My mother has now started sundowning. Well, to be more precise, resumed sundowning because she was exhibiting this last year in hospital, when she got hold of a phone during the evening and harangued me.
Sundowning is a term I have found in print frequently in reference to dementia patients. It refers to people who have been reasonably lucid during the day becoming progressively more insane as the sun goes down. As for any illness, the main cause is that people who are tired have less tolerance for any type of pain or distress than they do earlier in the day with interesting distractions and a good night’s sleep behind them. As my mother becomes more ill, she does less and less, consequently her sleeping pill works for a shorter time and she is often awake again at four or five in the morning.
The feature of her brain dysfunction that bothers her most is the constant sensation of movement. Although in the last fifty years or so she always ‘wakened with a headache’ and no one thought to label it a hangover and she did fall down the stairs in restaurants and trip over several corks but she never complained of what I, brought up Geordie, learned to call ‘the whirling pits’. It’s that bit at the end of a night of extreme celebration when the room starts revolving regardless of whether your head is down a toilet or either way up on a bed. I last experienced this horrible phenomenon over forty years ago and would be delighted if I never encountered it personally again. Now the balance centre of my mother’s brain has atrophied she is getting all the whirling pits due to her from the whole of her life at once. Sadly, the stiller she sits the worse it is, because the blood is circulating less in her brain. When she is active or manages a walk in the day, the blood circulation is improved, she gets tired physically and sleeps better. After a longer night’s sleep she is better the next day and complains less of the perceived motion. I should perhaps clarify that the motion is all internal, outwardly she appears perfectly normal and in repose. She does not move, shake, tremble or exhibit any signs of the constant motion she feels.
She was nice this morning but certainly made up for it this evening. She harangued me, moaned, wailed, constantly threatened suicide and so on for an hour and wouldn’t listen to any kind of comfort I attempted to give, just interrupting and shouting how would I like it? What was she going to bloody do? I couldn’t even get a word in to tell her that sticking her head in the oven would be pointless because a) it’s electric and b) it has an automatic cut off when the door is lowered, all she’ll get for standing with her head in the oven all morning is a grease line across her ear
She became increasingly more abusive over the hour that the phone call lasted. I didn’t hang up because although she may be sundowning she is old and ill. The cost to me is such depression, I’m a pensioner too and don’t deserve to be rung up at eight in the evening and shouted at for an hour. I didn’t drink all that wine, I haven’t spent my life sitting around complaining, or being vitriolic to innocent bystanders.
When I was sixteen my parents arranged for me to be locked up in a geriatric ward and starved while they went on holiday. I was in a double row of beds with no curtains or privacy, down the middle of a huge ward of insane old people. At eleven at night and sometimes two in the morning, every night and many mornings, the lady in the bed in the far corner began to scream and smear herself with her own excrement. This was my first experience of sundowning. The hungrier I got, the worse it seemed until I got to the point where I could have screamed along.
I will not scream along with my mother. Despite it being a holiday weekend I will see if I can contact her doctor’s out of hours service and get some tranquillisers prescribed for her.
Tomorrow morning she may have forgotten all about it. She may be lucid or even cheerful, until the next time she is sundowning, when it will be as fresh a complaint to her as it it old and tired to me.
Update.
Here I am the following morning after being harangued for another hour. I have talked also to the manageress of the care agency, who has a great deal of experience and suggests that an anxiety medicine might help and to keep the occasionally administered, as-and-when sedative as a last resort. She referred to the occasional drug as a PRN drug, standing for Pro Re Nata, which my elderly Latin translates as when the thing is born, or perhaps, as the occasion arises.
Well I came off the phone and when my other half came down to complain about the cat hairs on his golf trousers, I was nearly in tears, which is not a thing I do and I subsequently vented my feelings about having to look after two compromised brains. He said there was nothing wrong with him and I asked why then did we redesign the kitchen round his pill drawer and he said it was old age and I said rubbish I am thirteen days younger and only take vitamins and he said it was stress at work and I said he retired fourteen years ago after which he stormed out to the shops to get lemons. As you do. Lemons are handy in a crisis. Obviously.
I have been hoping all along that the crisis in my mother’s health and the crisis in my husband’s health would not occur at the same time but it looks like they’re headed that way.
After much consideration I think I may contact the doctor to get appropriate medication in place for my mother, as and when I can, considering we are in a Bank Holiday. I will visit my mother to get it up and running and explain to her I need a week off. And then, if possible and unless I am overtaken by circumstances, I will have a week off. It would be such a rest not to have to speak to her for a week, I can do it because of the care agency, thank goodness for them.
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JaneLaverick.com – potty and then some, all of us.