Things have been going so well lately and I've been remiss about writing and checking in. Today I went to see my mother this morning and all was well. My sister stopped by to see her this afternoon and she appeared fine, but the AL nurse took my sister aside and said she was walking the halls at night and that possibly she had a UTI.

This evening my mother called (7:45) and asked why I had a phone number of a friend of hers that passed away 15 years ago on her phone list. I told her I didn't and she said ok but she would show me tomorrow.

At 9:30 she called my sister to tell her that someone stole $3000 from her. My sister told her that she didn't have $3000 cash in her apartment and no one could have stole it from her. She was not combative, but was crying.

At 10:45 she called my sister again and said she was sitting outside and could see the roof and the sky -- she couldn't have been outside and still on the phone. My sister told her she should go to bed and she said she couldn't find the bedroom.

I called the ALF and asked them to check on her, they just called back and said she was very confused and was just sitting in her chair. They said she asked if she had a couch and they told her it was right there -- it's right next to the chair she sits in and she couldn't see it.

What is going on? Is she entering the next stage? Do you think she has a UTI? She is on no medication at all.

Rita

It's hard to say whether these changes are due to the fact that her AD is progressing or if she has another reason for this new behavior. It could be a UTI or another infection among other things. I'm a huge fan of getting checked out by a doctor for sudden changes, just to make sure that if anything is "fixable" that it gets fixed.

I'm such a wreck, my stomach is shaking. We will call the doctor in the morning to see if we can get her in -- this kind of stuff just makes us all so upset as I'm sure you know. Thank you soooo much Jellybeans for answering -- I just feel like crying.

I'm sorry this is so upsetting to you. Definitely try to get her into the doctor tomorrow. It might help if you were a little assertive when you called to make the appointment and say that it's urgent- it is. In the elderly, things need to be treated ASAP.

If for any reason you can't get her to her doctor you could either take her to the ER for mental status changes and have her worked up, though the ER is always stressful or you could even take her to an urgent care clinic. They do sell over the counter UTI test kits, but if it's not positive, I still think it's best to rule out other things too. (and even if it is positive, you'd still need antibiotics).
I'll say a prayer for you and your Mom.

Any sudden change could indicate some kind of infection or even unrecognized pain. It would definitely take some of the guesswork out of your mom's care. But please prepare youself to hear that this is a progression of the disease. We must always know in our hearts that there will not always be some other explanation.

Cry if you need to. These feelings have to be released or they will find their own, unhealthier, way out. We will hold your virtual hand and give you hugs to help you through.

Alzheimer Foundation of America Symptoms

This website's description has helped me understand better.
My mom is not on any meds either...not even OTC.
But my mom is 95.
My mom has not known me for more then 2yrs and I am her 24/7 caregiver.
She has no grasp of reality and cannot find rooms in her house that she has lived in for the past 56yrs.
She is like a good toddler. She cannot feel or understand bowel movements.
She has lost like the past 80yrs of memories.
I wonder daily why she is still here.
There are no answers, it is what it is whether it makes sense or not.

Sorry, but I have no answers for you, every situation is different. I do however think a visit to a doctor may help, especially to see if she has a UTI.

OMG -- you are sooo great -- I hate to admit that the tears are welling up as I write this. I'm so afraid to hear bad news -- I guess I don't want her to get any worse. She's 91 and I just thought maybe this would be the worst that she gets, but I know that being as healthy as she is -- the day might come when she won't recognize us. This is such a horrible and unjust disease. People are suppose to get old gracefully not like this.

Hang on grandma! You are doing the right things. You will check it out and fix what can be fixed. If not a uti, she may need some meds. Whatever it takes. Sending you hugs.

Is your mama in a regular ALF or an ALF memory unit? If the first, you may find that it's time to move her into a memory unit where staff should be better understand the stages of this disease...

When there's a sudden change like this, first have her check for UTI, constipation, dehydration, etc but --if it's none of the above-- these delusions usually are handled by medication...best given by a geriatric psychiatrist or a neuropsychiatrist. There's alot of info on this board about meds that can help.

She is not in the memory support unit yet. Let's see what today brings -- you may be right -- maybe it's time for the next step.

If not a UTI monitor her fluid intake. My mom seems to get much more confused when she's dehydrated. They don't remember to drink water and the fluids they get with meals just arent enough. Mom's alf goes in every afternoon and gets mom some juice or powerade to drink and it has really helped. I'll be thinking good thoughts for you!

Well I just got back from my Mom's and while she's confused about what happened last night and what she did and said, she's fine. She got dressed, was pleasant and went down for breakfast. I wrote her days activities on her dry-erase board (which I do every day and it seems to help) and she was going to participate.

The AL nurse said that rather than trying to get her into the doctor's office, we could just call and request an order for a urine test and they would administer it at the facility. We're going to do that today. But I'm thinking that since she was better today, it's probably the disease progressing -- is that correct thinking?

I would still get that urine culture. That way you don't keep wondering. If it is negative, then you could do a blood test looking for other infection or you could just assume she is moving to the next stage. When things are different at night than during the day, there can be issues with what is called sundowning. Search on that term, if the urine culture is negative and they can't find any cause for this. There are suggestions on ways to change a room around when this starts.

Good luck.

It could definitely be a progression of the AD or it could be something physical.
Delirium, whether or not it's superimposed on AD or not, has a waxing and waning course and it's hard to tell whether it's just a progression of the AD or if it's due to a physical cause. UTIs seem to be the most frequent cause of delirium, but aren't the only cause and a doctor could look for other things. If it were me, I'd still be taking her to the doctors, but that's not to say that's the absolute right answer, that's just what I would do.

