Tips on How to handle Anxious MIP (Memory Impaired Person)

[ndeossa]

MIL had many interest before Alzheimer's now while she is at home all she does is worried about everything; medication, the date, Christmas, cooking dinner (which she has not done in years), etc.

My husband and I are here from US trying to assess the situation and aid my FIL. We are thinking of getting her into some day care to alleviate the load from my FIL.

She has no interest in any activities, which means she needs constant attention at all times. We are uncertain how to relief her anxiety. Does anyone have any tips?

I read the article about "Compassionate Communication with the Memory Impaired" and shared it with my husband and in-laws, but still need to know if there are other things you do. I understand Alzheimer's is a very individual disease.

I have tried distracting her from the topic and stressing that she is in a safe place. My FIL just feels underappreciated and hurt to know that he has done so much for her yet she is still unhappy.

 

[LadyA]

She's not unhappy because of him. She's unhappy because...."something" . But she isn't sure what. She knows something isn't right. At least, she thinks, by how people react, that something isn't right. And it can't be her fault - so it has to be her husband's.

A Day Centre sounds like a good option. Maybe it could be presented as a Club or something.

 

[ndeossa]

LadyA, thank you for the response. That is a good idea to present it as a club. We just want him to have a break since it hard to care for someone with so much anxiouty

 

[Amy in the US]

I have been there, with my mother and her crushing anxiety, and i really feel for all of you. This was one of the hardest parts of dealing with my mother's dementia. She wasn't diagnosed at the time, and I knew something was wrong, but not exactly what. Looking back, this was clearly part of her dementia (likely Alzheimer's, and she also has no short term memory).

What worked for my mother was some combination of: straightening out her meds, insuring she was taking the right ones at the right times, better sleep, better nutrition, relief from all responsibilities (especially finances, household chores, errands, and anything requiring executive function and decisions), and 24/7 company (she had lived alone with only my long distance support).

I don't know if any of that will translate for your situation, but wanted to put it out there. Please feel free to ask questions.

I would stress for your FIL that it is her condition causing her apathy and likely the anxiety as well. There is likely nothing he can do to make her happy. The best you can do may well be content, or less anxious. Her lack of gratitude is a common symptom in PWDs and while it's easy to say, and hard to do, he should try not to take it personally (I realize this is probably impossible). The anxiety, lack of interest in previous hobbies and friends, and ungratefulness are all common symptoms in many PWDs.

I'd encourage all of you to read up on dementia. There are good fact sheets and info on this website. The US website has info as well, and a community forum/bulletin board. (TP gets more traffic and I prefer it, but you should be aware.) One of the hardest parts of dealing with dementia for me has been the steep learning curve. I think all of us, who haven't had prior experience, find it a challenge.

Best wishes to you and your family and please don't hesitate to ask questions.

 

[Graybiker]

Hi
Not sure I can help but wanted to reply. Mam was always anxious, dementia just made it worse.
I'll be frank and hope that's ok, in my experience, you can only give limited reassurance.
Day care is great, mam enjoyed it for a while, but as she was aware of her dementia she became concerned about 'making mistakes' and 'getting things wrong'. She then refused to go.
I then tried to concentrate on boosting her confidence. Mam loves crosswords, scrabble and puzzles. I try to do these with her while giving (not so) subtle hints so she gets things right. When she does it boosts her confidence and she feels generally better. This in turn reduces her anxiety.

I am very tired so sorry if this doesn't make much sense, but I wish you well
X
Ps. Mam used to be a member of the Townswomens Guild. She often thought day care was meetings for this. We always reffered to it is a day centre, rather than day care. Hope that helps x

 

[ndeossa]

What worked for my mother was some combination of: straightening out her meds, insuring she was taking the right ones at the right times, better sleep, better nutrition, relief from all responsibilities (especially finances, household chores, errands, and anything requiring executive function and decisions), and 24/7 company (she had lived alone with only my long distance support).

Amy, Thank you for the great advice!! I am going to look into the medication, perhaps that will help. She does sleep, but does not eat much and yesterday she she was so worried there was no way she can eat a thing, so I think her lost of appetite is due to worrisome. The funny thing is she is not responsible for ANYTHING, and perhaps it is that same thing that is upsetting her..

 

[Amy in the US]

You may be right about the lack of having something to do, contributing to the anxiety. I wonder if there is a way to introduce some sort of gentle routine or structure, and see if that helps?

 

[ndeossa]

Hi Graybiker,
thank you so much for your response. It means a lot to know that there are other anxious dementia people out there. She does not want to do ANYTHING other than worried about things she has not done for years. My husband and I are here from the USA, staying until January and I think our stay has caused her to be more anxious. However, my FIL cannot take it any more. She is asking the same question every 30 seconds, is not eating and looks so stressed. I think the idea of Day Center is really good..

thank you for being frank..

 

[Amy in the US]

Hi, nedeossa, it is difficult, and I'm sorry. I am glad to hear there is some relief for you in hearing that many of us have experience with anxiety and dementia. (While of no practical benefit, I think it can be reassuring to know you're not alone and that it can be due to the dementia.)

