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EVERY single night my mother, who has Alzheimer's, works herself into a tizzy...to the point that her COPD makes her so wheezy she can barely talk or stand. She has sundowned for quite some time but it has become focused on one single, all-consuming issue....she frantically searches through the phonebook, pacing with it from room to room, looking for her parents' phone number. When, of course, she doesn't find it, she becomes terribly upset - sometimes panicked, sometimes crying, sometimes ticked off...and sometimes all 3 at once!!!

One thing she seems to remember is that her Dad served in France during WWI so I told her she wouldn't be able to talk with him because Trans-Atlantic calls were difficult & expensive. That doesn't work because she says it doesn't matter how much it costs, she just HAS to talk with him. So I said his CO would cuss him out for getting a call that wasn't part of his official duty. No, the CO would be ok with it once he found out *why* she was calling. She has an answer for everything!

I've tried hiding the phonebook from her & told her I didn't have one. That just succeeded in causing her to rant for hours about what kind of place was this that it didn't have a phonebook while she paced continually from room to room searching for one.

I've told her the reason she wasn't finding a listing for her parents was because they couldn't afford the expensive luxury of a phone, figuring a child of the Depression would accept this as plausible. That worked a few times but now she's adamant that her parents were finally able to get one because her mother got the job at the woolen mill carding wool for the soldiers' uniforms.

Once, in desperation, I just picked a number from thin air & gave it to her. Wouldn't you know the woman who hasn't been capable of dialing a phone for 6 months suddenly has a fit of clarity & starts dialing away like she was an ex-AT&T operator!!! Thank God it was an inactive number but I'm not about to take THAT chance again! LOL

I've assured, reassured, re-reassured & re-re-reassured her that her parents know where she is & that they had already approved that she stay overnight here. Unfortunately, it doesn't stop the frantic phone number searching, panic, crying or extreme anger. This goes on for HOURS (usually at least 2 hours but has been as many as 4 or 5 hours) before she tires out from a combination of all the activity & her bedtime Seroquel, Trazodone & Risperdal.

I'm working on getting her admitted to the Alzheimer's wing of a local nursing home but, unless they have an unexpected opening, there won't be a bed available until January when the construction on their new addition is completed. Until then, does anyone have any suggestions of other "interventions" that I can try to either cut this behavior off before it starts, to lessen the intensity of the behavior or lessen the length of these episodes?

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GlassHalfFull reminded me that I saw information on a seniors helping seniors contact service when looking through the senior assistance list at my local county. I don't recall the name of the service, and it might just be a local one but I'll see if I can find it. There might be other senior services that will provide someone to make a call to your mom on a regular basis.
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She's confabulating. She will endlessly fill in 'facts' to contradict you. Her doctor should be willing to prescribe preemptive Xanax (or SOMEthing) to decrease the anxiety. Or change doctors to one more familiar with dementia. There must have been some article or guidance put out that doctors shall not prescribe anti-anxiety drugs to dementia patients because it statistically increases the frequency of falls or some such tripe because all the doctors seem to be singing the same song. Sometimes there are mobile doctors who specialize in care for patients with dementia...check with the administrators at the facility.
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In our community, the local hospital has a "memory and Mobility" group that has specialist that can do testing as well as treatment of patients with a variety of elder issues (or non elder if applicable). A gerontologist would be your best bet for a dr. Ideally one that specializes or has lots of experience with dementia.
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Change your phone number. If he won't cooperate, you don't owe him your sanity and your marriage.
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My mom doesn't have Alzheimer's but has spells of being anxious. We keep ativan on hand for these "spells" and mom even asks for them sometimes. She takes a really low dose (like 1/2 of a 0.5 mg pill) but that is enough to break the cycle and give her a chance to calm down and get past whatever caused the "frantics". A bottle of 30 can last 3 or 4 months - so not an everyday med.

As far as your problem, does your mom respond to music? perhaps start playing music about an hour or so BEFORE the frenzy begins...

I like the idea of an activity planned during that time...folding laundry is one of mom's favorites!

I would either lose the phone book or give her an inoperable phone. Someone on one of the other boards talked about a service where a volunteer calls seniors 5 days a week...perhaps something like that exists in your area and you can get a male caller for your mom so that she might feel better connected to her dad...

Does she have photos of her mom/dad (when they/she were young)? Perhaps that would help.

A comfort item? Blanket - stuffed animal - doll - something to fuss over...

If her dr. will not prescribe what is needed, time for a new dr. I know that is a big step but really...mom is addicted to her past life - doesn't the dr. want to treat that?

Does she watch/listen to TV? How about netflicks or other "Father Knows Best" or "My Three Sons" or Danny Thomas...Something with a strong male character presence. Just the sound of a male voice may help calm her down.

