Sundowner’s – Barefoot Lily Lady

Tuesday’s Caregiving Tip: Laminated Photo Cards

Whiteboards are a good tool we use to help Mom remember names.

Eventually, with very few exceptions, all those afflicted with Alzheimer’s lose the ability to remember names. In the beginning stages, it’s an occasional inability to remember the name of a friend. Somewhere in the middle stages of this mind crippling disease, my mother began having more trouble with names. I noticed names scribbled in notebooks, on church bulletins, on 3″ x 5″ notecards, and backs of envelopes. It was her tool for hiding the fact that she was beginning to forget the names of her close friends.

Momma belonged to a group of ladies from her church who called themselves “The Lunch Bunch.” Each lady friend took turns choosing the destination for their culinary adventures. It was a sad day when Mom decided she could no longer meet up with her friends. She told me it was because the lunch venues were so far away. In retrospect, the unspoken truth was Momma was embarrassed she could no longer navigate driving to unfamiliar places. Even sadder and more difficult to admit, remembering the names of her closest friends was becoming impossible.

Our church family has become Mom’s surrogate church family now that she lives with us. My mother enjoys visits from her new friends, but is nervous about not knowing their names. To ease her transition toward knowing the names of these new friends, I borrowed an idea from a friend I’ve never met who lives in Yorkshire, England. A fellow caregiver to her own mother with mixed dementia, Heather and I “met” on Creative Carer, Heather’s Facebook page dedicated to inspiring and giving ideas to caregivers for those living with dementia. Our mothers seem to be travelling parallel paths in the progression of their individual journeys in the uncertain world of dementia. Heather is amazingly creative in her approach to caregiving, capitalizing upon her mother’s lifelong passion for all things artsy and crafty (you’ll also find many creative art therapy ideas on Heather’s blog here). As her mother’s memory began to fade, Heather created some laminated pages for her mum, depicting life events, useful information, and snippets of joyful events that had happened in her lifetime.

The laminated cards are double-sided and fit perfectly in her purse.

With Heather’s brilliant idea as seed thought, I made some little laminated photo cards mom could keep in her purse. Each card has a photo of friends and family who come to visit, with names written on the card and perhaps a little reminder as to how mom knows that individual or family. I love seeing Mom discover these cards in her purse. It’s a perfect sundowning activity for her, as she loves to go through the contents of her purse during her late-night purse rummages.

Whenever a new friend comes for a visit, I take a picture of them with my mom, then create a card for her before their next visit. About an hour or so before a guest’s next visit, I take that card out of her purse and show it to her. She really appreciates having the card as a reference.

Next project on the horizon: create a few cards featuring her childhood, family, nursing school and wedding. Memories from her early years are still relatively intact; these cards may help Mom tell (and retell) her stories to visiting family and friends willing to sit with her for a moment and listen.

A Woman and Her Purse

In the world of Alzheimer’s, a woman and her purse (and a man and his wallet) aren’t easily parted.

Mom carries her purse everywhere she goes and sleeps with it under her pillow or worn on her shoulder and hugged tightly to her side under her covers.

Rummaging and rifling through the contents of her purse is a favorite Sundowning activity (for more information on Sundowner’s Syndrome, click here). I keep a baby monitor next to my bed and can hear and see her zipping and unzipping her purse at all hours of the night – over and over again. I can see her happily stumbling over the same piece of mail and delighting in reading it out loud as if for the first time.

The contents of her purse may vary a little bit, but I can count on a few things. She’ll probably have five or six combs, her glasses in a familiar blue case, a few colored pencils absconded from her coloring set, her favorite pieces of mail, three or four tubes of lipstick, and Kleenex…wads and wads of Kleenex. And, for good measure, there may even be a roll of toilet paper crammed in there. It’s a harmless security thing. Her purse filled with familiar objects brings her a little peace and reduces anxiety.

Some church and community service groups even provide “rummage bags” or “rummage boxes” for memory challenged residents of local nursing homes, as the act of rummaging through the contents of the bag provides a sense of calmness and occupies them for hours (see related article filled with ideas here).

