Does anyone have a relative with fluctuating alertness? How do you cope?

LostInLondon

Registered User
Feb 26, 2021
88
0
Hello,

Sorry, i'm new and not sure if this is the right place to post as my dad is currently in a hospital and likely to go into a care home (depending on the burden of cost) but there is no forum for that.

My dad was sectioned a few weeks ago after a week long spell of wandering off late at night (as us having to call the police each time), experiencing confusion, paranoia, accusing me of trying to not recognising us, telling us he is going to see his family and they live elsewhere and not accepting that he had a problem. He was initially sent to the hospital with a heart issue as his heart rate slowed down but I asked if he could be looked at. Weeks later he is in a mental health ward and has been diagnosed with mid to late stages of Alzheimer's. He has a very slow heart rate and as a result he cannot have the medication that will slow his Alzheimers down as that also lowers heart rate. The doctor said a couple of weeks ago that they will try to give him a microdose to see what that does (this hasn't happened yet).

Each evening in the hospital he packs his bag and asks the receptionist if he can come home. He has to be reminded where he is and that ha has dementia which apparently breaks his heart every time. He wants to come home. He has been told by nurses that he will be going into a care facility but he said he doesn't want to nor does he need to. From speaking to the doctor, we've been told that he keeps wandering and it will be difficult to manage him. Sometimes he thinks he's in a cafe, sometimes he thinks he is at work. They can stop the paranoia but he will always be wandering off and this is what frightens me the most. What if he doesn't return? What if someone takes advantage? He gets angry if we don't let him leave so we had no choice. He will listen to medical staff because of their authority but not us.

He called today (he remembers who we are) and seemed close to 'normal'. Whenever he calls he seems himself albeit much more tired and he doesn't want to speak for long. The sadness in him is unbearable but it's also very confusing when he calls. Confusing to us because he seems so normal. I think if I were in that situation I wouldn't want to go to a care home either. I would want to be at home. It's hard for me to hear when he is himself because I feel like he's being held captive like a prisoner. It would be easier to comprehend if he was always confused or always paranoid but he isn't. I get that we're getting his 'best side' because he actively chooses to call us at times and we are not there 24/7 but this situation is very confusing. I feel like the world's worst person.

If you have a family member with fluctuating alertness how do you cope with the different, inconsistent versions of the person? If they are in a care facility, when they are 'alert' and ask to come home, how do you not feel like you're trapping them from life?

Sorry for the length.

Thanks,
 

karaokePete

Registered User
Jul 23, 2017
6,568
0
N Ireland
Hello and welcome @LostInLondon

Sadly this is common and I'm sure others with similar experiences will be along to reply to you.

In general, lucidity can fluctuate all the time. An extreme form of this is know as host(ess) mode where the person concentrates very hard to be 'normal'. This can only be maintained for a short wile and takes a lot out of the person. It's often seen when the person talks to medics etc and can sometimes lead to help being withheld in the early stages as the person is thought to be OK when the family know that this isn't true.
 

karaokePete

Registered User
Jul 23, 2017
6,568
0
N Ireland
By the way, it may be of interest to you to check out the Publications List attached to the site as it contains information on just about every aspect of dementia. Apart from that, just stick around and ask as many questions as you need. Just click the link below to find the publications
 

LostInLondon

Registered User
Feb 26, 2021
88
0
Thanks for the warm welcome, karaokePete and thanks for explaining. It is definitely very confusing and probably the thing that makes me feel the most guilty. I feel like i'm putting a 'together' (but innocent) person in prison and that I have no right to do that.

Thank you for the fact sheet. I will have a read. I am honestly relieved to find a community like this. It's a heartbreaking experience and one for which I was absolutely not prepared.
 

