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I have questions about providing too much activity for our L.O.
dutiful deb
Posted: Monday, April 9, 2012 4:56 AM
Joined: 1/1/2012
Posts: 1878


It's 3 a.m. where I live; usually I'm in the lovely land of REM sleep right about now, but since I'm wide awake I thought I'd share something and see if anyone has any input.

Background:

On Tuesday, Mom went to the senior center with her friend. She even helped serve the lunch and had a great time.

...

On Wednesday, Mom went shopping with a friend for new supplies to stock our church kitchen.

...

On Thursday morning, Mom went to her Bible study group which consisted that day of three or four ladies and provided Mom with some companionship and conversation for an hour or so.

 

....

I work afternoons and spend most mornings with Mom, so last week with Mom going on outings with friends provided me with some respite, which I really appreciated. One friend in particular is very tuned in to Mom's disease and lets me know when she sees changes, more confusion, etc., so I saw this as a good opportunity for someone to look at things a little more objectively the way she does, and give me an honest view.

by the way....during my down time I watched some old movies, something I enjoy doing. If you want to forget about dementia for a day, do NOT watch Arsenic and Old Lace!  

...

On Friday morning I took Mom shopping, for about an hour, to the local Wal mart.

 

....

On Saturday I took Mom along with my little 3-year-old great nephew to an Easter carnival in our community. Mom had a great time  and enjoyed the time with her great-grandson but after about about  an hour she became agitated, acted confused, and wandered off a couple of times.

. .

This morning church was a little more crowded than usual, and Mom seemed agitated. She kept craning her neck and looking around in a very agitated fashion at every sound -- someone clearing a throat,  the crinkle of someone unwrapping a mint,  things like that. I've noticed her doing that at other times in similar situations but today it was more pronounced.

I fixed a small Easter dinner at my house (I appreciated the help I got here) with my mom and a few family members in attendance. The family stayed about an  hour and a half.   We kept conversation low key and after everyone left, Mom and I loafed on the couch and watched reruns of Rawhide and the Waltons, which had slow paced storylines she enjoyed. Even with that, Mom acted confused throughout the afternoon. When we went to take her home,  her legs gave out under her and she fell on the walkway in front of my house. I called 911 and she's fine, just very banged up. I'm calling her doctor first thing tomorrow anyway.

....

 I think it's possible there was too much stimulation over the course of the week, possibly culminating in her being overly tired on Sunday, but each activity lasted two hours or less and took place mid to late morning or early afternoon.  I thought the little jaunts would be good for her, but are there cases where the reverse is true?


Stephanie Z
Posted: Monday, April 9, 2012 10:40 AM
Joined: 12/15/2011
Posts: 4218


Hi dutiful, It's possible but there may be more going on. Since mom has vascular dementia, she may have had another small vascular event. You may never know. The decline from vascular dementia is not like Alz. It is a stair step decline whenever there is an event. Alz. on the other hand is a slow steady decline.

 

What is mom's physical status? Could she be coming down with something? A UTI is possible but other physicl problems could be happening. Sometimes we, as caregivers, make the mistake of seeing the dementia and thinking it causes every problem. We forget there is a whole person with multiple problems and issues.

 

I'd watch her closely over the next few days. Let her rest up. See if she bounces back. She seemed to enjoy the outtings with friends and she should keep doing them as long as she is able. If fatigue or increased confusion occur, activities should be modified to her level of functioning.

 

Hope this helps

Stephanie


rose_ro
Posted: Monday, April 9, 2012 11:15 AM
Joined: 12/21/2011
Posts: 2431


I am like the supervisor of Mom's life, to make sure she doesn't do ''too much.''

 

Think of it like a little kid, who gets overstimulated.  If I see a child out at night, usually the child is not happy, wants to be in bed,.

 

When my mom was first diagnosed, and was starting memory meds, she would sundown if she did ''too much.''

 

If we went to a doctor, I had to make sure she had time to ''recuperate.''

