My Mom has severe multi-farc dimentia, (maybe alzheimers), but on her record it says multi-farc dimentia. She is in a nursing home. Her most troublesome condition is that she moans much of the time, especially at night, whether she is awake or asleep. Several medications have been tried, but now it is to the point that the nursing home gives her hydrocordone almost every night to hush the moaning. Mom is in a drugged state the entire next day. She gets another hydrocordone during the night and the results are the same. The nursing home has been cooperative with me trying alternative supplements, etc, but they are getting very tired of the moaning and I am concerned that they may ask me to take Mom out of their facility soon. I feel like I am between a rock and a hard place. I understand their concern about the moaning, but I really do not like my Mom in a drugged state all the time, and do not want her to live the rest of her life that way.
Mom is much better when I am with her, but calls for me or other members of the family during the night amidst the moaning. I don't know what to do. I have been researching on the internet, and I think she may very well be suffering from 'separation disorder anxiety'. If this is the case, I have been unable to find any effective treatments for the syndrome for adults in my Mom's condition. Mom is beyond behavioral modification training or any other treatment that requires active mental participation by her. Mom is also very sensitive to the common Alzheimer treatment drugs we have tried. She usually has a negative mental response to them, or throws up daily when the drug dose is increased to the target level that usually produces results.
Please respond with any advise you have that may help.
Are you sure that she is not in pain? Has she had a very thorough physical exam lately? Maybe she has a urinary tract disorder or heartburn or intestinal pain. Ask them to check out all those things before just drugging her.
I'm fascinated at NH's in the USA ... can they really kick someone out? Seriously?
I have a lady in my facility .. we jokingly refer to her as the "Ghost that moans". I mean this woman DOESN'T STOP. Every single breath out has a moan/groan. Yes, it get's on our nerves, and yes, it bugs the other residents, but we can't just 'kick her out' because of it .. she doesn't KNOW she's doing it!!!!!!!!!!!!!!!!
These people have DEMENTIA ........ they are no longer able to conform to our standards .... why on EARTH do these Nursing Homes expect otherwise?
I look after 20 PEOPLE in my little Dementia Specific Secure Unit ... all of them have 'annoying' behaviours. One lady can't stop spelling (rubbish words mostly, just letters from the alphabet) she does it when she's awake, asleep, listening to music/stories/visitors, eating, drinking ..... she doesn't stop! She's only aware *sometimes* that she's doing it! Another lady claps constantly .... again, she can't stop! She doesn't know she's doing it! Another gentleman grinds his teeth NON-STOP (bright side: he won't have any teeth left to grind eventually?) Another lady gigles all the time, and no amount of anything will get her to stop .. she gigles when she's happy, sad, whatever! One gentleman MUST always move furniture (even during dinner), another needs to pace and touch to feel safe (not always touching the RIGHT person which causes problems), another lady is CONSTANTLY begging to "go home" or "go to her room", you take her, she's right behind you asking again .... annoying?
Yes, they all bug each other, but thems the breaks when living in a group community .... no medications will 'fix' them .. or heavens sake, if there was nothing wrong with them they wouldn't be there would they?
So ....... How do we deal with these 'behaviours'?
We have tactics to assist ... diversions to seperate ... activities to keep others occupied, we WORK hard, not physically, but mentally. We're always alert, and we know some tricks that 'sometimes' works .. for our moaner, I often put my finger to my lips and go "Shhhh" and for a short time, it works. Our speller stops spelling when she's listening to an audio book, our furniture shifter LOVES it when I put a mop in his hand (I get the floor cleaned too), Our happy clapper likes to fiddle so she has a busy box .. not all of these inteventions work 100% of the time, but they do work.
Last edited by angel_bear; 09-30-2007 at 05:58 AM.
Reason: add to the tome ...
