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Has anyone run into this pattern with their LO? Mom is 92, in NH, health is good except for blind and “dementia”. She was never diagnosed with any specific type of dementia, her “normal” behavior I would characterize funny, pleasant, singing, and loving, no outbursts or delusions or hallucinations, just zero short term memory. EXCEPT about every 4-6 weeks or so she gets into a pattern of what I would call agitation. This is preceded by a few days of being exceptionally alert and having really cognizant conversation. I can almost predict it (I tell my DH that she was “too good today”), knowing it’s leading up to more and more alertness, then agitation/insomnia, and I warn the staff when I think she’s going to be a handful that night. She thinks she’s back at work, having to complete work tasks and talks to people from her work past. Her “busyness” keeps her awake for up to 48 hours. They usually keep her out by the desk, because she tries to get out of bed to get back to work. After 24-48 hours of this she finally crashes and sleeps for a couple of days, then back to normal on Day 3.


Has anyone experienced this type of cyclical delusion? Is it a particular type of dementia? It’s scary to deal with, although I’m getting a little more used to it, and not panicking like I used to, demanding UTI tests that ended up being negative.

Rocketjcat

Now that you mention it Moms worst episode was during the last Full Moon we had...what? about 3 wks ago. Didn't notice on her 1st episode ...will be tracking it going forward.....

I attributed it to over stimulation so have been reluctant to let her engage in any such activities. A friend wanted to take her to the annual neighborhood party recently. I almost adamantly said no for fear of another attack. Glad I didn't as she had the best time......it all worked out....I was working so couldn't take her.

The silliest thing worked for us.....maybe it will work for you. When I finally got her to lay down she refused to close her eyes so I gently closed them with my hand a few times and left my hand there for a bit and it seemed to work.

Lets keep this thread going to assist each other! xxx000
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Kudos to you for keeping such careful track of your Mom's behavior. I'm 72 and BiPolar for my whole adult life. Recently my Dr. told me that science is thinking now that many older people maintain their BP patterns all thru old age. (Not good news for me.) I take 5 psych drugs to manage my illness. It seems that it would be really difficult to diagnose or treat an older person who already has active dementia, altho there are now some one drug treatments that might be added to whatever drugs she already takes to modify what sounds like mania and depressive episodes. I think the difficult thing would be to get a Dr. to accept the diagnosis for a person he couldn't communicate with. But this is one idea. Sure sounds like places I've been in at various times in my life. Good luck.

Betsey
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My mother also had this. Exactly 3 days and it happened every 6-8 weeks. She was hyper alert for the first day and without need of her walker or rollator, and she could tell you every detail about anything. She would be a little restless that night, and you could tell by her speech that she was moving into a bit of agitation or grumpiness. The next day she would be very negative, and the third day she would sleep the day away. It wasn't like she was forgetful, or like she didn't have memories, because during both those days (high/low) she could tell you every detail about what made her happy or what created the agitation. The only way I would know that we were going into an episode was that she didn't require her walker that first day, and she would ask to make me coffee. I would ask her regular doctor about it and he would say he didn't know, that it could possibly be one of her meds, or a side effect of diabetes.
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rocketjcat Sep 9, 2018
Thanks cub piper, it does sound very similar. Moms never been diabetic, but I wonder if it would be worth asking them to check her levels when she gets into one of these spells. Might be interesting.
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Papa got these episodes after he was diagnosed with Parkinson’s. Delusions and hallucinations can be part of PD. However, these episodes only happened when he changed locations: went to the hospital - went to NH - evacuated for Irma - etc. Haven’t had one since he’s been in the same place, thank God.
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My experiences with my husband, who is 84 and has been diagnosed with temporal frontal lobe/vascular dementia, have been similar, but not exactly. His recent decline gphas been a pattern of a few calm days followed by sundowning and extreme paranoia and agitation at night, little sleep, up and down almost all night, then he will have 2-3 nights of heavy sleep, late mornings and napping most of the day. I keep hearing that eventually the agitation and paranoia will subside-something that I pray will happen.
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M Mom also had a few emergency ativan at home I used a couple of times a year. Now the memory care abd behavioral unit said it makes her go UP instead of calming her calm down. I thought this was so great the few times we used it home. They said no. Sigh.
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BeckyT Sep 9, 2018
Xanax would probably work better. We give Papa 1/2 Tab when he gets antsy.
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I could have written your post! I also say "Mom is too good today."