 

As time went on, she could handle more.

 

In the care place, when so much was going on, she needed ''down time'' to process things, and maybe to regain energy.


rose_ro
Posted: Monday, April 9, 2012 11:20 AM
Joined: 12/21/2011
Posts: 2431


I would have her checked for a UTI.  Some thoughts, no criticism, just some ideas of my mom's stage....

 

i don't know your mom's stage, but I would never take my mom to a carnival, too confusing to her (but she never liked them much anyway).

 

I think your Mom's schedule would be fine - if she were getting naps in between things, or just time to do nothing.  It's not that she's even doing so much - for me, it's more like she's getting a change of environment and people...my mom always needs time to process or adapt...

 

My mom has very good hearing, she would hear everything in the church also  

 

I have to tell you, even for me, I wouldn't want to do so many things without a break.  I know some people love non-stop activities, not me (I'm getting older, but may also be tired from helping Mom...)  (not that she's doing non-stop things, but I know people who do love that)...

 

makes me think of a UTI - agitation, confusion, legs giving out...

 

It may help you as time goes on to keep notes...When my mom came back from an outing to her home town, a few years ago, with her sister...I knew something was wrong...My mom had some level of confusion, like she was processing things that were confusing to her...I think it was 4 years ago, she went without my father, she saw people she's known for years but would have looked different to her...

 

I had no concept of AD then, or of VaD...I just knew something was ''off'' with my mom...It was like she was herself, but with something else thrown in...She was frustrated, and tired...but she cried, too, when I tried to talk to her...

 

I think the weekend, without my father, was ''too much.''

 

So - just some thoughts...If we have anywhere for Mom to go, I usually make sure she rests the day before...

 

there are times in this care place that I have worried that things are ''too much'' for her...but on the other hand, there wasn't enough for her, here...

 

One fault i had with the rehab place she was at last week was that she didn't get a break in the morning, because of their schedule.

 

Perhaps give her some time to rest, and see if things get better?

 


dutiful deb
Posted: Monday, April 9, 2012 11:24 AM
Joined: 1/1/2012
Posts: 1878


Thank you, Stephanie. Yes, that helps a lot.  I, too, wondered if Mom may have had another TIA or other vascular event.

Mom has osteo arthritis which causes her a lot of pain in her hands, hips, and lower back.  My first thought was of a broken hip, pelvis, or other bone. She has a walker at home (left over from when my dad had cancer) which she started using last night and she told me she thought we needed to find her a stool to use in the shower.

Up until now Mom has been in total denial about her condition. She cared for stroke and dementia patients in her job for years, and can tell me what the signs and symptoms are but never attributed them to herself even though she is aware of the fact that she's had TIA's. She talks about "other people" having Alzheimers or dementia, how she feels sorry for them and hopes she never gets that disease, and so on.

Then last night she told me she wondered if she had another little stroke which caused her to fall, and told me that when I call the doctor I should ask for a consult with a neurologist because these strokes can cause dementia or other problems. That was just wierd. It was like a sunburst of lucidity coming through the clouds of dementia.


rose_ro
Posted: Monday, April 9, 2012 11:33 AM
Joined: 12/21/2011
Posts: 2431


When my mom has had UTI's, she does have these bursts of lucidity, which is why I sometime wonder if she has one!  Like - well, she's confused, but not too bad, so is it a UTI?

 

If it's a stroke, does that 6 hour window matter?  I get so worried about that now...

 

I posted about a woman we ran into last week at the rehab place, whose mother had a stroke, but it took them almost week to get the right diagnosis!


dutiful deb
Posted: Monday, April 9, 2012 11:55 AM
Joined: 1/1/2012
Posts: 1878


Thanks, Rose, for your reply. I am concerned about over-stimulation, but also know it's important to keep Mom somewhat active socially. It can be difficult to find a balance, that's for sure!

