Mental Decline & Dependency/Coping With Aging Loved Ones

@Phoenix32890,

My wife controls her ET with meds.

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Swimpy, HAPPY BIRTHDAY to your mother. 103! WOW, she's really seen some human history. I think her "happiness" helped her with her longevity.

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@cicerone imposter,

No doubt, ci. Attitude is everything. It also helps that the staff at her home loves her to pieces.

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Today, even the nurse doing the one to one care said that it's ...well, a situation not worth to be living.
My aunt 'ate' nearly two yoghurt yesterday, but had 'beaten' this nurse when getting fed. Hasn't drunk since days ... but doesn't refuse her medication.
She did recognise me as she knows the nurses - but she doesn't speak (often), instead she cries loud.
Communication is nearly impossible, so no-one knows, if she's got pain, what she wants or dislikes .......

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@JPB,

I've been noticing that with BBB for about two years now and have been familiar with the term from reading up on dementia a few years ago.

In BBB's case, the sun starts setting earlier and earlier these days. In fact, I was thinking about writing a post to ask for some help.

BBB is very lonely, very frustrated with her failing communication skills and her physical disabilities that restrict her ability to get out of the house much. Her mind is still vibrant on good days, but those good days are becoming less frequent.

BBB is finding it increasingly difficult to read, to write, and to speak. She says she's able to rehearse her thoughts in her head without any problems but when it comes to communicating them verbally or written, she has a hard time doing it and gets very angry about not being able to do it. When reading, she has to sometimes spell the words she's reading to try and remember what they mean and often has trouble understanding what she is reading. She finds it harder to read her newspaper and she's been having difficulties even trying to find words to post on A2K and says she probably won't be able to do it much longer.

She says that watching 24/hour news programs on TV helps her keep in touch with words. The repetitive nature of it, along with the visual pictures, gives her ample time to eventually understand what is being said.

I think she needs to be around more people so she can practice her speech skills with them. Unfortunately, she has no interest in the activities at senior centers. I need some activity suggestions for someone who is mostly interested in political and social issues but has a difficult time expressing her strong opinions because she can't find her words or it takes so long for her to find them that people lose interest.

I also need some ideas for helping her with her reading and comprehension of what she's reading. I was thinking that something like books on tape would work if there was such a thing for newspapers.

I just need some ideas to try to get some happiness back in her life.

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@Butrflynet,

I'm thinking about it -
I'm no use, we never did talk very well together even though we agree on some things, and now I simply can't hear her 99% of the time.

I've been thinking about it, though, but you may know resources more than I would.
I thought of something like NPR videos, but stopped with NPR myself for my own odd reasons (bland) several years ago and don't know how available all that is. I don't even know if they have videos.
But other news outlets do..

Still, none of that helps her keep talking and reaching for words.

One place I'd call and try to talk to someone who could help (which might take persistence) is Department of Senior Affairs in Abq.
General phone is 764 6400.
A visit could work better -
714 7th St. SW
Obviously they'd suggest senior centers, but someone up in the staffing may know of other groups.

The Y? The Library?

UNM social services of some sort? Maybe a group could be started up - it could be an idea that would catch on.

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@Walter Hinteler,

Nothing personal towards your aunt, Walter, but I can't imagine how horrible it must be to "live" like that. My father's last words to any of us were, "This is no way for a man to live", as my sister was preparing to return to FL after a visit. He died a couple days later. May your aunt find peace.

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@Butrflynet,

The mid-stages are very difficult for everyone involved. You're both aware of the changes and the anger/frustration that go with that knowledge. The sundowners website had a number of ideas but they stressed that there's nothing thats particularly effective for everyone.

Quote:

Some people have even tried aromatherapy treamtents to calm agitation, and more and more nursing homes bring animals into the facility to interact with the patients. The results have been very positive. Reminiscing with your loved one may also be helpful as long as it evokes positive memories from the past.

Herbs such as Ginkgo Biloba and St. John’s Wort have been used to assist patients with dementia and Sundowning Syndrome, as well as Vitamin E, but these may or may not offer some subtle decrease in symptoms. Again, the treatment depends very much upon the individual.

Light therapy can be especially helpful for people with Sundowning Syndrome, although again, it may or may not diminish symptoms, depending upon the individual. Lightboxes are available that mimic sunlight. The person with Sundowners must sit close to the light for a period of time, although they can do so while watching television, reading, eating, etc. The lightbox is probably best used in the morning hours and can make a big difference if the Sundown patient also suffers from depression.
treatments

I'd be wary of trying any herbal supplements without discussing them with her dr first but the light box might be something worth trying.

