After my last post, I wrote a post in my (facebook) FTD online support group. I was seeking advice on how others have handled these kinds of situations, since I know that night waking is very common in dementia. Several people on the post suggested that confusion and disruption such as this could be a sign of a urinary tract infection. Who would've thought?? Never in a hundred years would I have thought that mom's schedule confusion could be attributed to a UTI; she had no fever and no other sign of being sick or in pain. Nevertheless, after reading all of the comments and suggestions, and reading up on signs of UTI in a person with dementia, I decided we needed to rule out the possibility.
The problem is...how do you get a person to go to the doctor when she thinks it is night and refuses to get out of bed? Add on to that my dad is overwhelmed with work right now and is shorthanded and all of my kids are home on spring break! After some investigation work (and thanks to a conversation I remembered having a few weeks ago with a friend about a home test kit for UTI's), I made a trip to the pharmacy and found a home kit for UTI's. Of course I knew I wouldn't get my mom to pee on a strip for me, so I bought a pan to go underneath the toilet seat.
At 6:20 pm, I returned to my mom's house (from the pharmacy) and put the toilet pan on her toilet. I went to her bedside and prompted her to get out of bed and go potty.
"No, no you shouldn't be here so early....only at 6:59 I get up to potty...."
So, as you can guess, attempts to get her to the toilet failed. That is, until it was 6:59. On the dot, mom got up, used the toilet and I pushed my way in to test the strip before she caught on that something was weird in the toilet (she had no clue). A couple minutes later, the test strip read positive for a UTI. My dad emailed her doctor and we made plans to get her into either his office or urgent care for today.
Fortunately for us, her doctor read my dad's email early this morning and sent in an order to the lab for a culture test. Since the culture will take a couple days to process, he prescribed an antibiotic for her to take in the meantime. A quick trip to the lab and I was able to get her a cup; another quick trip to the pharmacy and I got her antibiotics. Though she was already tucked in bed when I made it back to her house, I convinced her to take both the antibiotic as well as some Tylenol (she is feeling a little warm now) by telling her that it was a sleep medicine. The only problem now is waiting for her to get out of bed this "morning" (which is really 6:59 this evening) to go potty and collect her urine sample.
What would we have done without this support group? We would've never known...until it turned into something more serious. UTI's, if left untreated, can result in blood infections and can be life threatening. Hopefully we caught everything in time to avoid anything else too serious. I am hoping that once the infection is gone, she will be able to get back into her regular routine and her confusion will be lessened. I suppose only time will tell.
Showing posts with label night waking. Show all posts
Showing posts with label night waking. Show all posts
Wednesday, April 1, 2015
Monday, March 30, 2015
Another Turn
Just when we think we have things settled down, we hit another bump in the road. You can never expect anything to stay the same for too long with this disease.
For the past several months, we've had a new routine that has consisted of two new (paid) caregivers. We knew that the time would be coming where we may have to replace volunteers; they've been wonderful but my dad is afraid of wearing them out. Luckily, mom has been so set in her routine that we generally know when caregivers are needed. For instance, we know that she won't be out of bed until 8:30 and she had her medicine/breakfast/potty routine that she seldom deviates from. It makes it a little easier for dad to get out the door for work in the morning and not worry for the couple hours before caregivers begin to arrive.
Last week, dad related to me that mom had woken up at midnight, disoriented. She thought that it was afternoon and went into the kitchen to make her sandwich. Dad followed her in there, put her sandwich away and took her back to bed. But she was very unsettled. For the better part of the night, dad tried keeping mom in bed, blocking her from getting out as she tried to be sneaky and escape. A couple of times she was successful in her escape and was found in the office, playing on the computer. She had become disoriented one other time, when they were getting ready to go on vacation last summer. She woke up in the middle of the night thinking that it was morning and was trying to get ready for their trip. When dad related the events of the previous night, I was hoping it was just another fluke, as it seemed to be in the summer.
Unfortunately, I don't think that this is a fluke, but rather an advancement of the disease. It is quite common for people with Alzheimer's/dementia to become disoriented and wake at night; they lose concept of time. My dad has had a rough weekend with mom. The disorientation came back. Mom has been waking up at night and thinking that it is night time in the middle of the day. Yesterday, we came over for family dinner and I realized that mom never came out of her room at 4:30 for dinner; I thought it strange. I went back to visit her in the office and it became very apparent that she didn't know what time of the day it was. She pointed to the time on the computer (it was after 5:30 at this point) and mumbled about how we needed to leave soon so that she could take her nap. She was convinced that it was afternoon and we left that night, I was a little nervous for what the night would bring for my dad.
I got a text from my dad at 7:08 this morning, asking me when I planned to come over (which is usually 9:00). After doubling her sleep meds last night, he told me that mom had been up since 5:40 and he was nervous to leave her alone. She was disoriented and upset because she couldn't find her night time medicine. I quickly pulled on some sweats and, without a shower, got my kids (who are on spring break) and car loaded to start my day at mom's. At 7:40 this morning, I found my mom fully dressed, sitting in front of the computer.
"Good morning mom," I said, kissing her on top of her head.
"Why are you here? You need to go too but why didn't he leave me my night time medicine? He's not supporting me and giving me my night time medicine," she rambled.
"Mom, it's morning time. See the sun outside? That means it's morning. Here are your morning medicines," I told her, cueing her to look out the blind at the sunshine and showing her the morning bottle of meds.
"I wonder if I can eat early now 'cuz it's not 4:30 yet," she said, waving a finger at the clock which read 7:49. "I wonder can I eat can I make my sandwich now."
Just then, my dad walked down the hall (on his way out the door for work) and he told mom that she could go eat.
"It's time for your Slim Fast dear, it's breakfast time. You drink your Slim Fast," he told her.