The paranoia associated with Alzheimer’s causes her to believe with all sincerity that people will try to steal her stuff. So precious is her purse, Mom will hide it to keep its contents safe. Now that she lives with me, I know where her favorite hiding places are located. When she still lived in her apartment or in her own home, sometimes she hid the purse really well. Really, REALLY well. For times like that, we found a handy little device called a Tile which helped us locate her purse using an app on our phone. We give it our highest endorsement and heartily recommend it for anyone dealing with an elderly parent…or someone like me who misplaces her car keys more often than she cares to admit.

Back to purses…

Sometimes my mom is hilarious. This was one of those days. Not long ago, I posted this on Facebook. I hope it brings you a smile too.

Alzheimer’s and Money Worries

One of the things that keeps Momma up at night during her Sundowning episodes is wondering whether she has enough money. She’ll go through her purse countless times in search of cash, a checkbook, a credit card…something. Anything that tells her she is okay financially. Continue reading “Alzheimer’s and Money Worries”

The Night I Scolded Momma

I’m sick and tired.

I feel really bad. Not just because I’m truly sick (as in a horrible head cold with dizziness) and tired (as in haven’t had a great night’s sleep in what seems like forever). I feel really bad because last night I scolded Momma and sent her to bed. I actually scolded my Momma. I treated her a bit like she was a little child.

To be honest, she was acting like a little child. Coming up with every childlike excuse in the book as to why she was sitting in the kitchen at 1:00 a.m. She had pulled an all-nighter in the kitchen the night before, with me getting up four or five times to check on her. But tonight, I’d had enough. I needed some rest. I told her, perhaps a little too gruffly, that I was sick and I needed some sleep. I told her that she needed to go to bed so that I could go to bed.

“Well, you go on to bed,” Momma chirped, a little too brightly for 1:00 a.m. “I’m not a child. I’ll go to bed when I am ready.” With that, she picked up a book and feigned reading (she didn’t have her glasses on and there wasn’t enough light on to see what she was reading).

I planted my hands on my hips. “No, Momma. You need to go to bed NOW.”

“I need to go to the bathroom and brush my teeth.” Momma was stalling. She had already done both of those things.

“Okay, Momma. Go ahead. I’ll set your toothbrush up for you, but let’s do it right away so that I can go back to bed and know you’re safely in your own bed.”

Momma continued to stall for what, in my ill state, seemed like an hour. There is just no point in reasoning with someone who lives in an Alzheimer’s world. She doesn’t understand my concern for her safety. She doesn’t realize that I’m afraid she might fall or wander out the front door. She has no idea that she has Alzheimer’s and that she is now suffering from Sundowner’s, a symptom in Alzheimer’s best described as an upset in the internal body clock which makes her mix up her days and nights.

Somewhat exasperated, I scolded, “Momma. You need to go to bed NOW. If you have to pee and brush your teeth, that’s fine. I’ll wait for you in your room.”

A few minutes later, she scootched into her room with her walker. She didn’t stop in the bathroom, so I asked her (with as much gentleness in my voice as I could muster), “Do you need to use the bathroom and brush your teeth?”

“No, Cindie! I’m not a child.” Momma plopped on the bed, obviously mad at me, then slipped her shoes off and pulled her legs up into bed.

“Goodnight, Momma. I love you more than your realize right now. Thank you for going to bed so that I can get some sleep and get to feeling better.”

With that, I turned off her lamp and closed the drapery that serves as her bedroom door, and then took a different route back to the kitchen so I could turn off the light over the kitchen sink, hoping that the darkness would make it less likely for her to be lured back in there a few minutes from now.

Fighting another dizzy spell as I laid my head on my pillows, I pulled the blankets up over my tired body, then laid on my side and watched Momma on the wifi monitor I keep on the nightstand. She wasn’t sleeping. She tossed and turned and I could hear her grumbling. But she was in bed…at least she was in bed. I picked up my phone and clicked on my Bible app and listened to the narrator read from the Psalms until I drifted off to sleep again.

