, I think comfort and love is the most valuable thing a person can receive. Their mind is full of confusion and stress and worry. My goal when my Mom was in this late stage of Alzheimer’s was to give her as many calm and peaceful and comfortable days and nights as possible.

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The Emergency Room…again

When my Mom’s loss of memory slid from early to middle stage Alzheimer’s, I still did not recognize the symptoms but assumed most of her symptoms were little more than aging.

Mom’s only physical ailments were ugly stomach aches. Bouts of colic plagued Mom as often as any newborn baby.

Mom would call her neighbor… who would call an ambulance… and off she would go to the hospital emergency room.

Despite my pleas to call me first, since I knew chicken soup often soothed Mom’s stomach better than any hospital visit, they would not listen.

==> The Hospital is exciting <==

Both Mom and her neighbor preferred the big, shiny red ambulance with lights flashing and horn sounding. I’m ashamed to admit now, but those Hospital Emergency Room visits became a dreaded ordeal for me. I worked from home, so my time was flexible, but I already pushed business aside 3 days a week to care for Mom. And an one of these unproductive emergency room visits could easily consume a 12-hour day. And every visit became the same scenario!

By the time I arrived, the pain had subsided and a frustrated mother would greet me. She couldn’t couldn’t remember where she was…or why. All she wanted was to go home.

==> Keeping my Mom in a hospital bed, and modestly under a sheet could become near impossible <==

Pain or not, Mom got a twelve hour IV while I filled forms, waited for interns, and did my best to keep Mom calm and in the bed without too many threats to strap her down.

After the first 5 minutes, Mom had no memory of a stomach no matter how many times I reminded her. While I told the doctor of symptoms Mom objected and let him know she felt perfectly fine. Occasionally, I thought my mother had lost her mind.

==> I didn’t know much about Alzheimer’s yet <==

After months of the same scenario playing itself out time and time again, accompanied by MRI’s and X-rays and tests and weekly visits to her family doctor, the emergency room was a disastrous waste of time in my book. On one hand, I thought Mom might be enjoying the attention, but on the other hand– who knew what medical mystery might be lurking inside her belly. It was a quandary–for sure.

The medical mystery was finally solved during Mom’s last visit to the emergency room. I’d had some business to tend before heading to the hospital so Mom had already been there a couple hours before I arrived. The nurses were not pleased to deal with her loud language and angry outbursts, crying out to be dismissed and allowed to walk away from the hospital alone.

I could hear their threats of physical restraint as I hurried down the hall to her room. In the past, I’d been able soothe her anger by reassurance that we’d leave soon. But I knew she surely felt totally alone on this day.

I entered the room just as a tall, scowling physician arrived. He scanned the clipboard at the foot of Mom’s bed, nodded in my general direction, and then gave quick orders to remove the IV and allow Mom to get dressed so we could leave.

Absent any bed-side manner, he turned to me and said, “You know, you can’t allow her to keep calling an ambulance every time she gets hungry.”

My jaw dropped as I took a step backwards. I was startled by his abrupt manner before I could respond. “My Mom has Alzheimer’s. We’ve been trying to have her stomach pain diagnosed for months. I never thought—“

“It’s hunger,” he said matter of factly. “She doesn’t remember whether she ate or not, so she doesn’t eat at all.” He nodded toward Mom. “She needs better supervision.” His white jacket flapped as he strode out the door with a grim shake of his head.

==> That was our last emergency room visit and the beginning of my education about Alzheimer’s <==

Mom’s oldest great-grandson was about to attend school near her home and had been looking for a place to stay. Now, it was settled, he moved in with Mom and made sure she ate 3 meals a day. It was a good situation all around, we thought. He had room and board and Mom was no longer alone with Alzheimer’s.

Besides the presence of Mom’s grandson, we also changed the way food was displayed in her home. We added a fruit bowl to the dining room table (Mom loved fruit), ready-made rice dishes, chopped fruits and salads and veggies—all in the fridge. We also loaded the refrigerator with Food and Nutritious drinks. Mom could eat for a month and never light an oven or wash a pan. We learned that If she could see food, in the fridge or on the counter or anywhere in plain sight, she would eat.

==> Keep healthy food in plain sight and ready to eat <==

Later on, it can become quite difficult to get the person with Alzheimer’s to eat.

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