Some days my mom with dementia seems at her baseline - happy, attentive, fairly good appetite - other days she falls asleep between bites of food, may or may not know who I am, and has body jerking and shrieking. Has anyone else seen this? How can her days swing so far from normal to frightening?
The important thing seems to be that when these things are going on, they are kept safe. They might be moved to a recliner where they go to sleep, or sit near the nurse's station where they can be observed more closely. Vital signs are taken and noted.
Of course it's concerning, but not uncommon.
1. Dementia-Related Causes
Lewy Body Dementia (LBD): People with LBD often have dramatic day-to-day (or even hour-to-hour) fluctuations in awareness, alertness, and cognition. Muscle jerks, tremors, or sudden movements can also occur, and hallucinations or vocal outbursts are common.
Advanced Alzheimer’s or other dementias: As the disease progresses, inconsistent recognition, appetite changes, and sudden shifts in behavior may happen.
2. Neurological Events
Seizures or seizure-like activity: Small seizures can look like brief jerks, sudden drowsiness, or unusual vocalizations. Seizures are more common in people with dementia than the general population.
Parkinsonism (sometimes overlapping with dementia): Can cause body jerks, stiffness, and sudden sleep episodes.
3. Medical / Metabolic Factors
Infections (like urinary tract infections or pneumonia): These often cause sudden confusion, agitation, or drowsiness in elders with dementia, sometimes without fever.
Medication effects: Some drugs (pain meds, sedatives, antipsychotics) can increase drowsiness, confusion, or cause muscle jerks.
Blood sugar or electrolyte imbalances: Especially if she has diabetes or kidney issues.
Low oxygen levels (heart or lung conditions) may cause sleepiness and confusion.
4. Sleep & Fatigue Issues
Sleep apnea or disrupted sleep can cause daytime sleepiness and worsen confusion.
Excessive daytime fatigue from the dementia itself may make symptoms swing from day to day.
🚨 What You Should Do
Document the episodes: Note time of day, what she ate or drank, medications given, and what the jerking/shrieking looked like.
Contact her doctor promptly: Especially because jerking + sudden sleepiness could mean seizure activity, medication side effects, or infection.
Seek urgent help if she has trouble breathing, prolonged unresponsiveness, or seizure-like activity lasting more than a few minutes.
👉 These fluctuations are not unusual in dementia, but the jerking and shrieking suggest there may be something more going on than “just dementia.”
Please report what you are seeing to either her primary doctor or neurologist.