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My grandmother (83) has early to mid-stage Alzheimer's and moved into an independent retirement facility a few months ago. Before her move, and since, she calls me several times a day reporting that she feels "sick". I try to get her to list symptoms, and sometimes they include headache, sore abdomen, dry mouth, shaky, and/or tired, but more often she describes it as "just plain sick" or "very, very tired" and "no appetite". Every day it is "the worst day yet", but when the symptoms and feeling of sickness disappear later in the day, as they often do, it's as though it never happened. In the past, she would call me several times and insist on going to the Emergency Room or the doctor's office. I would leave work to pick her up, but when I'd arrive and ask how she was doing, she'd say "Oh, fine!". If I'd say "Oh, you weren't feeling well earlier" (as in 15, 20 minutes ago), she'd say "Oh, wasn't I?!" as though it had never happened. On the other hand, it can sometimes last all day no matter what I try or whether or not I visit, or for more than a day at a time.


Some people have suggested she wants me to come over; I don't believe this to be the case, at least not consciously. Many times my going over doesn't help her feelings of illness. I worry she is somehow in a kind of loop - she's always checking her calendar, counting the number of days each month that she's been sick, and fixating on it (she operates primarily on notes in her day-to-day life - the only way she can really remember anything like instructions or reminders, etc., is by reading her notes). So I don't know if this can make it happen in a sense? Either way, it's extremely confusing and stressful, and sometimes she is almost crying on the phone and there's nothing I can do, making me feel really powerless to help. I try to get her to engage herself in a book, activity, etc., to take her mind off it, but after awhile she gets frustrated by that and says I don't believe her, "it's physical" or "it's real, why will no one help me".


Has anyone else experienced this constant "sickness" in someone with dementia or have any insights into dealing with it? I am going to meet with a geriatric psychiatrist today, so hopefully she can help.

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Mdm, when you said Metformin, it was an Aha moment for me. My mother took Metformin until she was about 88. She had this habit of munching crackers at night and taking extra Metformin. Bad idea! Too much Metformin can cause nausea, gas bloating, and general bad feeling in the tummy. The drug is not recommended for people 80 or older, because their livers can have a hard time processing it. If you think the Metformin could be making her feel bad, talk to the doctor. Or better yet, make an appointment with an endocrinologist to look over your mother's diabetes treatment. People with diabetes are allowed by insurance to have one consult each year. The most constructive appointment I've had with a doctor has been with an endocrinologist, who took my mother off the Metformin and (in her case) divided her Levemir dosages into two shots a day, rather than one. That got rid of the queasy feeling she got from the Metformin.

My mother's misuse of Metformin caused so much trouble. We went to several doctors to find what the problem could be. The only thing anyone found was lots of bubbly gas in her intestine. It wasn't until I counted her pills that I realized what was wrong. No wonder she was sick!

Some elders can be bothered by Metformin. A good endocrinologist may be able to pick something that will work better with your mother.
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Maybe I can be a little help here, Mdm. Sometimes I say my mother has made a late life career of being a sick person. She has been sick every day for at least 8 years. I used to worry that there was something I was missing and something I could do. It was frustrating. If you asked where she felt sick at, she would say she felt sick all over, or simply say she just felt sick. There was no way to zoom in on anything specific that was wrong. The doctors would say she was fine.

After a while I noticed that she always feels worse in the morning. Normally as the day wears on, she starts to feeling better. There are some days when she doesn't, but most days she is okay. We just have to make it through the morning. I think that in the morning she is a little dizzy and it gives her a sense of being sick. Many people are the same way about mornings.

Some things that could be relevant -- Is your mother diabetic and on oral medication? Is she on blood pressure medication? These things can have an effect on how people feel.
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Hmmm, my mother also often complains of being "sick" but not being able to be specific, just "all over" and she also takes Metformin. And as well it's usually in the morning. Maybe we're on to something?
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Thank you for your response, JessieBelle - that sounds very much like my experience! I've also felt/still feel that there's something I should be doing, but, yes, the doctors say she is fine.