Sarasa

Volunteer Host
Apr 13, 2018
7,257
0
Nottinghamshire
Hi @LostInLondon and welcome to Dementia Talking Point. This is a very friendly place and you'll get lots of support and advice here. First of all I'm sorry to hear about your dad. His wandering off and having to call the police out must have been very worrying for you. I'm afraid when people with dementia start to wander it is very difficult to keep them at home. They can't remember that it isn't a good idea as the urge to go somewhere else gets too strong, and even if you are with the all the time it can be very difficult to keep them safe. As for sounds lucid, @karaokePete has mentioned 'host mode' where someone with dementia can sound very together for a short space of time. I think if you were to spend a few hours with your dad you would see that he couldn't keep it up.
I wouldn't dismiss a care home out of hand. Your father will have twenty-four hour care and people on hand to talk to and look after him all the time. I know things are tough at the moment due to all the restrictions around covid but that won't be for ever, and then you would be able to visit freely and take your dad out too.
I noticed @karaokePete has mentioned the publications list, another good tip is to use the space bar at the top to search for topics. There are lots about moving people into care for a start.
 

karaokePete

Registered User
Jul 23, 2017
6,568
0
N Ireland
Thanks for the warm welcome, karaokePete and thanks for explaining. It is definitely very confusing and probably the thing that makes me feel the most guilty. I feel like i'm putting a 'together' (but innocent) person in prison and that I have no right to do that.

Thank you for the fact sheet. I will have a read. I am honestly relieved to find a community like this. It's a heartbreaking experience and one for which I was absolutely not prepared.
You are very welcome. The forum is a great place for information and support. By the way, I've also replied to your other post and I think you may find that reply interesting - for your own sake.

Best of luck to you, your family and your dad
 

LostInLondon

Registered User
Feb 26, 2021
88
0
Hi @LostInLondon and welcome to Dementia Talking Point. This is a very friendly place and you'll get lots of support and advice here. First of all I'm sorry to hear about your dad. His wandering off and having to call the police out must have been very worrying for you. I'm afraid when people with dementia start to wander it is very difficult to keep them at home. They can't remember that it isn't a good idea as the urge to go somewhere else gets too strong, and even if you are with the all the time it can be very difficult to keep them safe. As for sounds lucid, @karaokePete has mentioned 'host mode' where someone with dementia can sound very together for a short space of time. I think if you were to spend a few hours with your dad you would see that he couldn't keep it up.
I wouldn't dismiss a care home out of hand. Your father will have twenty-four hour care and people on hand to talk to and look after him all the time. I know things are tough at the moment due to all the restrictions around covid but that won't be for ever, and then you would be able to visit freely and take your dad out too.
I noticed @karaokePete has mentioned the publications list, another good tip is to use the space bar at the top to search for topics. There are lots about moving people into care for a start.
Hello, thanks very much for the welcome.

He is due to go into a care home but I just feel very guilty about it because of how lucid and alert he seems. It sort of doesn't make 'logical' sense to me but as was explained I guess this is common? The wandering is the most frightening thing, yes and those two weeks were absolute hell. I almost lost my own mind and I fear what will happen if my father returns.

I will have a look through the forums for others' experiences. As I say, I am glad this forum exists. A lot of people need to know they're not alone. It's a very isolating experience.
 

Louise7

Volunteer Host
Mar 25, 2016
4,785
0
Hello @LostInLondon welcome from me too, and sorry to hear about your dad although it's good that you've already received a lot of useful advice here. It's natural to feel guilty about him going into a home but he is going there to keep him safe so try to focus on that if you can. The hospital have said that they can't stop his wandering so he wouldn't be safe at home, and you would be constantly worried and frightened about what might happen to him. It may not seem like it now, but knowing that your dad is safe in a secure place where he won't be able to wander off and be placed at risk of harm or danger will be a huge relief for you. It will take time for you both to adjust to the move into a home but once your dad is more settled, and you are able to visit him in his new surroundings, you hopefully won't feel as though he is in 'prison'. Keep posting as this is a friendly and helpful community and there will always be someone here to offer support and advice.
 

