My wife is 78 yrs old. Some evenings she thinks our young children should be coming home and waits for hours at the front window until very late. I cannot reason with her. She is determined to stay there until they come. (Our children range from age 53 to 39. They won't be coming home at night.)
How do I handle this so I can get some rest and survive to take care of her?
1 - Make sure she gets most of her sleep at night. Make sure naps during the day are brief so she will be tired at night. This may cut down on the "confused time" with Sundowner's.
2 - Make sure she gets into the sunshine, but avoid 10 am - 2 pm when the rays are more concentrated to cause skin cancer. Sunlight helps to regulate the circadian rhythm.
3 - Put on more lights in the evening and afternoon. It appears that lengthening shadows are related to more confusion. More light helps things to "look normal."
4 - Redirect her attention as much as possible. Have her make a salad for dinner, set the table, select a movie or tv show to watch, select a radio station... Dance with her to music you both enjoy. The idea is to engage her brain in another thought or activity so "the looking for the children thought" isn't triggered.
5 - Be patient. That "watching for the children" thought is a very strong pathway right now, but will diminish with time.
6 - If her persistent thought/behavior causes her anxiety or "acting out," please notify her doctor. Anxiety and frustration is usually the cause of "acting out." especially when the world doesn't seem to make sense. She might benefit from a mild anti-anxiety medication.
**They called and went to a movie and wont be in until later, they said to go ahead and ...(insert something here)..eat dinner, go to bed, watch TV...
**They called and decided to watch the game at "Bobby's" house.
** "Sue" asked if they could spend the night so they won't be home.
**They already came home and went to bed. They came in the back door
The sun going down, changing light and reflections can be troublesome.
There are shadows that you see that make things different.
Make sure that inside the house is brightly lit. I would switch to LED bulbs in a brighter lumen.
Pull blinds or drapes so that windows do not act as mirrors and it looks like people are outside.
Place a dark entry rug in front of the door. Often people with dementia will not cross a dark rug thinking there is a hole in the floor. (works for some not for all)
If they sleep all day you will have a severe problem at night.
Be careful using medications because that predisposes to falls and more confusion. Many narcotics will also cause impaction...I never used those meds for my mom. Other than routine stuff she took all her life for her blood pressure and insulin-dependent diabetes. Mom lived to be 90 years, 3 months and was bed ridden the last 3 months of her life because she literally forgot how to stand and could not do it. Complications of kidney and liver disease from her IDDM killed her--not Alzheimer's. In the end I had to get her a feeding tube which she did really well but a body gives out and 10 years of chronic kidney disease (I did the feeding tube for comfort so she would not have to die of dehydration which can take weeks). So all her needs were met to the end and she died very peacefully and her skin was in perfect condition.
Doctors were amazed she lasted that long considering her litany of many chronic illnesses which are too many to list here. I also have to say that her medical management was constant but I kept her sugars very well controlled all her life to the end
We have the services of a geriatric psychiatrist. It made a huge difference.
She's got anti-anxiety medication since she's been highly neurotic all her life and worries about everything. But at least one of the nurses there told me she does not agree with the use of anti-anxiety medication. So I'm unsure how often she gets that.
After this episode, I decided not to visit her as often as I have been and never after lunch. This is causing me agitation, anxiety and sleeplessness. Some of the other suggestions are good ones, and I'll have my brother, the HCPOA, discuss this with memory care management. Thank you.
The geriatric neurologist, palliative doc, geriatric psychiatrist, primary doctor, gastroenterologist, retina specialist, have been a life saver giving her “quality” of life. Mom no longer has sundowning episodes, her depression is minimal, she sleeps most of the night ( not counting bathroom visits), the psychotic episodes have stopped. She’s more pleasant than she’s ever been. Yes, she is on a cocktail of medicines but it has tuned a turbulent
situation into a dignified journey. We tweak her meds and I’m in touch with her doctors regularly.
Geriatric neurologist and group of sensitive physicians is the best advice.
When my mom asked me “why are you here?” I said “you gave me life and I’m giving you quality of life”
My heart goes out to you.
And when she still sundowns, come up with a good plausible lie. If she remembers them as little, think back to when they were little. Did they ever go to camp? Stay at their grandparent’s house? Use something from her memory bank.
Maybe you could say they already came home and are sleeping.
Maybe you can say they're spending the night somewhere like a friend's, grand parent, ect.
Best of luck!