 

What I took Mom too wasn't really a Carnival--just used that for lack of a better word.  We watched the 3- year- old hunt Easter eggs, then he rode in the pony rides, petted bunnies and lambs in the petting zoo, got his face painted, visited the fire truck,  and planted a pumpkin seed.  The weather was sunny and Mom enjoyed the sunshine and fresh air. I asked her lots of questions and got her talking about some of the animals we saw. She grew up in Wyoming and was around horses and other farm animals, so it was nice for her to be able to talk about the animals--"That horse is called a roan" or "I remember when I was little and my dad would lead me around on a horse like that"--she loved telling her little great-grandson and I all about things that were familiar to her.

 

  She had fun but did seem to get agitated toward the end of the hour. It was pretty crowded in some of the exhibits.  I have learned that Mom does best if her activities are limited to two hours or less, don't involve a lot of traveling, and take place no earlier than 9:30 and no later than noon. We live in a small town and everybody knows everybody else, so we always see people she knows which gives her a chance to connect with friends, which in turn gives her a social and emotional boost.

 

 

I made an appointment for her to be seen tomorrow. She'll have today to recover and rest up and I'll monitor her closely.  


rose_ro
Posted: Monday, April 9, 2012 12:24 PM
Joined: 12/21/2011
Posts: 2431


deb, that's cute, that's the kind of ''carnival'' we all can enjoy

 

it seems like your mom had a great time...but i do think how she ''reacted'' might mean something is going on...

 

when she's resting up for the visit, you'll get to see if she improves, or stays the same or gets worse...

 

my mom always improved, so i knew she needed rest....

 

i am still stressed out that my mom has probably had a UTI for the last week, and possibly pneumonia...it hurts a lot that they were kind of ''pushing her around,'' when she was sick!

 

but even i, who have seen her through a few UTI's, and know the effect of an infection, didn't see what was happening...i knew she was really tired, but hey, it could have been the stroke

 

i've said this before, it's like i wish she had a monitor on her which would tell me what's wrong!

 

she still needs to get a test today for a possible GI problem


Iris L.
Posted: Monday, April 9, 2012 7:49 PM
Joined: 12/15/2011
Posts: 16452


Deb, even if your Mom is not a diabetic you need to keep her blood sugar stable and keep her hydrated.  It's so easy to get off one's schedule at holiday time.  It happens to me.

 

Iris L. 


bela
Posted: Tuesday, April 10, 2012 1:59 AM
Joined: 12/15/2011
Posts: 4110


As others have mentioned it could have been another vascular event

when my mom was dehydrated she could stand or walk

My mom is in the latter stages of AD; she is physically healthy and I would let her engage in any activity that she enjoyed if she could....

when you have your mom and go to places keep pushing fluids and see if that helps

please let your mom enjoy the things she enjoys while she can do these things

You don't have to keep her busy on the other hand; but you can.  I wore myself out trying to entertain my mother 5 years ago.  

I always take water and snacks and meds whenever mom and i go out and we certainly don't do anything too exhausting but she needs the water and snacks anyway.


dutiful deb
Posted: Tuesday, April 10, 2012 10:17 AM
Joined: 1/1/2012
Posts: 1878


The hydration issue is a good one; thank you for those that raised it. 

 

Mom carries a small bottle of water with her everywhere, and keeps them in the fridge, too, so they are easy to grab on the way out the door. But I realized after reading the responses above that although she carries the water bottle, lately I've rarely seen her drinking it and often she forgets it and leaves the bottle in my car. Thinking about it now, the bottles are usually nearly full. I'll have to give her verbal reminders from now on. I will also start taking my own bottle (water, that is   )

Mom copies my actions a lot, so if she sees me taking sips, she'll follow suit.

 

I also now carry a "Mom" purse--you know, those gigantic ones that many young mothers use that hold everything but the kitchen sink-- so I can carry extra things for Mom. I also like those little backpacks I see a lot of moms carrying, so maybe one of those would work.