Up all night screaming and yelling and very abusive. Please help. - AgingCare.com

Up all night screaming and yelling and very abusive. Please help.

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I just took my mother home from the NH rehab where she has been for a month..She has AD which was diagnosed in Feb. this year, but had progressed rapidly. She is now wheelchair bound and needs 24 care/supervision. Since coming home 3 days ago, she has been very abusive, combative and very aggressive. Will not take her medications or eat when she needs to. Only if she wants to at that time. She as been nodding off all day, and up all night...climbing out of bed that has rails...she has fallen several times and it is very difficult to get her up. She is mean and nasty to me and my husband...sometimes the kids. I am exhausted and tearful constantly...I have given up everything to take care of her...we will not qualify for Medicaid to put her in NH permanently because she was ok up until a year ago and the "spend-down" was not done correctly and she will be disqualified. Please help me.

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Hit submit too soon. I also want to say, Good luck, God Bless you , I know what you are going through, and all the words we all wish were magic that could help you. You are not alone. You are in my prayers.
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BING! The whole time I was reading thru these I was waiting to get to the end and say what ChristinaW just said. Check for UTI!
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My Mother acted like that, became a monster, and it was discovered she had a UTI. What will it hurt to let her eat when she feels like it? Make sure you give her lots of water. Don't fight with her. Don't let the kids go in there. It's not personal, remember? Pretend you have a wild animal in your house and be careful. Sounds like they have her too much of some drug and she is toxic. Give her a break. I'll pray for her. Take care, ok? It's awful, but it's temporary. xo
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Besides "sundowner's" and the increased confusion at night, the other problem is that when someone is up all night, everyone is exhausted and it is almost too hard to NOT just let them sleep all day. But people who sleep all day are virtually guaranteed to be awake all night. This happens a lot in rehab settings and one of our major goals is typically to get day-night reversal taken care of as quickly as possible. We can usually use a combination of changing meds and times so heavier doses of the sedating ones are given at night, plus getting enough help to keep someone awake during the day as much as possible. Once in a while a medicine that is usually sedating may actually cause insomnia and it is easy to fall into that trap by trying to give more of it and having progressively worse results. They probably should have tried harder to sort this out before they sent her home - a solo caregiver should not be expected to easily manage this all by themselves!!
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Ask her doctor if ALPROZALAM would be safe with other meds. It turned my mom around in a few days! It's an anti-anxiety med. (Zanax). Good luck and get help before you need it yourself!
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JD I don't have good answers for you, I just wanted to express my feelings of empathy for you. As others have said, do the best you can to take care of yourself. Your mom is coming to the end of her life, but you have a lot of life left. You can only do so much for her and even with the best medical care in the world's best facility, her options are limited and there's only one outcome for her. So your goal should be to get through this sad period in as healthy a fashion for YOU as you can, while doing what you can for your mom. My thoughts are with you.
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Thank you all. She as been sleeping all day and noticeably stopped urinating as frequently...this was a big issue at rehab...she asked to go constantly. I am now thinking that the end may be closer than we may think. I was never given any time frame of life expectancy. She usually eats really good. Even in rehab, but that has tapered off a lot too...in the last week. Do I have reason to be concerned? Is this normal? From all criteria I believe she is at stage 6-7...
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You sound like you're at the end of your rope. I would be too. What hell you must be going through.

Trying to establish a routine is a good idea but in the meantime have you considered a memory care unit in a nursing home? "Memory Care" is such a sweet term for dementia and/or Alzheimer's unit. Behavior such as your mom's is their specialty. Some facilities offer respite care for family. This would not help in getting your mom into a routine but it sounds like right now you're in survival mode and need help.

Until you figure it out do what angel suggests and walk away. Remember doing that when our kids were little and throwing a tantrum? If your mom can't get at anything that would hurt her just walk away, go into another room, and leave her be.
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Do you have anyone example family that could help you out while to take some much needed R&R for yourself? If you could at least get some of her meds into her she may settle down a bit. Even try some icecream to slip it into. You have to take care of yourself as well or you will crash, even if a neighbor could give you a break with her. If she is combative just walk away until she settles down and try again. As long as she is no threat to herself you can put her in another room for a while with a magazine or book with pictures it usually catches their attention.
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I understand the sundowning, but the change issue is moot, because she was like this in the NH for the last week. They said she was too much work for the rehab..and I really feel as if I have been thrown to the wolves. I am so exhausted and it has only been 3 days. She had been living with me before the rehab, but like I said, has declined rapidly and continues too. I don't think I can make it thru the day
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