Sarasa

Volunteer Host
Apr 13, 2018
7,257
0
Nottinghamshire
Hi @LostInLondon , I moved my mother to a care home because she was going out drinking with random men in the local pub, and on at least one occasion bought one home. She agreed it was a bad idea when she told me about it, but it didn't stop her going and doing it again. Mum was far from happy when she moved there, but I knew she was safe, and before lockdown I used to take her out to a local café and also go and join in the activities in the home. The staff and other residents became like family, and i hope that will be the case for your dad too, although the next few weeks until covid restrictions are eased will be more difficult, but I hope you'll be able to visit even if their a restrictions in place.
 

Duggies-girl

Registered User
Sep 6, 2017
3,631
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Hi @LostInLondon Your dad does sound as though a care home would be the best place for him due to the wandering which is putting him at risk especially at night time but I am concerned at the way the hospital staff are treating him. They should not be reminding your poor dad that he has dementia every evening as this will add to his distress. It would be better if they just told him that he will be there for a few more days while he is recuperating. It is well known that people with dementia are unable to retain or accept facts that they don't wish to hear and it is less distressing to tell them what are known as 'love lies' In other words tell them what they would prefer to hear. My dad did not believe he had dementia so the word was never mentioned to him again, he just had a slight memory problem as far as we were concerned. They should not keep telling him that he is going to a care home either. Instead they should say he going for a much needed rest in a nice hotel to be looked after for a few days until he is much better. This may sound like lying but it is much better than taking away any hope that he has of getting home (even if it is never going to happen) and eases the distress which is important for his well being. I would definitely speak to the staff about this because they are making him unhappy. When he starts packing it would be better if they just said 'don't pack tonight, you can pack tomorrow' and so on the same tomorrow.

My experience of hospitals is that they can make dementia symptoms ten times worse and often when the person leaves the hospital they can slowly recover to almost how they were before they went in. However this does not mean that your dad should come home as your dad is already wandering but hopefully once he is in a care home (where they have a greater understand of people with dementia) he is more likely to relax and become more like his old self.

My dad spent three weeks in hospital and it's a very long story. Actually it was three weeks in hell for him and for me which could have been a lot easier if the staff had listened to what I told them but they knew best. Dad completely lost the plot while he was in there but I did get him home and he recovered almost to his old self but he could never be left alone again and I had to move in with him 24/7 from then on.

This is a hard time for you as much as for him and I hope it is all sorted out quickly.
 

Banjomansmate

Registered User
Jan 13, 2019
5,450
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Dorset
The Banjoman’s sister said she didn’t want him ”put in a prison” when I was talking about the need for him to be in residential care so I was quite surprised when she first visited him at his Care Home and actually said “Well done for finding such a nice place” , so Care Homes aren’t necessarily like a prison although your Dad will probably have a DOLs order so that he won’t have the freedom to walk out by himself.
 

Weasell

Registered User
Oct 21, 2019
1,778
0
Welcome.
We all suffer from guilt, you just have to pick what you want to feel guilty about. There isn’t a ‘no guilt option’ that I know of!

The tidal nature of dementia can be deeply upsetting, sometimes the more lucid moments are the most heartbreaking.

@Duggies-girl offers very good advice to you.

If you get him into the right care establishment you can be a positive loving influence instead of ‘bad policeman ‘.
If you are struggling still, then ask yourself one simple question ‘ on a bad day can we keep him safe’ ?
 

Shedrech

Registered User
Dec 15, 2012
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0
UK

LostInLondon

Registered User
Feb 26, 2021
88
0
Thanks for the responses, I genuinely appreciate them. I will read the lengthier ones in a bit. I just wanted to comment on the fact that the hospital staff said he would be under section 3 (he was under section 2 ) and I understand from one of the links someone here provided that section 3 would entitle him to section 117 aftercare however they put him under Dols instead (as someone else mentioned) so we're still nervous about the cost. It's a lot to think about all in one go.