Hope some of this helps. God bless!
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I wish daddy was a fraction as nice as mom. The aging process for him has made him bitter and angry with the world. He refuses to go into AL. because he doesn't want to hang around a bunch of disgusting old people. instead, he says he has no need for assistance which is probably why my husband and I get 10 phone calls a day from him. We have tried for years to help him make the transition, but he insists on staying alone in that enormous house watching TV by himself all day, unable to care for himself in any real way, so of course we do everything for him. We are weaning him off of my husband slowly... He doesn't realize it but we already live in another state. It's our turn now. Those of you who don't understand, probably aren't dealing with anything close to what we are. We are exhausted, and at age 50, we are anything but healthy now. daddy has literally destroyed our quality of life, he's working on destroying our marriage, I can't sleep anymore, I feel misery and guilt all the time and almost never feel joy anymore. I cry all the time, sometimes in public places.. No warning any more the tears are coming I feel like I'm going insane. pretty sure it looks that way to the GP as well. All of you out there that haven't gotten to this point yet, save yourselves while you can. your elderly assailant won't even know you're not there. or they will forget soon enough. Don't listen to the "judges". people who say I'm pretty sure he was there for you sometimes when you needed him of course he was I was his childand even though he wasn't there for me very much... None of these judgy people are in your shoes. Get out while you can and leave it to the professionals and get as many drugs as you can that help the situation... But as soon as you can, exit stage left. Have friendly visits, but leave the caregiving to the caregivers. We need more jobs in this country anyway. caring for family members creates way too much emotional baggage. definitely the most thankless job in the world! None of us need any more of that. don't let it get so far that it takes your health like we did. nobody wins.
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Ozarkollie, I couldn't agree more with your tactics. Anything that helps or works is 100% alright in my book. As you pointed out these people are never going to get any better. best to placate them in any way possible, so I don't understand why these doctors are so hesitant to Medicate. I think they should prescribe xanax for your mom as well as some for you. What is the harm?! My mom in her later stages of Alzheimer's thought my husband was her husband sometimes. They would promenade arm-in-arm through the memory care unit and she would introduce him to all her friends as her husband. He would grin from ear to ear and never disagreed with her or corrected her. my husband is a true gentleman and former force recon Marine...and would never allow my mom to embarrass herself.whenever she got agitated which wasn't very often... We were so lucky... She was an angel. We would always give her a stuffed animal and she would name them and comb them. Corn on the cob was another huge favorite. she was a former teacher so she read very well. My husband often wear a shirt that says Ron Jon on the front of it so that was what his name became when he wore that shirt. in an effort to stay on topic, shame on that doctor. Out of curiosity any chance you're willing to tell what state this is happening in? I have an elderly MIL who swears doctors in Florida would not give a pain pill to a person with a hanging limb...and forget anti anxiety medication for anybody for any reason... They simply refer you to therapy. Its absolutely ridiculous. At the end, sleeping pills and anti-anxiety meds were the only thing that kept mom from pulling herself out of bed onto the floor thus causing internal bleeding. picture trying to navigate the emergency room with a person who wants to pull out everybody's IV. mom was simply trying to help those people tangled up in those "long stringy things." geez I miss her so much. She was even fun when she was completely advanced.when she passed she was talking to her mom in heaven. Mine was the last name she remembered which made me feel really good. We were very close.I hope you find a doctor that will prescribe what you need. My thoughts and prayers are with you.
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Pretty good idea to line up someone male for her to call. Unfortunately, there isn't anyone. I've been doing this caregiver thing for so long that I quite literally have no friends any longer. This forum and a few other unrelated forums are my sole social contact these days nesides the twisted world my mother (and I by association) lives in. I've called my brother several times over the last 6 months & tried to get him to talk with her but he usually won't. I think he spoke with her maybe 2 or 3 times in 6 months & cuts their conversation as short as possible...generally 5 min or less. Plus, she hasn't fretted over him like this in maybe 2 months so I'm scared that having him talk with her is just going to open THAT can of worms again. I'll try the letter idea & see how that goes but I can tell you from experience that telling her that her Dad won't be home until the end of the week or he's calling in the morning or that her parents had already given permission for her to sleep here are all very hit & miss...usually miss. She'll tell me that I'm wrong about all of that & go right on being inconsolably agitated. I do have 0.5 mg Xanax that I can give but I've desperately tried NOT to use them...not out of some noble quest to not sedate her, but because her doc made a federal case out of the fact that I even *asked* to have a standby supply of them. I'm half afraid to use them for fear he won't refill the Rx, if needed. "They make the confusion worse", "they increase her fall risk", "we don't want her hooked on them". It's the same familiar song & dance I heard from her previous doc...but, to this guy's credit, at least he worked with us on the Risperdal, Trazodone & Seroquel. The first guy tried Zoloft & when she had bad side effects, just threw up his hands, said he didn't know what else he could do for her & we'd just have to accept that "this sort of thing is gonna happen" & wouldn't try other meds. The "get hooked" excuse always burns me. You just sat there & lectured me on how Alzheimer's is a terminal illness & that it will ultimately kill my mother....but then you won't give her a medication that makes her time left more pleasant for her (and, yes, therefore me) because she could get "hooked". What's it gonna do, kill her? The Alzheimer's is already doing that! Yes, it could increase her fall risk...but not any more so than running from room to room in a frenzy, so agitated you can hardly breathe & remain upright! They make the confusion worse - I can handle confusion...it's the agitation, panic & inability to be redirected that is the problem and, yes, a sedative would help with that. Anyway, gotta stop ranting about ridiculous doctor excuses or I'll be here all night! It's funny you would suggest giving the meds earlier as that idea came to me very early this morning. I will say, we had a very pleasant evening without the frenzy or panicked pacing. BUT...she just happened to take a long mid-day nap today, too, that she usually doesn't take so I don't know if the nice wvening was from the slightly earlier meds or from the nap. Trying to remain hopeful that the med time change is what did it & will continue to work but the scientist in me has to see these results repeated on a relatively regular pattern before I'm prepared to deem the timw change to be a success.
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I have had a problem with sundowning with my husband and called the dr. who gave him an anti anxiety med. for nighttime . After two weeks on it there was great improvement. I am now able to get a reasonably good night's sleep. He would work himself up into a frenzy every night and go from room to room trying to sleep prior
to that. Now that he has been on it six weeks he has settled in and only gets up to use the bathroom and back into bed. He has heart issues too and sleeps intermittently day and night. It has saved my life so far.
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Ahhh, the phone book, know it well. What I found worked the best was to tell mom that the parents or her sister or whoever it was that was so urgent to talk to, was out of town on vacation. They are due back in the morning and will be phoning to check in. Or I would tell her that parents will be picking her up in the morning. Of course always reassuring her that she has wonderful parents, kind sister, and they are very responsible people and we would hear from them tomorrow. Most of the time something like this worked.
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I was going to suggest what Blannie already did as well as a combination of other suggestions. But when she's sundowning, it isn't going to be possible to reorient her or explain to her. You'll have to find some way of appeasing her while allowing her to believe she's actually able to contact her father.

