There are a lot of challenges that dementia can bring to a family. One of the most challenging is when the dementia patient forgets key events in their life.
“Dad keeps asking about Mom. He wants to know where she is and why she isn’t living with him. When we try to explain that Mom passed away several years ago, he gets so upset. It is as if he is hearing this for the first time. He wants to know why we didn’t tell him. And he wants to visit her grave. He goes into a deep depression. Then the next day he is asking where she is again. I am about to pull my hair out! I don’t know what to do.” ~Clara
Clara is not alone with these challenges. It could be a spouse or a child or someone else close who has passed away. Or like Joshua, parents may have divorced. And the one with dementia does not remember.
“How do I tell Mom that Dad abandoned us 40 years ago? She was so hurt then. It wasn’t easy on her. She had 3 children to raise. But she managed. And she did a great job. Now I want to do a great job caring for her. It hurts me to see her pining for him again” ~Joshua
When Telling the Truth May Not Work
When a dementia patient gets fixated on a particular topic it can be hard to get them to let it go. Try to step into their world. Sometimes a therapeutic lie may be your best option. Clara finally realized that telling Dad mom had passed did not help either of them. So, she offered a story that he would buy into.
“I told him that Mom had gone to visit her sister Bette in Michigan. She was staying a while to help Bette after an illness. Thank goodness he bought it! He settled down then. Of course, the next day I had to repeat the story again. And this went on for a while. And then one day, he stopped asking. I felt a little guilty lying to Dad like that. But it seemed to soothe him. And that is what really mattered” ~Clara
Joshua’s Mom Was Usually Confused Later In The Day
The Memory Care Home where Joshua’s Mom Karen was living noticed that it was usually late afternoon when she would start looking for her husband. There were probably two reasons for this. The first was this was the time of day when her husband used to return home from work. The second is called Sundowners.
Sundowners is a state of confusion that is commonly noticed in dementia patients when the sun goes down in the evening. Not all patients with Alzheimer’s or other forms of dementia will experience this but many do. The symptoms can range from mild confusion, sadness and anxiety to full-blown episodes of paranoia and anger. Some people will exhibit symptoms all day long that grow progressively worse in the late afternoon and early evening hours.
Why Does This Happen?
There are a number of theories why this happens. Some doctors believe that it may be a hormonal imbalance that occurs at night. Others feel Sundowner’s Syndrome is caused by fatigue, much like a young child will get cranky late in the day if they have missed their nap.
Darkness has also been studied. When there is less light and more shadows this may cause confusion and anxiety and the Alzheimer’s patient tries to make sense of what they are seeing around them.
- Agitation (becoming increasingly upset or anxious)
- Confusion about time and events (looking for someone who has passed away)
- Anger (May use foul language or yell. May even hit or throw things)
- Restless (pacing)
Regardless of the reason for this sudden change in behavior, if you are caring for someone who is experiencing Sundowners symptoms you need some solutions to help. Using medication should be the last resort.
The Staff Used A Proactive Approach
Luckily for Karen and Joshua, her caregivers knew just what to do. Rather than wait for Karen to get confused and agitated they engaged Karen. When she would ask about her husband, they would say something like
“I guess he had to work late again tonight. Hey, how about we make some aromatherapy hand cream while we wait.”
The staff would then get Karen engaged in the activity. Furthermore, they used essential oils that are reported to have calming effects. Sometimes all it takes is a proactive approach from a relaxed and caring caregiver.
The staff also suggested that Joshua try to visit at a different time of the day. Because he looks a lot like his father if could be causing some of the problems. And he would get upset when his Mom got upset, which also didn’t help the situation. The staff took pictures and small videos during the day so Joshua could see that his mother was fine.
These dementia challenges can be tough for families. But with the right approach, you will be able to move past the situation.