Sundowning and throwing my dad out of his house

[MichelleG452]

Hi, I am new to the forum and I am asking a question on behalf of my dad.

My dad is 82 and a little frail now, he is caring for my mum with Alzheimer's (middle stages). She can be aggressive, angry, moody and depressed. She does not accept her diagnosis and is in complete denial. She has just had memantime added to her drug regime and also takes donepezil and citalapram. However, she is quite often refusing to take her medication or hiding it. So we do not know what benefit there is.

Our current concern though is that she gets progressively worse later in the day and by about 9 pm she does not recognise her husband, my dad, and eventually chucks him out of the house and tells him he has to leave. My dad often feels there is no alternative but to go and then has to drive up the road and wait until she calls him, usually crying and begs him to come home (with no knowledge it was her who told him to leave - he is a stranger who has no place there - when she calls him she is calling her husband to come home). When he gets home she is distraught, crying etc - and telling him that there were strange men (now men not just one) in the house.

Now while we have he lighter evenings and better weather this is manageable (to a degree, he is an 82 year old frail man) but as the evenings get darker and the weather worse, I really do not want my dad having to leave and go out in his car.

Sometimes he gets away with going into the spare room to sleep, but he doesn't really manage to sleep as she will be in and out and can't settle.

Any suggestions? No amount of 'distraction' or reasoning with her seems to help.

Thank you
Michelle

 

[TNJJ]

Hi, I am new to the forum and I am asking a question on behalf of my dad.

My dad is 82 and a little frail now, he is caring for my mum with Alzheimer's (middle stages). She can be aggressive, angry, moody and depressed. She does not accept her diagnosis and is in complete denial. She has just had memantime added to her drug regime and also takes donepezil and citalapram. However, she is quite often refusing to take her medication or hiding it. So we do not know what benefit there is.

Our current concern though is that she gets progressively worse later in the day and by about 9 pm she does not recognise her husband, my dad, and eventually chucks him out of the house and tells him he has to leave. My dad often feels there is no alternative but to go and then has to drive up the road and wait until she calls him, usually crying and begs him to come home (with no knowledge it was her who told him to leave - he is a stranger who has no place there - when she calls him she is calling her husband to come home). When he gets home she is distraught, crying etc - and telling him that there were strange men (now men not just one) in the house.

Now while we have he lighter evenings and better weather this is manageable (to a degree, he is an 82 year old frail man) but as the evenings get darker and the weather worse, I really do not want my dad having to leave and go out in his car.

Sometimes he gets away with going into the spare room to sleep, but he doesn't really manage to sleep as she will be in and out and can't settle.

Any suggestions? No amount of 'distraction' or reasoning with her seems to help.

Thank you
Michelle

Hi.I think you need to call SS and her GP for an urgent referral and needs assessment.This cannot carry on as it is an accident waiting to happen.Can all these events be documented?What we all tend to do as carers is think with our heart when in fact sometimes we need to think with our head.Easier said than done I know.Do they not have carers?

 

[Izzy]

Hi @MichelleG452 and welcome to the Dementia Talking Point Forum.

I’m so sorry to hear about the problems you and your mum and dad are facing. It does sound pretty much like ‘sundowning’ to me. It’s mentioned in this fact sheet -

https://www.alzheimers.org.uk/about-dementia/symptoms-and-diagnosis/symptoms/sundowning

I know how hard it is to deal with as my mother had sundowning episodes every evening. I have to confess I never did manage to address them. On more than one occasion I telephoned the out of hours GP service as I was at my wits’ end and didn't know what to do. He gave her a low dose of risperidone which seemed to calm her down a little. I then got a regular prescription for it.

I wonder if it is worth talking to your mother’s (and your father’s) GP about it. It may be that she will need some kind of medication to calm her a little. Your dad needs help too as his lack of sleep and the stress must have a big impact on him. A conversation about all of it might help. I used to write down a description of my concerns and hand them in for the GP to read before we visited. In this way I didn’t have to talk about my mum or my husband in front of them.

Here is the link to the needs assessment process fact sheet - https://www.alzheimers.org.uk/get-support/legal-financial/dementia-care-needs-assessment

Wishing you all strength.

 

[MichelleG452]

Hi.I think you need to call SS and her GP for an urgent referral and needs assessment.This cannot carry on as it is an accident waiting to happen.Can all these events be documented?What we all tend to do as carers is think with our heart when in fact sometimes we need to think with our head.Easier said than done I know.Do they not have carers?

