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Night-time mental disturbance
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2010guardian posted:
I don't know the best title for this. I got Ken up to go to the bathroom late at night before I went to bed. Sometimes I have to coax him to get him awake enough to get out of bed, including telling him how to move to get out of bed.

About 3 nights ago, I was going through this process, but he was in a deep sleep. I just kept working with him until he got on the side of the bed. He still couldn't open his eyes. He finally went to the bathroom. He came back and sat on the bed. I had to coax him to get him to lie down and he would instantly sit up in bed easier than any other time. He got up again and went to the bathroom and then walked through the house. After sitting down on the bed, he asked me, what I was trying to do to him. I said I'm trying to get you into the bed. Then coaxed him to lie down. Then up he came again and we reaped that a couple of times.

He then asked me where I was taking him. I said nowhere, just to bed. Then other questions: what is wrong? am I going to have to be like this the rest of my life? am I having a stroke? He talked in a low voice and demanded I answer his questions. I told him he was just confused and it was his Alzheimers. I then went over and tested his strength while he put his arms out. He thought I was trying to get him to go someplace and do something to him. Finally I got him to lie down and I put my arm around him so he could tell that I was beside him. He went to sleep.

The next morning I decided not to say anything and see what he would remember. He immediately came to me and said, " We had a problem last night. I thought you were trying to get rid of me so you could bring someone else in." This is so sad that he was hurting so bad and thought I was trying to get rid of him. I told him that anytime he is in a deep sleep, I'm not going to force him awake. I feel like this was a potentially dangerous situation. It makes me feel insecure and I don't know what else can happen in the night.
Have you heard of this before? I try not to think of it, but it's still there.

Kathy
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cjh1203 responded:
Hi Kathy. That sounds so distressing, for both of you.

Paranoia can be part of Alzheimer's, so that might explain his fear that you were trying to get rid of him. It wouldn't explain why it was so hard to wake him, though.

I wonder if it could possibly have anything to do with any medications he's taking? You might take his medications to your pharmacist, explain what happened and see if he/she can tell you if that might be a side effect of one of his meds.

Other than that, it's hard to know what to suggest. I think your decision not to wake him from a deep sleep any more is probably a good one, under the circumstances. If the pharmacist can't tell you anything, maybe talking to his doctor will help.

I hope this was just a one-time thing.

Every day is something new, isn't it?

Take care.

Carol
 
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2010guardian replied to cjh1203's response:
Hi Carol,

You have given me some insight. I'm not familiar with paranoia. I checked it out on the web. I am very surprised to read what all it involves. My husband has accused me of having a boyfriend on the side for several years, off and on. He was not like that all the time, just once in a while. I couldn't believe what I was hearing. I'm not sure how to handle this. I'm concerned that sometime if it should happen, what he will do about it if he thinks I'm being bad against him. What I've learned about Alzeheimers, this distrust is part of it. The article suggest therapy. I don't think therapy will help since this is part of the AD.

Ken takes 2 benedryl for sleeping pills. This past incident was the 2nd time he has been in a deep sleep and I've had trouble waking him. I swore the time before that I wasn't going to force him awake. Now I know for sure that I won't forget this. It's possible to drop off one of the benedryls. I think he'll go to sleep anyway. In the past when he forgot to take the benedryl, he would go to sleep, but wake up and have trouble going back to sleep.

I will talk to his AD doctor next month about it. Ken and I are exercising now. He rode the bike for 1/2 mile. He's feeling better. We try to go every day.

Thanks for your help.

Kathy
 
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cjh1203 replied to 2010guardian's response:
Hi Kathy.

Here's an article about paranoia, hallucinations, etc. in Alzheimer's patients (you may have already read it). One of the examples it mentions is a patient thinking his/her spouse is cheating.

I know that, often, trying to reason with an Alzheimer's patient can make things worse. Maybe, though, you could say to him just before he goes to bed something like, "I love you very much and you're the only man I ever want." I don't know if that would help, but maybe it could reassure him.

Here is an article about medications used to treat paranoia in Alzheimer's patients. It doesn't sound like Ken is anywhere near the point where he would need those, though. They can have very serious side effects but, in patients where paranoia, hallucinations and aggression are out of control, they may be worth the risks.

How wonderful that Ken (and you!) is exercising willingly and regularly! That was a battle my aunt constantly fought with my uncle -- he refused to do anything but walk to and from the car and, occasionally, the mailbox. I would think that exercise is one of the best things an Alzheimer's patient can do, and you must be thrilled to see an improvement in Ken.

How are you doing? How did your eye surgery go?

Carol
 
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2010guardian replied to cjh1203's response:
Hi, Carol,
I've read the articles and watched and listened to the video. They are very informative. I want the newsletters and more information on the one site. I'm not sure if I want to pay $57 a year for a subscription. I'll listen to it again, and I got some good information from the video.