First, ask a male friend, or even a male relative if she wouldn't recognize the voice, to pretend to be your grandfather. Then create an address book with a lot of names, including your pseudo-grandfather's phone number.

Second, give her the address book and tell her when she's upset that you've gotten the number for her so she doesn't have to look it up. If the male "grandfather" is primed, with some knowledge of her real father, then he can pretend to be him and perhaps offer her some comfort.

Third, I also like the idea of writing letters. Perhaps the fake GF could also write some general letters, without going into too much detail.

Another thing is to plan activities that span the sundowning period... we used to fold laundry, work on dinner, sometimes I played piano for Mom....things to help her segue through the initial sundowning period while also being relaxed.

This really is sad; although I don't normally advocate the use of meds to calm someone down, I think in this case if it helps her it's worth it. As I read your post I recalled a few times when my mother was so anxious that nothing we said would calm her. It was upsetting for her - she was so completely unable to get her bearings and we couldn't help her. But it never lasted more than 5 - 10 minutes.

I think she must be seguing back to the time when she was a girl and her father offered some special type of comfort, or perhaps they had a special bond, that she's trying to recreate.

So I would ask her doctor what could work in this situation, or try Jessie's suggestion and administer the meds earlier.
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Ozark, I wonder what would happen if she had the medication an hour or two earlier so it would be taking effect about the time these episodes start. The only thing I can think of beyond that is bending the truth in a very honest way -- say that Dad doesn't have a phone where he is, but that her parents love her. I like cwillie's idea of saying that she could write a letter. The letter would never happen, but maybe it could help calm her. This disease can be too cruel to bear at times.
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P.S. One other idea (since you're being very creative), I wonder if you knew any man who could play the role of your grandfather. He could talk to your mom for a minute, then say he had to go to work on some project or something...tell her that he loves her and he's safe and he wants her to be happy and go to bed...something like that. But that she can't call him again, or he'll get in trouble with his CO. Use her nickname if she had one or any other thing that might get your mom to believe it's him.
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Tell her doctor about this. Your mom doesn't deserve to be miserable on top of what's happening to her. Her doctor may have to try different things, but I'd insist he give her something. Mom is miserable.
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OMG, I don't have an answer for you, I just wanted to say my heart goes out to both you and your mom. How touching and sad that she wants to talk to her parents so desperately. And how kind of you to try to work with her to calm her down and figure out creative ways to do that.

Would some kind of medication possibly calm her anxiety? That's what I'd research.
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Awww, that's so sad. Have you tried talking to her about what she needs to tell them? Is it possible that she could write it in a letter for you to mail "tomorrow"?
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