Getting your FIL some additional practical support is a really good idea. One of the difficult realities of dementia is that it is progressive, and no matter how well managed things are right now, needs will change over time.

A quote I read elsewhere that has been helpful for me at times is "care needs drive the decision making." Another hard part of dealing with dementia is remembering that we have to make choices for, and provide what is needed for, our PWDs. All too often this isn't what they say the want (and they may not be able to make a good decision about it anyway), or it's not what they would have wanted, or what they used to say they would have wanted, and it's often certainly not what we or other family or carers want, but there it is. Such a difficult issue and one all of us here have grappled with.

It's all so hard and I'm sorry.

 

[Pinkys]

Re asking the same question: I got a lot of help from a book called 'Contented Dementia'. It suggests a strategy for trying different answers, until one is found which seems to give some ease. The theory is that the person is not really interested in the answer which is obvious and true..Where is Billy? Billy lives in Spain now. But in an answer which is reassuring in other ways. Where is Billy? Billy is married now. (question really means is Billy OK?) or Where is Billy? He has just popped out for a minute. (Question really means Has Billy left me?) then having found the answer which seems to help, you repeat it until the need for the question dies away. I found this helpful because it gave me something to think about while I was being driven mad with repetition, and also because sometimes I did seem to hit on some answer which eased the anxiety a little.

How very sad for your FiL to feel so unable to make your MiL happy, or even not sad. It truly is a terrible illness.

 

[ndeossa]

How very sad for your FiL to feel so unable to make your MiL happy, or even not sad. It truly is a terrible illness.[/QUOTE]

Hi Pinkys,

Thank you for the example, you gave about Billy. I will keep that in mind. Her questions all related to things she needs to do.. It is really sad to see all that FiL does for her and still she cannot relax. He tries his hardest to make her happy and still she is filled with fear and worried.
Right now the two questions are 1) "I need to do my Christmas shopping" 2) "Christmas cards have not been sent". Of course both were done weeks ago and she was part of the doing.. It is really hard, I honestly think she may need anxiety medication. We having a Dementia Specialist see her soon, since her last evaluation was 2015.

 

[chessinguk]

Practical things that are worth trying include playing music - my Mum really liked a cd of favourite light classical music, it really calmed her down and reduced her anxiety. I used to put it on when she was anxious before sleep, as background music, during the sun downing period, when dementia seems to be worse. She also enjoyed music from her youth, like Glen Miller and Max Bygraves singalong CDs. It was also really nice for me to have a bit of familiar music in the house and lifted my spirits as well, being able to join in and sing along also really helped.

My mother in law also suffers from anxiety and she has been helped by having a doll to cuddle and look after. She thinks it's s real baby and she chats away to it and really loves it. She has become much calmer and happier as a result. (We find ourselves having to take the "baby" from her to look after it whilst she eats, so that she can concentrate on eating her food).

I would also second the recommendation of " contented dementia" it's a great book! It really helps to understand that the way you react to the person who is ill can sometimes change their mood - well worth a read.

It's really hard for your FIL - he really needs to understand that it is not his fault that his wife is anxious and unhappy, it's the disease! we were really lucky when my mum was really ill, we had a young girl - 15 years old- who came and played scrabble with mum and just chat to her for a couple of hours each week, giving her a new face to see and allowing me to have a couple of hours off from caring. She was wonderful.

Your FIL needs some time each week to himself, day care is a great option!

Best wishes

 

[IAmNotANumber]

I have similar issues with my mother. She is anxious all day long and can't seem to relax. She worries about when she last phoned her sister and repeats this question all day long. The standard procedure I have been told is to create distractions, however this is really difficult as tv is not an option ( too confusing ), music is not an option, books and crosswords are also not an option. We chat, but the conversation usually revolves around the same questions over and over again all day long. I love my mum to bits so don't mind at all, but the world around us seems to bear no relation to our world. The politicians creating Brexit to fund their jobs talking about Brexit, the TV and movie stars with inflated salaries and meaningless purile reality tv. Nothing is real anymore, just my mother's anxiety and the way society has been distorted out of all proportion to brainwash people into believing that money, job titles, status and the rat race is what matters when in fact, a society should really be judged on the way it treats its elderly. My mother has been prescribed lorazepam to help with the anxiety. It seems to help her when the anxiety becomes too much for her.

 

[ndeossa]

I have similar issues with my mother. She is anxious all day long and can't seem to relax. She worries about when she last phoned her sister and repeats this question all day long. The standard procedure I have been told is to create distractions, however this is really difficult as tv is not an option ( too confusing ), music is not an option, books and crosswords are also not an option. We chat, but the conversation usually revolves around the same questions over and over again all day long. I love my mum to bits so don't mind at all, but the world around us seems to bear no relation to our world.
My mother has been prescribed lorazepam to help with the anxiety. It seems to help her when the anxiety becomes too much for her.

Hi IAmNotANumber,

Thank you so much for your response. I will look into this medication, since that is not one she is currently on.

