Wednesday, March 26, 2014

With sundown comes confusion

Mrs. R. said, “Well, I guess I should get my things together and get in my car and go home.”

It was just after 8 p.m. or before 8 p.m., the sun down not for a long time, Monday or Tuesday, any day of the week. Mrs. R. was in her wheel chair in the living room.

Priscilla said, “Mother, you are home.”

“I am?”

“Yes. You are in our home, Bob’s and mine.”

“I’m not in my home.”

“This is your home,” Priscilla said. “You live here, with us, now.”

“Well … okay.”

Confusion in Alzheimer’s patients that time of day is called “Sundowner Syndrome,” Priscilla said a doctor told her. Not all dementia patients exhibit symptoms.

A few minutes after talking about driving to Texarkana, Mrs. R. said, “I don’t see John anywhere.” John is her physically 57-year-old, mentally 5- or 6-year-old son, for whom she gave daily care until he moved to a group home about four years ago.

Priscilla said, “Mother, John is at his home.”

“His home? How did he get home without me?”

Priscilla explained John’s group home and the care he gets there. “By now, he has had his shower and he is sitting in his recliner and watching TV.” She gives the same explanation every night.

A number of web sites address the syndrome. gives a short explanation, noting no one knows what causes the confusion. As with all things medical, there are several possibilities, garnered from guesses and studies, including sensory overload during the day, hormonal imbalances that occur at night, simple fatigue or inability to see well in the dark.

A few minutes after being informed of John’s whereabouts, Mrs. R. said, “I see John’s shoes by the couch, but I don’t see John.”

One night last week she thought the couch cushions were John.

After a time, Mrs. R. begins to stir in the wheel chair and say she needs to get up and get ready for bed. Priscilla and I put her in bed. The questions continue for a while, Mrs. R. asking which bed room we will sleep in, if we have fed the dogs and why is the door open behind her bed? There is no door behind her bed. One night last week when Priscilla went to the back door to let the dogs in, Mrs. Rodgers asked, “Are you going outside to the toilet?”

Do not get any idea of Poor Priscilla or Poor Bob. We are doing what needs doing. There are people who don’t want to know anything about Alzheimer’s and other forms of dementia, who do not want to admit they will be the old people in nursing homes. If you don’t get out early, you will be, though.

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