Thank you. She has been to the memory clinic and they are trying to help - I have tried to explain to dad that he should not wait for it to reach crisis. But we are all worried about upsetting mum as well. What is SS - and when you say urgent referral - who to? No carers yet although I have had a meeting about introducing some care but because of mum's denial it is making it very difficult.

 

[Izzy]

SS normally means Social Services. The urgent referral would be to them. The link I gave above explains the process of the needs assessment.

https://www.alzheimers.org.uk/get-s...27.1053239044.1566647422-933246296.1549371315

 

[TNJJ]

SS normally means Social Services. The urgent referral would be to them. The link I gave above explains the process of the needs assessment.

https://www.alzheimers.org.uk/get-s...27.1053239044.1566647422-933246296.1549371315

Thanks I never can find things when I need them

 

[TNJJ]

Thank you. She has been to the memory clinic and they are trying to help - I have tried to explain to dad that he should not wait for it to reach crisis. But we are all worried about upsetting mum as well. What is SS - and when you say urgent referral - who to? No carers yet although I have had a meeting about introducing some care but because of mum's denial it is making it very difficult.

They will come out to assess the situation.Could you dad not stay with you for a little bit of a break?

 

[MichelleG452]

SS normally means Social Services. The urgent referral would be to them. The link I gave above explains the process of the needs assessment./QUOTE]

Thank you

 

[myss]

Hello @MichelleG452 Welcome to the forum. I'm sorry to hear that your dad is experiencing physical reaction from your mum's behaviour - and you have been given some good suggestions above.

One thing I would like to add - is there anyway your dad can insist and/or supervise your mum to take her medication? I know that Memantine can be given in water soluble form as we had told the memory clinic that my dad was a bit stubborn with taking his tablets at the time. The water is also colourless. Perhaps with the regular taking of her medications, her behaviour may be lessened or more manageable.

 

[marionq]

In the short term while this is being sorted out put a lock on that spare room for your Dad and tell him to keep a phone in there.

 

[Beate]

Insisting on taking medication in the face of refusal will not help - you will have to use subterfuge. Some medications are available in liquid form, ask the GP. If that cannot be provided, hide the tablets in food. Something like mousse is good.

 

[myss]

Insisting - or persuading - helped with my dad - admittedly not everything single time but most of the times. Sometimes subterfuge such as the doctor said you have to take your tablets was used too.

 

[MichelleG452]

Hello @MichelleG452 Welcome to the forum. I'm sorry to hear that your dad is experiencing physical reaction from your mum's behaviour - and you have been given some good suggestions above.

One thing I would like to add - is there anyway your dad can insist and/or supervise your mum to take her medication? I know that Memantine can be given in water soluble form as we had told the memory clinic that my dad was a bit stubborn with taking his tablets at the time. The water is also colourless. Perhaps with the regular taking of her medications, her behaviour may be lessened or more manageable.

That's very helpful thank you - water soluble could definitely be an option, I will investigate!

 

[MichelleG452]

That's very helpful thank you - water soluble could definitely be an option, I will investigate!

 

[Mandy76]

Hi, I am new to the forum and I am asking a question on behalf of my dad.

My dad is 82 and a little frail now, he is caring for my mum with Alzheimer's (middle stages). She can be aggressive, angry, moody and depressed. She does not accept her diagnosis and is in complete denial. She has just had memantime added to her drug regime and also takes donepezil and citalapram. However, she is quite often refusing to take her medication or hiding it. So we do not know what benefit there is.

Our current concern though is that she gets progressively worse later in the day and by about 9 pm she does not recognise her husband, my dad, and eventually chucks him out of the house and tells him he has to leave. My dad often feels there is no alternative but to go and then has to drive up the road and wait until she calls him, usually crying and begs him to come home (with no knowledge it was her who told him to leave - he is a stranger who has no place there - when she calls him she is calling her husband to come home). When he gets home she is distraught, crying etc - and telling him that there were strange men (now men not just one) in the house.

Now while we have he lighter evenings and better weather this is manageable (to a degree, he is an 82 year old frail man) but as the evenings get darker and the weather worse, I really do not want my dad having to leave and go out in his car.

Sometimes he gets away with going into the spare room to sleep, but he doesn't really manage to sleep as she will be in and out and can't settle.

Any suggestions? No amount of 'distraction' or reasoning with her seems to help.