During her manic episode she keeps insisting her deceased husband is in the garage and she wants to look for him no matter that it is dark outside. There is no convincing her otherwise. She is not so much agitated as she is busy going thru drawers and papers and walking around rather fast and surprising well without a cane or walker; generally making a mess of anything she gets into.

She won't eat or sleep for 12-24 hrs. TG she will drink. My Mom is in her own home so I imagine your Mom in the NH gets more agitated as this high energy episode has a limited outlet.

She does however get agitated when I try to interfere with whatever she is doing. Her DR called this ODD...Obstinate Defiant Disorder. It is so scary as I think ...this is it....the new normal...I have lost her now. Just like your Mom she sleeps for 24-48 hrs afterwards and is OK again.

I gave her an Ativan that was prescribed post stroke 3 yrs ago and it helped a great deal. Am wondering if anyone knows of any other Meds to give during these episodes...was it OK to give the Ativan?

Her Dr just retired and we have been assigned a new Dr. so I feel very lost during this time of crisis.
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rocketjcat Sep 9, 2018
Thanks Lucy. Yes I can almost predict when one of these episodes is coming on, depending on what she’s talking about and remembering more and just “busy”. Luckily it’s only once a month or so. The LPNs attribute it occasionally happening during a full moon, but I think it’s coincidental. Ha. Mom is in a wheelchair so doesn’t get into too much trouble, but she definitely would if she could. These are the times she’s rolled out of bed trying to “do” something so has to be watched more closely. So 3 nights ago we decided to increase her Melatonin at night from 3 mg up to 8 mg to see if a better regulated sleep pattern might help. I really hesitate to add a stronger medicine...she is the poster child for bad side effects of medication.
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My mum is bi-polar, and also has Alzheimer's disease. She was diagnosed with bi-polar back in the 1960's and with Alzheimer's 2 years ago.
Her bi-polar causes her to have days of agitation/obsessions and sleeplessness.
Maybe your mum has undiagnosed bi-polar?
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My Mama has been in Memory Care for almost 1 month. She does the same. About once a month, while she lived in her home, she packed up her whole closet. She was going home to her Mama's house. She must have been up all hours doing this. Then, Everytime after a few days of UP, we had sleeping beauty for awhile. The Memory Care place said she was up and wandering for a couple of nights. She had some kind of altercation with another resident pushing them away. This was during her night time wandering. Unfortunately, she has now been sent to a Geriatric Psych Hospital for this behavior. These cycles seem to happen with her. They are looking for a anti depressant for her. She is agitated and has anxiety which they are going to help with. Its so sad to see them go through this I know. Hang in there! You are not alone with the cycles! They estimate my Mama is about 10 years with Alzheimer's or mixed dementia.
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Reply to BootShopGirl
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My LO went through episodes similar to what you describe. She never went into sleeping for a few days though. After she got on a daily med for anxiety/depression, she had a much more normal sleep cycle. She sometimes thought that she worked at the MC office. They would let her roll in in her wheelchair, fold papers, etc. Later, she would tell me that she was tired of working and was going to quit, which, I told her it was fine to just quit or take a leave of absence, so she could relax.

Based on what I have seen ,most people with dementia have some sort of delusions and sleep disorder at some point and time.
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Your question had me searching the net for "manic episodes in dementia". Interestingly this is recognized as a feature of FTD (frontotemporal dementia), you might want to do some reading about that to see if that fits.
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