 

[Moog]

Hi,

I hope this helps. My mum has gone through that stage - mostly. She's had dementia for about 7 years so I've seen all the permutations. She suffered badly with 'sundowning' which is the anxiety that commonly occurs mid--late afternoon and evening when the light fades and the shadows get scary. A dementia sufferer can perceive light differently to us - the sunlight on the waves can be dazzling and the twilight scary and foreboding.

My mum's anxiety questions related to 'where's Mum?' (my grandmother - her mum who died in 1985). If I brought in fish and chips for supper - "Has Mum got some?"

The questions about her parents were always her flagging up that the environment she's in isn't supporting her emotionally. It's really a just code and we needed to interpret it. It helped to think of Mum as a toddler with fairly primitive emotioal needs. When things weren't right for her, it's like a toddler crying 'I want my Mummy'.

Distraction was the main way - animal programmes on TV (anything with monkeys or funny animals made her laugh), Mr Bean (she suddenly loved his slapstick comedy), or the main thing - edible treats: cupcakes, chocolate, choccy cookies, whatever was her flavour of the day.

The book mentioned before 'Contented Dementia' by Olive James a well-known psychiatrist is gold dust. It helps you embrace the 'new person' your dementia sufferer has become.

Currently my Mum likes a cuddly monkey who - if you press a button on his paw - he laughs like crazy and then passes wind. It's the instant tear-stopper when she's upset.

Her little edible treat now is a banana sliced in to chunks, then put turn the chunks over to form a disc, and a blob of squirty cream from a can. It's relatively healthy and distracts her long enough to stop the tears, and it takes minimal effort to eat

Time with Mum is now like entertaining a toddler - funny faces, light-heated programmes (sometimes gentle children's programmes like the Telly Tubbies on TV.

Antidepressants - my Mum had terrible sundowning with my Dad phoning all day saying she was crying and he didn't know what to do. Sertraline was the one that worked for her. She's now in a calm mood about 95% of the time, with only the odd crying moment when she's got tummy ache, her nappy is full or from separation anxiety when Dad isn't in the room.

Hope this helps to some extent.

Moog x

 

[Moog]

Forgot to say. Some local authorities providing FREE sitters. Our local one in Kent offer 4 hours a week via a care company. They will take the client out or sit and chat or do activities. We have 2hrs twice a week as this allows my father to take a nap knowing someone is entertaining Mum.

Also, there are voluntary befrienders - Royal Voluntary Service.

Check if there are Admiral Nurses in the area - these are specialist dementia nurses who can advise on support you can get in the home.

For my parents we have a combination of carers for breakfast, lunch and teatime, plus nightsitter, and free sitters twice a week.

Age UK run dementia day centres which we referred to as 'coffee mornings' as Mum has never been happy to acknowledge her dementia - from 10am-3pm once a week she was doing activities, given lunch and while there, taken to the loo and back.

I know it's like a patchwork quilt of help but once pieced together, it makes a difference to the sufferer and the family and soon becomes the norm.

Moog x

 

[Ez2610]

Some great advice here based on experience. It's overwhelming how many of us are loving and coping so well, and sometimes not well at all, with our PWD. I'll be getting the book, and investigating the meds. Thank you for sharing and helping others cope better, or maybe just feel better (I know I do).

 

[Moog]

Hi IAmNotANumber,

Thank you so much for your response. I will look into this medication, since that is not one she is currently on.

The issue with Lorezapam (a Valium-type drug) is it can only be used for a week or so constantly before it becomes addictive. At that stage, a larger dose is needed to maintain the effect, and should you need to stop the drug, the unpleasant withdrawal symptoms are worse.

We used this for Mum in 'emergencies' when nothing else would work and she was crying her heart out. It did make Mum go very quiet and subdued even at the lowest dose of 0,5mg, and, to be honest, it's a horrible feeling drugging up someone you love. She'd be quiet, sleepy and confused as to why she was so groggy.

With Lorazepamn - a) check to see if the sufferer has reduced kidney function - if she does it effectively increases the strength of the drug as the kidney's can't excrete it quickly from the body, so a lower-than-usual dose may be needed, and b) only use it in the 'in emergency break glass' scenarios.

My mother was temporarily prescribed a sleeping pill called Zopiclone which helped her get a restful sleep. The risk was when awoke and got up, she felt groggy and was more prone to falls. Luckily, we had a waking nightsitter who was there the instant she awoke so could assist her to the bathroom.

Keep asking questions here - between we've all be through ALL the scenarios so there are always options to try.

Moog x

 

[Moog]

Don't forget - dehyrdration really exacerbates the symptoms of dementia. Still need to aim for 1.5 litres a day. When Mum is dehydrated she makes no sense and is very distressed. Get her to drink a 150mls of liquid fairly quickly soon brings her back again.

 

[nita]

The other thing to watch out for, often mentioned on here, is urinary tract infections (UTIs). When my Mum had one of these she became more confused and more questioning. The doctor can diagnose this by taking a urine sample and then prescribing antibiotics.

I also think the damage to the brain caused by dementia makes the person disorientated and confused - my mother in the early stages kept saying "What's happening?" and "what's the matter with me?" It must be extremely distressing for the person undergoing these mental changes.