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Old 05-15-2012, 08:56 AM   #1
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Utensils and visions

My MIL is now seeing people walk past her at night. She wouldn't sleep in her bed because she saw someone pass her. She asked her son, 'did you see her walk by?'. This seems to be a new thing. Not sure how often. It seems when Brother in Law takes his turn to be with her, she does something new.
Also, SIL broght dinner over and it was ravioli. MIL picked it up and ate it with her hands. She did that with the chicken fried steak too. I mentioned this to my husband but he said she ate spaghetti the other night and she used a fork. He also said she ate like she was starving, which we know she's not. I pointed out that not using utensils was a new symptom of the AZ and his response, well she ate with a fork when I was there. Does this come and go? Is this an advancement in her illness?

The family moved a coffee table out of her living room and she said she wanted to go home. I also said that with familiarity she can cope and cover more. This shows how her ability for change has increased.

How long does this go on? Is there something with the visions? She makes the family sleep with all the lights on. By the next day when they have to go to work, they are exhausted trying to make sure she's ok. I've asked them if they could have the doctor find something to calm her but deaf ears...
Thanks again for listening.

 
Old 05-15-2012, 09:21 AM   #2
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Re: Utensils and visions

Your MIL is having delusions which are common with this disease. It could be a shadow or an image from what she saw on TV earlier that is in her mind. It could be a dream. They have a very difficult time telling what is real and what is imagined or dreamed. A shadow become a shadowy figure and the lights being on will tend to dissipate the shadowy figures. Dreams are another issue because the wake up thinking they are real. What you can't do is convince her that they are not there because they are real in her mind. Don't keep a TV on in her room, especially at night because she can confused TV images with reality as well. If she can hear or see the light of a TV in another room when she is in her bedroom that can also trigger delusions. And sometimes you can find no reason. Yes, a change of care giver can lead to different behaviors.

Yes, the use of utensils can come and go. Foods that are easy to pick up may get picked up just for that reason. Using the utensils becomes more and more difficult so why use them if you have a little ravioli that you can pick up. But the spaghetti is much more difficult to eat with the fingers so the fork is worth the effort. The ability to do something doesn't just disappear in a moment. It goes away gradually. On a good day, Mom will use a fork to eat her salad. Then she will eat her entree with her fingers. Other days she just uses the fork to band against the spoon or glass. Some days she will eat with her fingers and some days she will just stare at the food with no idea how to get it to her mouth. It is very possible that you saw MIL eating eating with her fingers and hubby saw her eating with a fork. That is the crazy way of this disease. Up one day and down the next. You know the progression as the up days are less and the down days are more.

Moving the coffee table is a huge lesson in familiarity. They do NOT like change, even minor changes. If at all possible keep everything the same. I do understand the "trip hazard" that a coffee table poses but that has to be balanced with keeping familiarity in tact.

I do understand the up all night and exhausted the next day. They have to go to work and MIL is dozing in the chair getting ready for tomorrow night. I was successful using Melatonin to aid Mom's sleep. It is a naturally occurring chemical that we all have in our brains. As we age it decreases and one of the reasons the elderly doesn't sleep as much... and it decreases even more in those with Alzheimer's. By replacing the missing chemical a better sleep patter can be obtained. It is over the counter but it is always good to check with her doctor. Mom gets her dosage at bedtime because it is quick acting. If it doesn't work the first few nights keep trying because it takes a while to get the Melatonin cycle working again. After a few nights Mom was going to bed and sleeping all night instead of staying up all night. If that doesn't work Trazadone... which is a prescription is great for sleep as well.

As for how long this can go on.... forever!! Or it will seem that way. Mom was the night walker for months. It appeared she never slept. In fact she was dozing during the day in a chair or taking short naps at night just not sleeping long at one time. Yes, Mom was exhausted and it was not good for her physical or emotional well being but it was what her brain was telling her she needed to do... keep moving. It was only with intervention that it stopped

Love, deb

 
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Old 05-15-2012, 09:21 AM   #3
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Re: Utensils and visions

Yes the person will gradually lose the ability to use fork/spoon properly. But they can still hold it. If you simplify the things by her plate. Finger food may help her more. Sometimes we had to feed my FIL back in 2008 because he had trouble using the fork or spoon. He even had pride not to use spoon!! Gradually she would have swallowing problem. For now, it is just the way she eats that is going to be in a mess.