I agree that the mornings are probably the worst for her, so thanks for pointing that out - maybe if she was engaged in some way first thing in the morning, it would help get her over that slump.

She takes Metformin for diabetes and Coversyl for high blood pressure (and Galantamine for dementia). She actually seems to be in very good physical health, though - she is very agile, spry, and has no other serious health conditions. Her diabetes is managed with the medication, and the high blood pressure I'm not too familiar with - she was taking that before I got involved in her care 2 years ago so I am not sure on the history of that.

I should book an appt. with her GP to ask whether something can be changed in her medication that might help with this.
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MCM, have you checked not only the side effects of the meds she's taken but potential interactions? One can't always rely on doctors for side effects advice, especially if the meds are prescribed by different doctors. One doctor who should have known about the interaction of coumadin and diflucan prescribed the latter, eventually sending my father to the hospital with internal hemorrhaging b/c diflucan enhances the coumadin effects.
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I would use validation strategies from Naomi Feil (look up her books). Acknowledge her feelings, they are real to her. "I am sorry you are not feeling well, maybe you picked up a virus. Drink plenty of water and rest. I will bring you chicken soup when I visit. We can check with the doctor if you are not better soon."

Obsession is fairly normal at that stage. At least this is a mild obsession ;-) One thing is for certain... This too shall pass.
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Thanks for the quick replies. We have done blood work, urinalysis etc., and the doctor said everything is fine. And, yes, I'm always sure to acknowledge her feelings, say I'm sorry you're feeling sick, if you're not better by tomorrow, we'll go to the doctor, etc., and have taken to calling her every hour or two to get her to drink a glass of water. She's gotten to the point now where even when I say these things, she's frustrated and just wants answers or wants it to go away now, and brings up how long it has been like this.

I try to find out what she's eaten in the morning, but she doesn't remember. I had her make a food chart when she lived at home, but now it's more difficult, as she goes down to the dining room for meals.

Perhaps I will ask the dining room attendants to keep a closer eye on what she's eating, but of course they are very busy! Thank you the book recommendations - I will look the author up. I will also see if a doctor can look into the anomalies you speak of in her blood work, rather than just conducting the general, run-of-the-mill tests.

It's also good to know that obsession, and awaking with anxiety, can be a typical thing at this stage.

Thanks!
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Based on what I have seen, some people with dementia may obsess over things that worry them. My LO worried over other people and her cat. She was constantly worrying about how they were, where they were, were they sick, injured or safe. She would cry she would be so concerned and reassuring her only had temporary success, because she would forget what you just told her. Her doctor prescribed a daily med. In her case Cymbalta and it was like a miracle. She stopped with the anxiety and worrying. She became quite content and was still quite alert too. I'd discuss with her doctor.

I'd also consider that she may need more consistent reassuring. Can the staff do that where she is? My LO told me that she was scared a lot. She said that things were changing and she seemed to be in a dream. No doubt, things can be scary. I wonder if having staff who are available to give her redirection and comfort would help.

I'd also consider that her reports of issues could be delusions. I might discuss with her doctor and ask for a geriatric psychiatrist referral.
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Oh my gosh, thank you everyone for your answers! Sunnygirl - I went to a geriatric psychiatrist yesterday and she is going to prescribe an anti-anxiety. I do think this will be helpful, since my grandma has always been an anxious person and I believe the dementia is making it worse.

However, this Metformin idea is a fantastic one, JessieBelle! I'm going to call the pharmacist right now, and then look into seeing an endocrinologist. I have to check what time she takes the Metformin, because she is usually sick in the morning - if it's a morning pill, then that seems like a solid lead! I'll also ask the pharmacist if there are any other concerns he might have, as you suggest GardenArtist.

Thanks so much for the ideas - I will let you know how it goes. Perhaps this could help your mom as well, Nomad!
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OMGosh--my hubby takes Metformin and is sick every single morning. He knows it's the Metformin and that almost makes it worse. After the initial am dose and the ensuing sickness (bloating, diarrhea, sometimes vomiting)..he slowly settles down and it OK the rest of the day.

Definitely check on that!!
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