Saturday, February 16, 2008

Catching up again

It's been over a week since my last post. What a week.

On Tuesday Sunrise called Drew and told him they thought Dad had had a TIA or maybe another stroke. They were concerned because he was barely functioning. He wasn't eating and he barely responded when they talked to him. Drew called me and he and I went to Sunrise. It was as they said. Dad was weak, droopy-eyed and non-responsive. He hadn't eaten any of his dinner. Mindy showed up a little later. She and I tried to get him to eat a little bit of bread and cheese from his sandwich but he didn't get much down. He did drink a small glass of juice. After discussing it for a while we decided to take him to the hospital.

We were in the ER for a long time. They did some tests but we weren't hearing anything back about the results. While we were there Dad seemed to brighten up a little. That was a bit of a clue right there. He'd had that juice and it seemed to help. Drew and I think that what was really happening was Dad stays up all night trashing his room and then he's exhausted during the day and can't eat like he should. Turns out we were right. Since he wasn't getting enough to eat his diabetes meds caused his blood sugar to plunge. Ahem. Do you think that maybe the staff at Sunrise could have caught that one?

I had to work the next day so I left at around 11:30. They finally admitted Dad and Drew spent the night with him. He said things got a little rough in the early morning when Dad's mellowing meds wore off. Mindy relived Drew in the afternoon. I went over there at 5 prepared to spend the night. Stacey showed up at around 7. She was just going to visit for a couple hours because she had to get up very early to go to work.

About an hour before she got there Dad started to get agitated. He was asking lots of questions and was fidgeting with his hospital gown. He kept trying to remove his IV and he pulled at the sensor stickers that were on his chest. He wanted to know what part of the room was "his house". He was angry that he had to share his room and he didn't like having strangers come and go. He was crazy concerned about edges and boundries. He'd run his hands along the hem of his gown and along the edge of the bed. He'd say, "Your place is there and mine is here. Right here. This is yours and this is mine." He was trying hard to get it figured out and he got angrier and angrier as time went on. Then he wanted to know who was paying for everything and what we should do. I kept telling him everything was paid for and there was nothing for him to do but rest. He kept saying, "Let's go. Let's go talk to the people. Let's go." He kept getting up. Finally I decided to let him go out to the hall. Sometimes letting him walk wears him out. Stacey showed up just as we were walking out of the room. Dad tried talking to a nurse for a little while and then he turned and noticed Stacey. That was enough of an interruption to break his fretful stream and we were able to get him to go back to the room.

But things didn't get any better. I kept hoping the evening meds would show up because I knew there'd be a sedative in there. They finally brought them. Dad didn't want to take the pills and we had to talk circles for a long time before he gave in. Then he had a hard time because he'd open his lips but clench his teeth. He finally got them all down.

He had to pee every five minutes, no exaggeration. We'd get him into bed and get him all covered and cozy and almost immediately he'd sit up and say he had to piss. Sometimes he could make it to the bathroom but we also had to help him use the urinal bottle. That was when we had to let go of any squeemishness we had about seeing our father's nakedness. This went on all night.

We kept waiting for the sedative to take effect. We could tell that it was but Dad fought it. He fought it like mad. It was like trying to get an overly tired toddler to let go of the day and go to sleep. Dad was like a toddler on steroids. He'd get up and stand next to the bed, lips and eyelids drooping, legs wobbly and shaking. We kept telling him to sit down and we'd push him down on the bed. He started throwing punches. At one point he picked up a wooden chair and tossed it on the bed. Stacey said, "This is what he must be doing every night in his room." We called some nurses to help get him into bed. Stacey and I waited out in the hall and listened to them getting him into his bed. We knew that as soon as they were done he'd be right up again. He did stay down for about 15 minutes but soon he said he needed to pee and jumped right up again. We helped him walk to the bathroom but he stopped at the door and leaned against the frame. His legs just wouldn't carry him any further. At that point I got pretty angry. I said, "That's it Dad. You're going back to bed and you're going to stay there. Stacey has to go home. We're done. Let's go. Pick up your feet. Pick up your feet." I kept talking as we dragged him back to bed. He fell asleep quickly and Stacey went home. She was pretty upset.

Dad slept for about an hour and a half but then the whole thing started up again. He'd sleep for a bit longer in between but he still got up several times during the night. I tried sleeping on the floor for a while. Then one of the nurses brought me a more comfortable chair and I slept in that. Sometimes Dad could make it to the bathroom but most of the time he couldn't and he'd pull his Depends down and pee would go everywhere, including on me. At 4 am he started to get combative again. More yelling, more throwing punches for 2 1/2 hours. He finally fell asleep. When he woke up at around 8 he was fine. Drew showed up at lunch time and I went home. They released him soon after.

I went home and crashed. That night Jeff and Bill came over and we had a nice, wonderful evening of playing ukes and drinking wine. A lot of wine for me. Thanks, guys. It was exactly what I needed.

I'm taking a break. I'll write about Dad's trip the the VA doc later.

2 comments:

vivage said...

I've read up quite a bit on the noctural issues with Alzheimers and it really seems as if he's got the noctural thing going on strong.

Most of what I've read also talks about the difficulties of new places and new routines and all of those things causes extreme stress and overtiredness that exacerbates the nocternal stuff.

The third thing is visiting only when he is in a good mood and keeping visits short.

I'm wondering if you guys give him a couple of weeks to settle in (sort of hard to do if the living place doesn't know how to watch for his diabetes) and start only visiting during the day if that would go easier on all of you.

You should really read this webpage: http://www.ec-online.net/Knowledge/Articles/reflections.html This woman gives some really good practical advice to things that are seen from an Alzheimers patient.

Hey, and it was good to see you tonight. Fun having a drink out with adults!

Donita Curioso said...

I enjoyed the whole night. Dinner was awesome, the show was really fun, it's always a hoot hanging with the brothers and topping the whole thing off by having drinks with everyone made it just perfect.

Thanks for the AD input. I also did some reading yesterday about all this. I'll be posting about his doctor's visit soon. His doctor and the psychiatrist think he has a severe case of sundown syndrome. His meds have been adjusted so hopefully it'll be less of a problem. Being in a hospital is just the worst thing for him. There's way too much stimulation and the surroundings are strange.

We'd LOVE to give him a few weeks to settle in but these emergencies keep popping up and then we're back to square one. I don't think we need to spend the nights with him at Sunrise, especially now that he's got an order for sleeping pills. It's these damned hospital stays that are the problem. Someone from the family has to be there or he'll be danger to himself or his room mate or the nursing staff. They'd have to restrain him and we really don't want that if we can avoid it. They did that at the Pheonix hospital and it was horrible for him.

So now we have a plan and we just have to try it and see if it works.