Saturday, December 11, 2010

Sundowning, Alzheimer's and WB

Read enough to know that the day may come when WB may exhibit this disturbing Alzheimer symptom. 

Even though he sometimes becomes restless at night and medications have been prescribed to relieve it, last night was the first time we had experienced his true confusion with his abilities to differentiate night from day.

You learn as you plow this field how to handle the stress and anxiety AD brings on in the patient. Any travel or activity plans, sudden decision to leave the house, doctor appointments, company coming, etc. exacerbates this. Just about anything that does not fall into his daily routine, will cause WB stress and anxiety. 

We have been talking about traveling to Texas to see Mike and his family for quite some time and WB now wakes each morning and rushes to get dressed for travel. He has been gathering his "gadgets" daily, afraid we may forget to pack his nose spray bottles, flashlights, glasses, pocket knife, hairbrush, mouthwash, phone and charger. Definitely seeing a pep in his step since about October,  WB is most likely concerned that he may get left behind. This symptom is called shadowing and he has been shadowing for years now.

It all started around mid-morning yesterday.

He knew Kate would be coming in after her last tests. He now relates Friday with Kate coming home. So, any Friday that she does not come home creates a double dose of confusion for him.

Leaving WB with Michelle about noon to gather a bill of groceries created even more stress. When I returned, he had begun gathering his things for travel and was ready to change clothes upon my return. I had to once again remind him that we were not ready to leave for Texas. Note: my trip to the grocery totally screwed with his mid-day nap.

Most days about mid-afternoon, he will tell me he's hungry and that he has not eaten all day. I truly wish one could see the before and after AD pictures of Bill and his ever-expanding waistline. If something doesn't give soon, he will be in 42 pants and triple x shirts. I shudder as the last thing we need to spend money on right now is a complete new wardrobe for him. All the while I am trying to cut him back, he is sneaking snacks from the pantry and fridge. Its never been about quality for him, but quantity.

Dr. Lee blames some of this on the Seroquel which increases appetite and then of course the AD will cause him to have no recollection of if he ate or what it was. Just the opposite can happen when AD patients just forget to eat altogether and nearly starve to death.

Hunter came in and the four of us enjoyed a BBQ dinner and settled on plans to take WB to see a 7:30 movie. WHOA, a double date with daughter and beau sounded like a perfect Friday night event with an added bonus of BOGO tickets and the cinema is less than 2 miles from the house.

I had surprised Kate with one of her faves last night (brownies and ice cream) and dished up a moderate bowl for WB to enjoy while attempting to check us in at the movie online. I had my back to him less than 10 minutes when I noticed he had returned to kitchen to triple up his portion. Caught like a deer in the headlights, he was nearly choking himself to get it down before detection.

Scolding him with a smile while cleaning the chocolate syrup from his chin and chest,  I ran to get him another shirt. It was then that he told me he did not want to go. Because he had missed that one nap, there was no alarm for me when he announced that he was ready for bed at 7:00 pm.

I sleep in the den and it has been this way for quite some time. WB snores like a 500 pound grizzly and has a tendency to wander. Overall, it just works. I feel that I can better catch him before he's out the door and down the road.

Having scrapped the movie plans, we (Hunter, Kate and I) settled in to visit, talk over collegiate issues, the holiday itinerary, etc. and eventually plugged in The Grinch. I think we had all dozed intermittently when Hunter and I both were startled with banging. Nothing going on out in the yard, I settled back down and within minutes, another thud.

It only took me a second to get to the master bath to find WB coming out of the shower. Supposing he recognized the shock on my face he explains while drying himself off, "I've been running so late that I wanted to go ahead and get a head start." The pitch of my understanding must have been alarming to him as he asked for the time. 

Then comes, "I'm so sorry, Honey."

It only took a few minutes for him to realize that it was dark outside and others in the house were still moving about. I had him dried off, dressed and back in bed with a Xanax in 10 minutes. By 12:30 he was snoring again.

If you read and study this illness as much as we do, you recognize the symptoms when they strike. Although not shocked, I am saddened. Even though his decline into oblivion has been  evident, it is still happening too fast for me. As much as I prepare myself for these dips, it never ceases to take my breathe away. No matter what we do, no matter how we refocus our efforts, we cannot stop this.

Still sleeping soundly, chances are he will not remember. Chances are, I will not mention it. We will all resume our planned activities with a sideways glance and more attention to detail. Doubtful I will alert his doctors, as that may only increase the medications and getting to the other side of this holiday is my goal. I am confident that adjustments can be made here to get us through it. If I am wrong, so be it.

Instead of hysteria, I will adjust his diet again by removing all caffeine and further restricting his sugar intake. I will have him up by 9:00 in the mornings instead of allowing him to sleep until he gradually rises. We will eliminate a mid-afternoon nap, supper will be moved up to just after dark and I will try to keep him from eating anything before bedtime. As cruel as this seems, it is all in an attempt to manage his care in the home.

Just now when gently rustling him from his long winter's nap he asks, "where's the backhoe?" Sure hope he wasn't of dreaming of digging a big hole for me.

Will be posting links on sundowning some time this weekend.

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