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My Aunt used to have episodes infrequently where she would go into an aroused state hallucinating and physically active with no awareness of her limitations and she was in constant danger of trying to walk or do something she can no longer do. She would go until exhausted and then sleep for days, and recover. These were defined episodes with normal periods of six months or more in between.
Over time the episodes diminished in intensity to days of wakefulness and days of sleep, still hallucinating and attempting to do things she shouldn't try to do because of safety reasons, but with less energy and urgency.
Now the cycle of waking and sleeping is constant. Usually 48-72 hours awake and 24-48 hours asleep. She eats with tremendous appetite when awake, but cannot be roused or take medicine or water when sleeping..
What is this stage of Alzheimer's? Is it a stage? The memory care facility cannot manage her on noc shift because they only have one caregiver on duty for 14 residents. I have to just hope she doesn't fall. I used to try to stay with her at night when she was awake, but I work and can't do that regularly.
Is there more information I could find? We understand she has her own reality and we respect that. She "works" at the bank mostly, and is in a good mood and mostly enjoys her hallucinations. She has a full social life in her world, seeing all her loved ones. But I've not known another elder with this extreme wake and sleep cycle. Can anyone explain this to me? I thought deliriums were separate from dementia, but it seems she is in delirium the whole time.

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I forgot to mention that when my mother is off meds altogether..........she will have one good day................and then psychosis. I can't even describe it :(
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My mom (90) is bipolar and the extreme restlessness and constant moving is part of her mania. She never stops moving for days and nights. So exhausting for both of us. I can't sleep because she wanders around all night long - knocking things over, opening cupboards,dropping dishes, breaking things, - it's a nightmare. Even when eating, - she marches in place - never stopping. When I lay her down to try to get her to fall asleep, her legs and arms and hands continually move. Also, non-stop babbling. It's maddening. Docs and I are working on balancing her meds but unfortunately, most meds affect her in the opposite way intended. Often times, she reacts to meds by becoming even more restless. It's hard to keep her on something long enough to get a decent trial our of the drug. I don't think there is really an answer. Just trial and error and hope. There were short periods of peace (lithium for a while, Risperdal for a while............but sooner or later, things got crazy again). Mom has been treated by professionals and she did a couple stints in treatment centers.
I really don't believe there is a good answer. I tell her I love her and do the best I can to comfort her (try hugging a moving target).........and then I get some peace on the days that she finally sleeps. This is our life together.
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Twinflower, my Mom had delirium and it was scary to watch.... she would have her arms reaching up like she was trying to reach for something, and her legs would be peddling as fast as they could go. She would do that for hours. Then the next day or two just sleep and sleep. The nursing home tried different meds for her until they finally found the right balance, then Mom was back to dementia.

My Mom was in her final stage of dementia which she didn't have until she had a very serious fall, and she accelerated into the final stage within a week. Yes, Mom did fall out of bed quite a bit during those 3 months as she was so very restless, so the Staff had her bed down as far as it would go with rubber fall mats on both sides of the bed.

It was fascinating watching the "social life" of the other residents who were in this long-term-care facility. The residents were happy doing whatever it was in their world. One lady was busy using her finger nail to get what she thought were dried food off of the dining room tables.... another lady was the hall monitor, and the staff would allow her to move a chair to the middle of the hallway to direct traffic at night because she wasn't ready to retire for the night.
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Twin, is she in someone's home? Sometimes medication management takes a week or more of an inpatient stay on a psychiatric service. Can you work with her doctors to get her the relief she needs?
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She isn't on any medication. She is very sensitive to medicines and previous attempts to medicate this condition resulted in a worsening of symptoms and was withdrawn. I guess it's just not usual and her individual progression of disease. It is hard to manage her safety. I'm hoping she won't break a bone and have to go through that.
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Is she on any antipsychotic medication? If not, it seems that she should be.
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