Thank you
Michelle

We are currently going through a similar ordeal with my mother not recognising my dad and believing him to be her own father or one of her deceased brothers. She is not happy that they are in the house and is furious and treating my poor dad like a very unwelcome guest.

She also experiences episodes of Capgras syndrome where she believes that he has been replaced with an impostor and she becomes absolutely terrified and hysterical, desperately looking for the "real" husband.

He has to go outside and come back in, sometimes it works and sometimes it doesn't. I am also worried about the dark nights coming in and how he will manage. I don't want him having to go out in the cold and hang about outside until she has decided that he's not her father/brother/impostor. He is nearly 78 and has lost a lot of weight recently from the stress of this situation.

I am sorry to say that I don't have any real suggestions, just wanted to let you know that you are not alone with this concern. We have been going through this for 4 months so far. My mother was 'normal' until the end of April and suddenly developed dementia one day when she thought my dad was her brother! She is far worse in the evenings - frantic at dinner time and trying to make dinner for her, my dad, me and the brother/father/impostor, sometimes her sister, who she mistakes me for!

Then at bedtime it is hit or miss whether my dad will be shoved into the spare room/couch. Last night she declared that they were divorced so could not share a bed.

We've had no help from anyone. Memory clinic nurse has been out a few times but we have yet to see the consultant and SS had no offers of help, just said to take her to a day centre, but she is not aware that she has a problem and would never willingly attend anything like that. So we are just plodding on each day as best we can - leaving the room and coming back in and hoping she recognises us!

 

[MichelleG452]

We are currently going through a similar ordeal with my mother not recognising my dad and believing him to be her own father or one of her deceased brothers. She is not happy that they are in the house and is furious and treating my poor dad like a very unwelcome guest.

She also experiences episodes of Capgras syndrome where she believes that he has been replaced with an impostor and she becomes absolutely terrified and hysterical, desperately looking for the "real" husband.

He has to go outside and come back in, sometimes it works and sometimes it doesn't. I am also worried about the dark nights coming in and how he will manage. I don't want him having to go out in the cold and hang about outside until she has decided that he's not her father/brother/impostor. He is nearly 78 and has lost a lot of weight recently from the stress of this situation.

I am sorry to say that I don't have any real suggestions, just wanted to let you know that you are not alone with this concern. We have been going through this for 4 months so far. My mother was 'normal' until the end of April and suddenly developed dementia one day when she thought my dad was her brother! She is far worse in the evenings - frantic at dinner time and trying to make dinner for her, my dad, me and the brother/father/impostor, sometimes her sister, who she mistakes me for!

Then at bedtime it is hit or miss whether my dad will be shoved into the spare room/couch. Last night she declared that they were divorced so could not share a bed.

We've had no help from anyone. Memory clinic nurse has been out a few times but we have yet to see the consultant and SS had no offers of help, just said to take her to a day centre, but she is not aware that she has a problem and would never willingly attend anything like that. So we are just plodding on each day as best we can - leaving the room and coming back in and hoping she recognises us!

Thank you so much for your message, it is good to understand that others are in the same position, it helps us make a bit more sense of it (if that is even possible). My dad's GP has prescribed memamtime in soluble form today plus something to help keep mum calmer in the evenings, not sure if it will help. It does seem there isn't much practical support available as it is simply so difficult to know what to do. And like you our biggest issue is that mum is in compete denial and does not accept there is anything wrong - she thinks she is looking after dad. It is so terribly sad. I hope you and your family find a way to cope.

 

[Starting on a journey]

Mum took her first dose of mementine tonight. Within minutes she was upset because the little red light wasn't on the TV and it was all the tablets fault.(the little red light goes out when the TV is on). As she is on the 5mg dose we may have a bumpy ride ahead. Fasten seatbelts please!!

 

[canary]

Memantine doesnt usually work that fast @Starting on a journey - it usually takes a couple of weeks to "kick in"
See how it goes

 

[Starting on a journey]

Memantine doesnt usually work that fast @Starting on a journey - it usually takes a couple of weeks to "kick in"
See how it goes

I did wonder, but it did seem to start so soon after the tablet had been taken, almost as if she had taken "street" medication . Thanks for the advice I shall watch what happens when she takes it today

 

[canary]

@Starting on a journey Perhaps it was because she knew that she had taken the tablet, so everything that went wrong "had" to be due to that - much in the same way that other things that go wrong "have" to be due to us