Good ideas, osso. The reference librarian at the library would be a good person to ask.

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@JPB,

Hah! I just sent a PM moments ago, which I suppose you already know.

On sundowner's, have you heard that it is actually related to the sun going down, or does it just seem to happen towards the end of the patients normal wake/sleep cycle? Well, when I get real interested, I can research it myself, if you don't have anything on the top of your head.

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@JPB,

I should add others can probably hear BBB - I think Diane can - so that shouldn't be, I don't think, a big obstacle.

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@roger,

Good question.

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@roger,

I don't think anyone knows for sure, roger. The reason my mother referred to it as the "colic hour" is because it reminded her of when her babies suddenly erupted for no explainable reason at the same time every afternoon. Fortunately babies outgrow it and doesn't last all night. I think the connection to seasonal darkness and SAD is an interesting one.

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WebMD has a page on it -- causes unknown, but they offer some coping suggestions.

Quote:

What Causes Sundowning?

The causes of sundowning are not well understood.

Some research suggests that sundowning may be related to changes to the brain's circadian pacemaker. That's a cluster of nerve cells that keeps the body on a 24-hour clock.

Studies in mice suggest that neurochemical changes in the brain that are characteristic of Alzheimer's disease may play a role. Researchers found that older mice make more of an enzyme that's associated with anxiety and agitation before they go to sleep than middle-aged mice do.

Several things may increase the risk for sundowning. These include:

pain
fecal impaction (serious type of constipation)
poor nourishment
being on too many medications
infection
noisy and disruptive sleeping environment
Treatments for Sundowning

Ways to reduce the severity of sundown syndrome include:

Increase Daily Activity. Being more active during the day may help Alzheimer's patients sleep better at night. Caregivers should:

Discourage daytime naps.
Encourage exercise, like walking.
Encourage hobbies that get dementia patients up and moving.
Monitor Diet. Caregivers should take these steps to improve dietary habits:

Limit caffeine and sugar to the morning hours.
Plan an early dinner.
Keep snacks light before bedtime. More

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@JPB,

I dunno. That internal clock seems to collide with the way most of us mark time. Well, not a collision, but two different systems working at the same time.

I wake up, piddle around the house, dodge traffic on the way to breakfast, find a parking place, and there I am. That's how I really mark time. By events. At a certain poing in the Alzheimer's process, there simply no (remembered) events to mark time. It's just - suddenly you're at a restaurant, so you should probably think about eating. It's hard to visualize, but that seems to be the way it is.

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@roger,

Interesting. Especially in those who have difficulty with insomnia, I'd imagine. But it's true when you think about it. Once retired from the workplace the clock and time no longer has the same meaning and we establish new normal routines that have nothing to do with the time of day.

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@JPB,

Yeow, lots of matters to think about there.

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Mr B's 90+ year old grandmother is failing in the opposite way. Her body is failing miserably but her mind is sharp. She's legally blind, can't take care of her own hygiene, falls frequently and has just been relegated to a wheel chair. She's miserable as hell. I don't know which is worse --- the body going or the mind going. Neither is a picnic.

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@Butrflynet,

BFN --- this yahoo article gives some well thought out suggestions.

http://voices.yahoo.com/treating-sundowners-syndrome-top-10-behavior-management-1987341.html

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@JPB,

The whole subject of daily time for us is fascinating and I'm pretty sure we have had bunches of threads about it on a2k, off and on.

I have considered myself as just getting started at the beginning afternoon while spending a life showing up for early classes or jobs. I think my most creative hours were and still are around 4 pm to, say, 7 pm. I've a history of being ok at 2 a.m. re design or report writing.
All this, usually.

I am taking it that I'm adaptable -
just recently I gained an older dog, who has her own traits.
I'm now starting to retire around 7 pm, reading, etc, but a slow down.
She gets me up around sunrise.

So - I would add to the whole sundown thing, the matter of how people can adapt, or not.

How this relates to - let's say, a patient population - could be interesting.

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@JPB,

Everyone wants her to find peace.

I think that I can handle this situation (as a relative) quite good, since I've made similar experiences when my mother died more than two years ago (there, it was more the 'social worker Walter', who made the decisions).

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