Why do I share this with you?

This is some of the tough stuff that happens when you choose to provide care for someone with Alzheimer’s in your own home. It’s the reason why caregivers need a break from the responsibility from time to time. I’m thankful for the support system I have in my husband, our daughter Beth and granddaughter Violet, our Friday night caregiver Kathryn, our Sunday morning caregiver Kathi, my sister Vivian, and a sprinkling of friends who help out from time to time. Without them, I couldn’t do this.

And I’m thankful this morning that, with Alzheimer’s, last night is forgotten. Momma still loves me.

After Midnight Search

Sometimes life is just clearer in retrospect.

I know now that I should have responded to the video monitor’s prompting much sooner. Perhaps I would have been able to get more sleep if I had gone to Mom’s mental rescue sooner. It was after midnight, and Momma was having yet another bad night struggling with sundowning. I watched and listened in on the monitor as she yanked the chain on her bedside lamp and sat up in bed talking to herself. Nothing new; the same questions she always asks – those questions that never go away, even with an answer. I heard the familiar “zip” of her purse as she went through the contents of her purse over and over again. Between each examination of the contents, she would carefully hide the purse beneath her bed sheets. Then, in delighted surprise moments later, “find” the purse and go through the unzip and search motions again.

In the wee hours of the morning she decided to get out of bed. I pushed my head deeper into my pillow and watched from my own bed via the video monitor as she “furniture-walked” without her walker, opening and closing each drawer in her room, rifling through the contents and rearranging everything to her liking. She seemed to be looking for something. Momma was safe enough, just restless and confused. She left the room twice to use the bathroom, but always came back to her bed promptly.

I felt guilty just lying there watching, but I felt utterly exhausted and was in a bit of pain. You know that feeling you have in your leg after a middle of the night leg cramp? Well, I haven’t had a muscle spasm, but I’ve been having that type of “after pain” in my right leg all day. Add in a brewing migraine headache and a mom who just won’t go to sleep, and you have an equation that equals not enough sleep.

At two thirty, I got up to take some more ibuprofen, then drifted off into a state of semi-sleep, still listening, still peeking to see what Momma was up to. By four in the morning the tone in her voice changed to one of frantic agitation, so I made my way down to her bedroom to see if I could help, or at least redirect, so we could both get some rest.

Not wanting to startle her, I flipped on the hallway light so she would see me coming, rather than just have me appear out of nowhere in her room.

Bleary-eyed, I said in my loudest sleepy voice, “Momma, you really need to get some sleep.”

“Well, I’m not going to bed until I figure out who the guy in this picture is.” Momma held out a photo she normally carries in her purse. It was a picture of her with my Dad. I told her, “Well, that is you and Dad.” I could see her beginning to process that information and quickly realized that she was processing the word “dad” and couldn’t make the transition in her brain from my dad to her husband. I added, “Momma, that is your husband, Jerry.”

“Oh, Jerry Robert! Well, now that I know that, I can go to bed,” declared my sweet Momma as she crawled into her bed and nestled her weary from wondering head into the pillows I had fluffed for her.

It was a little disheartening to know that she was struggling to remember her husband’s name, and that I had let her struggle with that search for so many hours, rather than helping her fill in that piece of information so she could feel more settled. How scary that must have been for her.

I sleepily climbed the stairs and went back to my own bed with a prayer in my heart for Momma and me. This time, sleep came easily. Four and one-half hours of sweet sleep.

Sundowners and Sleepless Nights

“Hi, Cindie!” said Momma with more brightness in her voice than a live-in caregiving daughter hopes for at 1:52 a.m.

“Hi, Momma,” I groggily responded as I peered into her bedroom doorway. “What are you up to?” The soft light from the streetlight outside mom’s bedroom window snuck in a bit through the slats of her blinds, allowing me to see her distinctly hunched form in silhouette as she sat in the dark on the edge of the bed.

Out of the darkness, her voice continued, Continue reading “Sundowners and Sleepless Nights”