Ken always feels bad when he had done something out of character. He goes overboard trying to see that it doesn't happen again. He had a lot of hallucinations before he was diagnosed. Afterwards, he did say much about it. He said the spirits were standing around watching him, and one looked like me. He said, 'I just wave my hand and they move.

I am extra tired today, so I'm not pushing myself to do work.
I had my eye surgery and walked out of the hospital amazed that I could see so clearly. Last Monday I had a check-up and my other eye is blurry, but he said I didn't need that surgery in that eye. It corrected to 20/40 after my Radial Keritotomy surgery. That one eye has never adjusted to one strength, so I vary from 20/40 to 20/50. I'm thankful that I can see so well, coming back from being 1/10th from being legally blind.

Thanks for the information.

Kathy
 
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Judith L London, PhD replied to 2010guardian's response:
Hi Kathy,

Has Ken been diagnosed by a memory care clinic expert? Some of his symptoms are similar to Lewy body dementia although people with Alzheimer's may have delusions and sometimes hallucinations. It is significant that he remembered that something happened the night before.

Discuss the night-time bathroom stop with him. He may be more comfortable with a urinal if he can use it. That way, you don't have him up and walking in the middle of the night when people in general are sometimes disoriented.

Hope this helps,
Judy
 
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2010guardian replied to Judith L London, PhD's response:
Hi Judy,

I'm not sure what a 'memory care clinic expert' is. He was diagnosed by a psychiatrist who have him verbal tests.

Ken usually remembers things that happen at night. Sometimes he won't mention it for 2 or 3 days, but lately, he tells me the next day. Do you mean that a person with
AD does not remember what he says or does the next morning?

I'm sure Ken won't want a urinal. He usually gets up with no problem. The bathroom is a few feet away from him.

I read about Lewy body dementia. It seems very strange.
In the past, Ken has acted out his dreams by hitting, kicking, yelling. When he did hit me, he didn't have any power behind the punch. It just woke me. I could usually tell when it was coming on by his jerking and twitching. The next morning he would tell me what he was doing, or maybe I was doing something in his dream. We discussed this with his doctor and he said there was nothing that can be done about it. Ken has not acted out his dreams since he retired and doesn't live a stressful life. Also if something really worried him, he may carry that to his dream and act it out.

I would be afraid of taking him off the Aricept and Naminda. He is doing so well with it. Thanks for the information. I will keep reading about it and consider talking to the doctor about it.

Kathy
 
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lbcash replied to 2010guardian's response:
Reading this post has helped me understand my grandmother's feelings better. I wasn't aware of the paranoia either. My grandmother is accusing my grandfather of trying to cheat on her. (He has alzheimer's as well). My Mom helps care for them and nurses come from Home Health to care for my grandfather. During her very confused states she thinks that my mother and the nurses are girls coming to the house to take my grandfather away from her. Needless to say she is very vulgar to them and tells them he is hers and where they can go. She becomes very aggressive over it at times.
 
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2010guardian replied to lbcash's response:
Hi,

I'm glad this has helped someone with the understanding of what is going on.

It must be very difficult for all of you and just think how much your grandmother is hurting. This is a double trauma for you all. Hearing other peoples stories helped me realize that Ken's dad had alzheimers and we didn't have a clue.

For yourself, read the information on Web MD about brain food and things to do to keep your mind active and alert. I was surprised that one of the biggest things is exercise. I am concerned about my children. Soooo, take care of yourself.

Your mother's heart must be breaking to be treated so badly by her mother. It's good that she has outside help.

It seems that this attack of paranoia came from my waking my husband from a deep sleep. He has been taking 2 benedryl each night for sleep and I had forgotten when he told me that he is really in a deep sleep for the first few hours due to the pills. The last two nights I gave him only one benedryl and he lays awake for a long, long time. I asked him if he thought it was good for him to be in a deep sleep and he said, "No!" So he will get only one pill from now on. I'm also thinking of Melatonin.

I know your mother needs your support. God Bless you all.

Kathy
 
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Judith L London, PhD replied to 2010guardian's response:
Hi Kathy,

A memory care clinic is a group usually associated with a hospital or university where a whole team of professionals gather to assess the nature of the dementia and the individual's functioning ability.

A psychiatrist with experience diagnosing the various types of dementia is fine.

Keep the medications going even if he seems to be slipping; they may be keeping his level of functioning up regardless and when people go off the medications, there usually is a dramatic slide downward.

Keep up the good work,
Judy
 
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2010guardian replied to Judith L London, PhD's response:
Hi Judy,

I definitely don't want him to go downward.
His most difficulty lately has been having difficulty in saying what he is thinking. He is still choosing exercise even when he doesn't feel like it.

Thanks for your help.

Kathy


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