My dad has evening like the one you described. He calls me, doesn't know where he is, says people took things from him that I know he does not even have at the NH, is totally confused about everything, and the next day, he's fine. He's on the execelon patch and Abilify and that seems to help. He's pretty good during the day but at night, and not every night, but at night is when things start to happen to him mentally. I normally just reassure him, tell him he's had a long day and that it's raining, too hot, too cold... and that he's just worn out. I tell him to get a good night's rest and that things will look better in the morning. So far that has worked, except for once when he got mad at me or trying to placate him. ("Who do you think you are???")

It's a good idea to see if there is anything physical causing this distress. Dad has never had a UTI that I am aware of, but he sundowns badly. He's about stage five but can still has good daily living skills. He's very social, too, although that seems to have fallen off lately. I also suspect that he puts up a good front with folks, even me, and that he sounds a lot more sharp than he is. He will just say off the wall stuff out of the blue, especially when he's tired.

Maybe your mother was over tired. Have you asked if she's had trouble sleeping lately?

She has had a lot of trouble sleeping lately -- so she says, but she also seems to be going to bed too early -- like 6:00 p.m. and of course she's awake around 3:00. The nurse told my sister that she is walking the halls at night and that they really can't watch her as much as they'd like because they have a lower level of staff on the night shift.

Of course last night she didn't go to sleep until around 11:00 or 11:30 and this morning when I went over there at 7:00 she was awake, but not yet dressed -- I also don't think she had showered, but I didn't press that point -- thought there wasn't any use in doing that.

Today she has a few activities scheduled and my sister is taking her shopping for a little outing. Hopefully, she won't go to bed too early tonight.

I have to research more into that sundowners -- sure sounds like a partial explanation. However, I'm still thinking we might be going to stage 6.

It is updetting..It happened to my mom..She is usually happy so a sudden change throws you off when you visit..definetely have her checked out..it is always better to be safe than sorry..9 out of 10 times on here our LO has a UTI..We have all seen it happen..But it also gives you insight if it should ever happen again so you know what signs to look for...let us know how it goes..hang in there!!

Hello Grandma,
I experienced very similar episodes with my mom. She too was in an ALF, but not in the dementia unit -- we were waiting for an opening, but she passed away before that happened. Anyway, many times she would call one of us in the evening and say bizarre things too, things just like what you describe. She told me once she was sitting in an alley with other cars (just like your mom - she couldnt have been outside her room and on the phone too), once she called my sister and told her that my brother slept on her bed all night long so she had no place to sleep (again, didnt happen), etc. She would also call and cry. I cant honestly tell you if it was a UTI or if it was natural progression of the disease because both occurred. It could have been "sundowning" too. No matter what it is, it is very disturbing and hard to deal with.

Hang in there Grandma, you are not alone. Just try to assure your mom that all is well with her and that she is safe and loved.

Peace,

Mari

My MIL has two periods of confusion a day...before 10 am none of her phone calls make any sense at all. The morning calls are a series of calls all about one subject....'bring me my passbooks'or 'where's T?' (our son, living and working 3 hours away)...nighttime brings more confusion but of a different tone. The nighttime confusion is often either off the wall or belligerent, 'you've taken all my money''you don't tell me anything, it's your fault I don't know where T is or what he's doing (after being told daily for 6 months now)' 'you're nasty to me' 'T's never coming back' etc etc. In our case, it's where we are in the disease, but at first we didn't know, and tested for UTIs, pain etc.

The staff have started giving her her sleeping pill later at night, when she slept at 8 pm she was up at 4 or 5 going in other patient's rooms. Getting her to bed later gets her up later in the morning, although she complains bitterly about her sleeping pill being later, she hates any change in routine that she can remember. Perhaps not letting your mom go to sleep so early might be good for her and eliminate the middle-of-the-night wandering?

Dear Grandma15: I am an RN whose mother passed away from FTD and whose step-dad has Alzheimer's Disease.

I can tell you that medically, quite frequently the cause of an abrupt change in behaviors, cognition or function can be secondary to a "silent UTI."

These silent UTIs usually don't have any symptoms; no pain, burning, frequency or odor, but they are there. The only symptoms for many of our loved ones are abrupt changes in behavior, cognition or funcition.

Despite stringent preventive meaures, my mother got these silent UTIs about five or so times a year. Her only symptom was that abrupt change in behavior or cognition.

Once treated with the appropriate antibiotic, she was back to her usual level of function.

So, this is a good place to start. And yes; the facility is the one that should test the urine. A dipstick will be done first to check for bacteria. If present, then a lab culture will be done to check for the most effective antibiotic. The culture takes about three days to come back.

In the meantime, the MD usually treats the patient empirically with a broad spectrum antibiotic. If that antibiotic turns out not to be effective by culture, the antibiotic will be changed.

I'm willing to bet there's a pretty good chance that this will be your mother's issue.

If it isn't, then a checkup with the doctor to rule out other causes is in order.

Let us know how this is going , we will be thinking of you.

I wish you the very best,

Johanna C.

Hi All, I thought you might want an update to the confusion night.

We had the urine test done at the ALF and have not yet received the results. It was done on Thursday and maybe with the weekend that was the delay. Or as Johanna mentioned, possibly the dipstick showed bacteria present and we're waiting the culture.

Anyway, I prepared her for the urine test and told her she needed to drink more water. I told her that sometimes if you're getting an infection it can cause you to be confused. She was all for taking the test and wants to know the results.

The strange thing (to me) is that she remembers this "out of body" experience and will replay the events over and over and tells me how they seemed soooo real. I'm suprised that she remembers them.

She's doing fine now, and I'm thinking that maybe it wasn't a UTI? She hasn't had any antibiotics so how can she be better? Maybe it is a progression.

So many questions.

I would love for her to stay up later so she didn't wake up so early, I'm just not sure how to keep her up since I'm not there in the evenings.