I so love listening when Angel Bear gets on her soapbox.... and once again she is absolutely right. I remember one lady who would sit in her chair in the hall and yell at everybody that passed by.... "I want my pink Cadillac". According to her family she never had one or mentioned one until late dementia. We had a moaner. Originally her moan resembled "gooo hooome" but eventually just became a moan. Another was a dolfer in a cotton mill all of her life and she continued to do that same hand motion all day. My grandmother would pick lint and my Dad checks the doors and secures the premisis repeatedly. I would have to take him outside with me so he didn't lock me out.
No, they do not underestand what they are doing or that it annoys others as we would. You have to be creative in finding way to help them. The little lady that thought she owned the building and was charging a quarter a day rent... I let her roll the change from the vending machine. She would sit at the table in my office and work dilligently until she was finished. Then she would ask me to take it to the bank for her and happily trot off to her room. There was never the right number of quarters in the rolls but it kept her happy and she stopped annoying the other residents to collect her rent.
These patients did not seem bug each other to a great extent. It was the visitors that became more annoyed. I never considered kicking out a patient. If they could conform to normal standards of behavior they would not be where they were. They were with us because they needed a safe place they could live out their life with dignity and respect. Each of their individualities had a reason to them somewhere in their fog. It meant something to them or is a way of expressing their emotions. Just because we didn't understand why they did it doesn't make it wrong. So at least at the home I worked in Angel, kicking one out was not an option and we didn't medicate them into a stupor. Even the 90 year old wheel chair bound play boy was only limited in his roaming. A broom stick in the wheel chair spokes kept him from chasing little old ladies into their rooms but he still enjoyed whistling at them as they walked down the hall. I smile when I remember the individuality of each of these dear souls.
So follow Martha's advice Rick and be sure she is not in pain. Beyond that, know it is probably the only way your mom has left to express her emotions.
Angel Bear and Deb....I sure hope the homes you both work in appreciate you two! They are so fortunate in your perfect responses to each individual...and the fact that you both so willingly share thoughts and ideas here!
My Mom is in a place with great employees also...and I never leave without letting them all know how much I appreciate them.
Rick...there are individuals where Mom is that also have behaviors that make some visitors raise eyebrows. That is exactly WHY they are there! I surely hope the responses offered here can be of help to you............Pam
Last edited by petal*pusher; 09-30-2007 at 10:03 AM.
This is a tough issue and it happens so often and never a simple answer. I can understand them giving her the pain med at night but not during the day so I would ask them to stop that. If the moaning is so loud that is is bothering others even during the day then perhaps this is not the right NH for her. I would also try putting head phones on her that plays soft music or music from her past. Perhaps she moans because it occupies her mind...i suspect her moaning is not pain related but then it is hard to judge at her stage. Multi-infarc dementia is very different from Alzheimers so meds are different. However, in the end stage they both look like the same patient. I know it is extremely hard to see your loved one on drugs but if you feel you have tried everything then what is there left to do? No one knows what to do with these patients so everyone treats them differently...the main goal is to make the patient comfortable the best way we know how. Be sure they have recently tested her urine for UTI and her blood work to see if there is in fact an infection going on. I am sorry that you are having to go through this good luck.
i too work in a nursing home and i am the activities director for our unit. I have the wonderful job of keeping the elders that sound alot like yours busy. I too have a teeth grinder and a screamer. i give the teeth grinder candy and that helps her to stop for awhile so she can talk to me so we can do 1-1. and the screamer... all i can say is good luck i try to do 1-1 with mine but it does no good. if you come up with any ideas please let me know.
Our "crow" was full pelt screaming. One of our other gentleman who no longer walks but can potter around in a lounge chair on wheels called me over. I said "What's up?" and he said "That lady over there (pointing to the one screaming like a crow) needs to go to the toilet" I said "Why's that?" and he said "Because you need to shove her head down it"
SHE got sent to her room the minute she would start screaming. I mean, she's loud enough that they can hear her in the next block (100m away !!). Even if you approach her and ask her to stop screaming she states "am I? I don't mean to" and then will scream again while your right there!!
(*we reckon she IS doing on purpose, because she's got that kind of personality and has always done her best to Pi55 people off) but .......... you can't tell really!