She forgets that she has been to the bathroom and demands Milk of Magnesia because she thinks she is constipated. She becomes aggressive and cries and talks about how she just wants to die and that we (my older sister and I) are depriving her of relief from her constipation. She had two BM's last night and even commented about it. Today she only ate a small bowl of cereal for breakfast and did pretty good but did spend a lot of time looking around the house (for Milk of Magnesia bottles). Finally she told me that she was not able to go to the bathroom and needed some MM. I told her that she was not constipated that she had two BM's just last night. She told me that was a lie and to not talk to her anymore. When my sister got home she demanded MM and said she was going to leave (in 30 degree weather) and walk and find some. She thinks my sister and I are bossing her and wants to live her life on her terms. She literally cannot remember something that happened ten minutes ago. My sister explained these symptoms to her PCP and he said that he noticed some changes but offered no diagnosis. He prescribed Seroquel but it turns her into a zombie and makes her prone to falling. She can get around pretty good for 93. Just a few weeks ago we spent three hours outside working in the yard on a warm day. I am just at wits end on what we need to do next. She will be ok for most of the day (on some days) then in the afternoon she just snaps. I know she doesn't understand what is going on. My sister is a special education teacher and can handle her outbursts better than me. I moved back in with them three years ago as I knew my mom was getting older and would need help. But I feel helpless. Hearing her rant and rave and about my sister not caring anything about her breaks my heart. To start with it was once every few weeks, then once a week then every other day but now it is every day sometimes several times a day. Does anyone have any suggestions on what we should do next? I feel she needs to be on something to calm her down a bit as she has mentioned going upstairs and jumping out of the window before when she was ranting. This is all so new to me as my mom has always been a solid rock. She has never wanted anyone to take care of her and that stubbornness is coming out now. It is just so hard to see the person that had all the answers for you all your life suddenly not remember that they just had a BM. She has had a good life and is just ready to die. Sorry for venting but just reading some of your experiences has made me feel not so alone. Thanks for listening. :)
“ There often comes a time when a parent with dementia can not be cared for by their ( adult ) children any longer . Mom needs to be placed in a facility with a village to care for her who are NOT her children. She views you as a child and will be angry with you because she does not want to be told what to do from her child . You need to take the family dynamic out of the caregiving . Have Mom placed . “
Sundowning happens in the afternoons and causes a lot of confusion and agitation in elders with dementia. My mother would insist I was hiding her mother ( who would've been 137 yrs old) and siblings in the closets at her Memory Care Assisted Living facility during that period of time. She maniacally wheeled herself around the bldg looking for them and yelling their names. I called her doctor and asked for a prescription for Ativan which did help.
From The Mayo Clinic:
I've heard that sundowning may happen with dementia. What is sundowning and how is it treated?
Answer From Jonathan Graff-Radford, M.D.
The term "sundowning" refers to a state of confusion that occurs in the late afternoon and lasts into the night. Sundowning can cause various behaviors, such as confusion, anxiety, aggression or ignoring directions. Sundowning also can lead to pacing or wandering.
Sundowning isn't a disease. It's a group of symptoms that occurs at a specific time of the day. These symptoms may affect people with Alzheimer's disease and other types of dementia. The exact cause of sundowning is not known.
Factors that may worsen late-day confusion
Fatigue.
Spending a day in a place that's not familiar.
Low lighting.
Increased shadows.
Disruption of the body's "internal clock."
Trouble separating reality from dreams.
Being hungry or thirsty.
Presence of an infection, such as a urinary tract infection.
Being bored or in pain.
Depression.
Tips for reducing sundowning
Keep a predictable routine for bedtime, waking, meals and activities.
Plan for activities and exposure to light during the day to support nighttime sleepiness.
Limit daytime napping.
Limit caffeine and sugar to morning hours.
Turn on a night light to reduce agitation that occurs when surroundings are dark or not familiar.
In the evening, try to reduce background noise and stimulating activities. This includes TV viewing, which can sometimes be upsetting.
In a strange or not familiar setting, bring familiar items, such as photographs. They can create a more relaxed setting.
In the evening, play familiar, gentle music or relaxing sounds of nature, such as the sound of waves.
Some research suggests that a low dose of melatonin may help ease sundowning. Melatonin is a naturally occurring hormone that induces sleepiness. It can help when taken alone or in combination with exposure to bright light during the day.
It's possible that a medicine side effect, pain, depression or other condition could contribute to sundowning. Talk with a healthcare professional if you suspect that a condition might be making someone's sundowning worse. A urinary tract infection or sleep apnea could be contributing to sundowning, especially if it comes on quickly.
Know that behaviors change suddenly and often with dementia. Mom's Sundowning lasted in earnest under a year and then she calmed down and became convinced she was living in a hotel and being wined and dined nightly.
Its horrible to witness these changes in our mother's. I agree with you. Heartbreaking to lose them during The Long Goodbye.
Best of luck.
I wish you the best.
The best thing you and your sister can do now is to educate yourselves about dementia, and sundowning as well, so you have a better grip as to what is going on.
There are some medications that should help with the sundowning, so talk to her doctor about that.
Your mom's brain is now permanently broken and you and your sister need to learn not to take anything your mom says or does so personal as she cannot help it.
And sadly she will only get worse so I hope you have a plan B in place in case homecare no longer works for you and your sister.