"Yeah yeah? I can go eat now too? I can go make my sandwich now early?"
"You can eat whatever you want," dad answered.
"Oh good oh good! Oh thank you, thank you!" she said enthusiastically. She hopped up from her seat and practically skipped down the hall with a big smile on her face, thanking my dad for "allowing" her to eat early.
Mom sat at the table and began her "dinner" routine of making her pb&j sandwich, pouring her Root Beer in the glass beside her. Try as I might, I could not convince mom that it was actually morning and not evening. I could not convince her to take her morning meds; I even poured them into my hand to show her but she did not see the Sleep Aid medicine, so she could not be fooled into taking her morning pills in disguise as night time pills instead.
So now, here I sit on mom's couch, at 8:50 in the morning. Mom comes out every 10 minutes or so to poke her head out the window and the garage, looking for dad to bring her her night time medicine. Right now she is sitting beside me asking repeatedly where he wants, insisting on night time meds. I don't know how the rest of the day will play out, but I imagine it will be a long day. And an even longer night for my dad. I'm not sure how he is going to handle caring for mom all through the night and turn around to do a labor intensive job during the day. I don't know yet what the answer is. Maybe-just maybe-mom will get back into her routine, but I know well enough that this is all a part of the disease, and it seems to be changing yet again.
UPDATE: It is 9:50 and mom just came out in her pajamas, looking for dad (and medicine). Despite looking out the window and seeing the sunshine, she still thinks it's night time :(
For the past several months, we've had a new routine that has consisted of two new (paid) caregivers. We knew that the time would be coming where we may have to replace volunteers; they've been wonderful but my dad is afraid of wearing them out. Luckily, mom has been so set in her routine that we generally know when caregivers are needed. For instance, we know that she won't be out of bed until 8:30 and she had her medicine/breakfast/potty routine that she seldom deviates from. It makes it a little easier for dad to get out the door for work in the morning and not worry for the couple hours before caregivers begin to arrive.
Last week, dad related to me that mom had woken up at midnight, disoriented. She thought that it was afternoon and went into the kitchen to make her sandwich. Dad followed her in there, put her sandwich away and took her back to bed. But she was very unsettled. For the better part of the night, dad tried keeping mom in bed, blocking her from getting out as she tried to be sneaky and escape. A couple of times she was successful in her escape and was found in the office, playing on the computer. She had become disoriented one other time, when they were getting ready to go on vacation last summer. She woke up in the middle of the night thinking that it was morning and was trying to get ready for their trip. When dad related the events of the previous night, I was hoping it was just another fluke, as it seemed to be in the summer.
Unfortunately, I don't think that this is a fluke, but rather an advancement of the disease. It is quite common for people with Alzheimer's/dementia to become disoriented and wake at night; they lose concept of time. My dad has had a rough weekend with mom. The disorientation came back. Mom has been waking up at night and thinking that it is night time in the middle of the day. Yesterday, we came over for family dinner and I realized that mom never came out of her room at 4:30 for dinner; I thought it strange. I went back to visit her in the office and it became very apparent that she didn't know what time of the day it was. She pointed to the time on the computer (it was after 5:30 at this point) and mumbled about how we needed to leave soon so that she could take her nap. She was convinced that it was afternoon and we left that night, I was a little nervous for what the night would bring for my dad.
I got a text from my dad at 7:08 this morning, asking me when I planned to come over (which is usually 9:00). After doubling her sleep meds last night, he told me that mom had been up since 5:40 and he was nervous to leave her alone. She was disoriented and upset because she couldn't find her night time medicine. I quickly pulled on some sweats and, without a shower, got my kids (who are on spring break) and car loaded to start my day at mom's. At 7:40 this morning, I found my mom fully dressed, sitting in front of the computer.
"Good morning mom," I said, kissing her on top of her head.
"Why are you here? You need to go too but why didn't he leave me my night time medicine? He's not supporting me and giving me my night time medicine," she rambled.
"Mom, it's morning time. See the sun outside? That means it's morning. Here are your morning medicines," I told her, cueing her to look out the blind at the sunshine and showing her the morning bottle of meds.
"I wonder if I can eat early now 'cuz it's not 4:30 yet," she said, waving a finger at the clock which read 7:49. "I wonder can I eat can I make my sandwich now."
Just then, my dad walked down the hall (on his way out the door for work) and he told mom that she could go eat.
"It's time for your Slim Fast dear, it's breakfast time. You drink your Slim Fast," he told her.
"Yeah yeah? I can go eat now too? I can go make my sandwich now early?"
"You can eat whatever you want," dad answered.
"Oh good oh good! Oh thank you, thank you!" she said enthusiastically. She hopped up from her seat and practically skipped down the hall with a big smile on her face, thanking my dad for "allowing" her to eat early.
Mom sat at the table and began her "dinner" routine of making her pb&j sandwich, pouring her Root Beer in the glass beside her. Try as I might, I could not convince mom that it was actually morning and not evening. I could not convince her to take her morning meds; I even poured them into my hand to show her but she did not see the Sleep Aid medicine, so she could not be fooled into taking her morning pills in disguise as night time pills instead.
So now, here I sit on mom's couch, at 8:50 in the morning. Mom comes out every 10 minutes or so to poke her head out the window and the garage, looking for dad to bring her her night time medicine. Right now she is sitting beside me asking repeatedly where he wants, insisting on night time meds. I don't know how the rest of the day will play out, but I imagine it will be a long day. And an even longer night for my dad. I'm not sure how he is going to handle caring for mom all through the night and turn around to do a labor intensive job during the day. I don't know yet what the answer is. Maybe-just maybe-mom will get back into her routine, but I know well enough that this is all a part of the disease, and it seems to be changing yet again.
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