Lights on is common. It is sundowning. Now at sunset or in the dark, she would be afraid and have more panic. So leave some night light on. Don't have to be lots of lights. Just some night lamps here and there to save energy. She just wants light. Not lots of lights... Close all the curtains because she would be afraid of the dark outside.

Too bad her family is still in denial. Well, wait until she gets worse. Yes familiar stuff helps. The table is gone so she is missing something there.

Take care,
Nina

 
Old 05-15-2012, 09:30 AM   #4
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Re: Utensils and visions

One further comment.... prompting may her MIL use the utensils. Cut up her food, put a piece of the fork, and hand her the fork. I have even guided that first fork full to Mom's mouth. Sometimes they will continue with the fork if prompted in this way but sometimes they will lay it down. I usually try two or three times during a meal. If I can trigger Mom's ability to use the fork or spoon I let her do it. If not I let her eat with her fingers... or fed her. Just depends on the day

Love, deb

 
Old 05-15-2012, 09:44 AM   #5
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Re: Utensils and visions

MIl does have a tv in her room, a very BIG tv. Her doctor told them to move it to the living room so that she'd have to get up and move a little, not...
At this point, I think it's there to entertain her kids when they have to stay with her. I've asked them to move her tv to the living room to no avail, so I guess they can deal with the delusions. The caregiver says it hasn't bothered her enough to say it's time, but hey she's got a job. It's not about what she thinks but what is appropriate. The kids just don't want to deal with it. A shame.
One night BIL couldn't find his mom, she was in the closet trying clothes on at 2 in the morning. Deb, the melantonin sounds like a good solution. I will mention that. MIL has had this at least 5 years or so that we know of. the family doesn't notice the changes even though they see her every 3 weeks, alternating. SIL told me about the food thing and I told her that could be a new symptom and then she told me about another incident with the food and connected the dots.
I really didn't know about the visions. I know she's been delusional but not saying someone just walked in front of her then and there. Oh well, onto the next chapter possibly. Hard to tell, as you say each day is different.

 
Old 05-15-2012, 09:58 AM   #6
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Re: Utensils and visions

TV is not a baby sitter and they can create more problems than they solved. I just had a feeling there was a TV or vivid dreams involved. Even if they saw that person earlier in the evening... that may be the one memory that sticks until later in the night and scares them. There is one guy in Mom's facility that will sit in the living room alone with the TV on and yell about those people in the room with him. Dad would get upset at bedtime about the murders and burglars. It was nothing more than the news. For him, what he saw on TV, was current and present in the moment.

You wonder why those that are close can't see this disease but it happens more than you think. Long story that I will not go into but I saw my MIL for the first time in years at my FIL's funeral. It took me about an hour to figure out that she had cognitive impairment. The BIL and SIL that were always there had no idea. They thought I had lost MY mind. In the end they did realize that I was right. I do believe that much of the problem is awareness of all the effects of this disease. Most know the memory loss but not many understand all the other cognitive loses and what that means.

With Melatonin being a naturalistic approach to the sleeping problem it is easier for many to accept over what appears to be medicating. Eventually the need for a good night's sleep will override the hesitance to find a solution!

Love, deb

 
Old 05-15-2012, 10:47 AM   #7
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Re: Utensils and visions

You've hit the nail on the head. It's about the cognitive loss more than the memory loss. I was talking to someone the other day whose mother had been in a memory care unit that he said he liked over some of the others in our area. He said that they had an on staff Geriatric doctor which he said that you don't find alot of. He noticed the difference in the care by a geriatric doctor vs regular md. I found it interesting to talk to someone else with experience as well as I do reading this healthboard.

 
Old 05-15-2012, 10:57 AM   #8
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Re: Utensils and visions

Each NH has its own medical director. My FIL's home has this GP who comes every Thursday to check out the sick ones. Of course, each resident can have his own doctor. But my FIL uses this doctor and he is pretty good.

Nina

 
Old 05-15-2012, 05:26 PM   #9
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Re: Utensils and visions

Mitsy.. Mom and Dad's AL also had a geriatric physician. I agree that the care is different from that of a general practitioner. I also found a geriatric physician in private practice for my parents when they moved here. Usually they are connected to large groups of physicians (usually in connection with a large hospital) with many specialties. Now Mom is under the care of the hospice doctor who is also a geriatric specialist. I do highly recommend them

Love, deb

 
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