My mother in law lives with my family and has dementia. We have seen things like constant pacing, lost focus, and lack of hygiene. Over the weekend a new behavior manifested itself. We had some family over for dinner. Normally my mother in law goes to bed around seven thirty so we ate a bit earlier to accommodate her schedule. She would not go to bed and kept insisting she had things to do in the kitchen. This went on for close to two hours. My wife kept encouraging her to go to bed and my MIL would say goodnight only to appear again in the kitchen. The last time she pulled out her teeth and started washing them in the dish pan. My wife attempted to redirect her to the bathroom at which point my MIL became very agitated yelling she would wash her teeth wherever she wanted. She never gives my wife any trouble so this was an eye opener. This went on for about ten minutes. Yesterday we had another episode because she insisted she was going to do the dishes which we don't let her do because of the hygiene issue. This episode didn't get to the level of the prior night,but it is worrisome. Normally she only balks at bathing and hand washing. This new behavior has us concerned and we are not sure how to handle it as redirecting her didn't help at all. Evenings tend to be the most difficult times as my MIL is sundowning. Any suggestions ? Thanks.
My mom's GP was aware of her dementia but could not help treat it properly. The GP was not trained on dementia or aging, so a lot of red flags went unnoticed and went from bad to worse. It wasn't until mom got to an actual Geriatrician that she got effective treatment. Changing doctors to a geriatric specialist made a huge difference in care. I'm just sorry mom didn't get to see one from the get-go.
The geriatric specialist had other meds to try for behaviors. Took mom off some the GP prescribed that were contraindicated for people with dementia. Changed dosages on others. Was a big help to me to understand what was going on and what to expect next.
Regular, unchanging schedules are really important for dementia patients. Eventually, every day must be like every other day. You and your wife will have to determine if you can live that way as long as it takes. The way I recognized and had to come to terms with this in my mom's situation is that small deviations to the day sent her into a temper tantrum that was unbelievable. Swearing, stomping, holding-her-breath, yelling, screaming tantrum like you'd get out of a mad toddler. Her emotional control was going, going, gone.
Her PJs were in the dryer a little bit longer than necessary, and she had a holy meltdown. Scared my teenagers to see that. We were on the way to the hardware store and she also wanted apples, so I decided to go to a different store that had everything in one place. She tried to cane me in the head while we were going over 60 on the highway. Once we got her moved into a senior facility, if I didn't get to her apartment exactly at the time she expected, she started threatening to pee on the floor in the hallway.
Dementia is going to change your MIL's personality in ways nobody will see coming, so what was the norm will no longer be possible. This site has a lot of very knowledgeable people who have been through it all, so don't be afraid to ask a lot of questions to the community.
Mom might also like to have her hands rubbed with lotion. If so, wipe her hands down with a Lysol wipe first, then maybe some moisturizing hand sanitizer, and then a hand lotion. You might have to do it to yourself first or with her at the same time so she will copy you, if she won't let you do it for her.
Look on Youtube for Teepa Snow videos. There's one with a bathing technique you might like. You put them in the shower in their clothes. Make sure the room is quite warm. Like too warm for you. Get them wet with warm water so they will want to take off their clothes. Cover with a towel any part that not being washed. This towel will be soaking wet, but warm and the person won't feel so exposed or cold. Make sure the room is brightly lit as well. Hand mom a wet washcloth to hold while you/your wife washes her. She might want to help wash herself too. If not, it keeps hands busy at least.
Good luck and let us know how it's going!
However, yes, dementia progresses and the first time you see a different behavior is just another page turning in the book of dementia. Sometimes the pages turn slowly and sometimes you skip forward to the next chapter.
The answer that sandwich42plus gave is very good advice.
You will need a lot more in your toolkit than redirection.
Sundowning may be part of it, but you will find answers working with your MIL's neurologist and geriatric doctor.
If she isn't seeing one of them or both, you need to get her seen ASAP. Depending on the type of dementia it is, treatments do exist. It may be time for MIL to have something for anxiety and sleep. DO NOT attempt over the counter meds for this though. Seniors have a very different physiology than non-seniors, just like children under 12 have pediatric meds and doses.
It's time to get some help in the home to get her bathed once a week.
What is your plan as this spirals downhill to more manic behaviors, up all night, raving, ranting, accusations, paranoia, combativeness, aggression? You need to put a plan in place right now because you cannot afford to wait for "the right time" or in the middle of a crisis.
I would suggest you talk to the area agency on aging and get a social worker assigned to come do an in-home assessment lickety split.