Follow
Share

Mother , 75 has diagnosed depression, anxiety, insomnia, , plus undiagnosed cluster B personality disorder. (My LPC brother identified this). Status post major neck fusion surgery on May10. She has delerium in the hospital, but it cleared after 5 days. She was on Seroquel in hospital for agitation at bedtime. Sent home back in normal sleep med, zaleplon.



Insomnia is bad. Psych NP tried her on mirtazipine last week. Didn’t work. Yesterday gave her Seroquel. We had full discussion that it was anti psychotic but also used for insomnia, and that she’d had it in the hospital.
She left me a very angry voice mail at 4 pm because she could not find a soup in her pantry. I missed the call and called her back at 10 pm when I saw the voice mail.
She was super angry about being changed to Seroquel, said she’d not heard that she was being given that. In the visit she said “I don’t care if it is anti psychotic as long as it helps me sleep.”
On phone last night was was so mad that she’d been given that. Said she was mad at her surgeon, mad at psych NP.
Today, she was calm. A whole different person. The stuff she was mad about didn’t seem to register today.
Could this be sundowning?

This question has been closed for answers. Ask a New Question.
My GUESS (and anything we can say about a person we have no idea the history of is a guess) would be that this is a combo of her usual mental illness exacerbated by a serious surgery and many changes in her locations, activities, and the numbers of people she must deal with.

Quite honestly, one can guess, but this would be difficult to know in a case this complicated with the switching about of some very VERY powerful medications.
Helpful Answer (9)
Report

Alvadeer basically hit the nail on the head…

it’s probably everything, thst surgery.. is not fun… no surgery is really fun.. but neck fusion…that sounds like a pain in the neck..
how’s her carotid artery?
Still good blood flow to brain?
Hoping every day will be a bit better, with less pain more healing…
Helpful Answer (2)
Report
Oedgar23 Jun 2023
Carotids checked out ok at her pre surgery cardiac clearance. What’s interesting is she had high bp and needed meds before, but now has low bp
(0)
Report
It sounds a bit like my MIL, who is now livid with her primary care doctor because the doc didn’t warn her at her last appointment of an impending mild heart attack a few days later. No heads up.

In her case, I think it’s a bit of denial along with getting scared.

My MIL does have her days and nights completely mixed up and as she tells it, she doesn’t go to bed until around 4-6 am. Someone told me this is sorta sundowners but IDK.

I just wanted to let you know that I hear you and I can relate.
Helpful Answer (3)
Report
Oedgar23 Jun 2023
I’ve read that sleep issues are a dementia problem. She says she’s been like this for years. I’ve had a 10 year estrangement from her so I don’t know!
(3)
Report
We are not the prescribing physicians and I don’t think we can assume this is sundowning. The case is very complicated given the multiple diagnoses and surgery. Personality disorders, you must know, also present with various outbursts of anger. You really need to talk at some length the physician.
Helpful Answer (8)
Report

Oh Edgar...
10 year estrangement from your LO..... It's time to help out... A lot is now on your plate...that you may not have had time to absorb....
Sift through all articles, questions, concerns, and responses...
And get to know her doctors, issues, and her concerns... Sundowning is not always the "goto" diagnosis, as Kathleen pointed out.
You do need to get into her health life and take her to appointments etc to know what is going on....
Yup, I have sleep issues... started when I had to take care of my LO's and that is just so much fun for my family who has to deal with my sleep issues.... Tag... I'm getting down that road faster than time travel... maybe.. I suppose... It's not fun for my LOs....especially, sorry... to say... my beloved dog....
I hope this website helps you find clues or answers to your concerns... It has helped me over the years.
Maybe take your mom for walks, spend time with her, take her to lunch, go to a library.. botanical gardens, museum, or something close by and fun...
My FIL took our child to the local airport to watch the small cesnas land or take off... And they visited the local zoo, and other local attractions in our area... Perhaps you can take your mom to a local attraction for fun afternoon... Maybe she is bored?... Give her something to look forward to... A fun day !!! Some libraries will have current events listed for the month.
we just got a calendar for CONCERTS IN THE PARK! Listed 4 local parks with dates and bands so you can plan ... then someone said they just listed in another park... Shakespeare in the PARK... another fun free event to enjoy !!
things to think about doing with mom during the summer!!! Make it Fun!! Make it an adventure for all of you, who you invite to join you!!! why not? Make it fun for all of her LO's... invite the whole team, if you have one, to take part in a free adventure in the park with music or plays... !!! YAY !
AND THEN IT GETS TO THE POINT.. mom cannot go anywhere and I didn't have a supporting team to tag along with us... soooo.... the story goes.... tag... you're it, invite your friends to join you... Make sure, if you do go to a park, you get a chair she can get up and out of without too much effort...
Helpful Answer (2)
Report
Oedgar23 Jun 2023
Thank you for your kind and thoughtful reply. I’m in a bit of a weird place with my mother. A very weird place really. I was perfectly content being a strange for her, and from what her friends tell me, she was also content being estranged. She had a hospital stay for Covid last fall, and got out and came home alone to no power, utilities, etc. at her home. Rotten food in the fridge. The place overrun with cockroaches. General hoarding conditions. She says she had no money. I still don’t know why that happens. I think she was compelled to come to my house because I was her last resort. I think she’s nice to me on the surface most of the time, but I really think she just tolerates me for the help I can give her.
(5)
Report
If mom is in a facility... see what events they plan, and join her in those events... Make it fun... If facility allows, bring small treats that people can share...
Helpful Answer (1)
Report

It's way beyond that.It takes weeks for brain meds to take effect.
Helpful Answer (0)
Report

Personality disorders are difficult to treat. Has she seen a pulmonologist at a sleep disorder clinic yet? This can rule out if it is her brain or something else
Helpful Answer (1)
Report

Are you the POA? If so, call and confer with her PCP. Is she living alone in her home? In ALF??
She is most likely fearful, grieving the changes in her life and,these emotions will drive a lot of her behavior also. Medications should be directed and supervised by her PCP. Also, if she is alone and responsible for taking her own meds,this could be a BIG part of the issues ( is she really taking correct prescribed meds on time??).....
Helpful Answer (2)
Report

Like we said, we are not doctors, having, having said that I found the psychs and NP psychs just wanted to pile one medicine upon another....getting all kinds of reactions. We fired our facility psych that was treating my MIL and let her PCP to treat her along with the facility therapist. MUCH better response from MIL. Happier and healtier. BTW- the drugs the psych wannted to put my MIL on would have destroyed her liver and made her a zombie.
Helpful Answer (3)
Report
jemfleming Jul 2023
My experience with a facility psych evaluating my mother three years ago at a rehab was the same. It was during COVID and I asked for an evaluation due to the isolation of that time. I found that they tend to do a cookie cutter diagnosis. Everyone has advanced dementia and needs drugs. It is easy $ to be attached to a facility and just crank out the same diagnosis and “therapy”. If the family questions the diagnosis they are “in denial”. Since bringing her to my house, every nurse, therapist, and aide has expressed surprise when I tell them about that diagnosis. That is because she remembers names, dates, can converse and although she has her confused and agitated moments, she is far from needing to be drugged. Good for you for using common sense and reason. I too have relied on our Primary Care doc for a better evaluation and plan.
(1)
Report
No she is just angry 😡 Anyone with insomnia is having a difficult time . If the pharmaceuticals are not working try CBD oil right after dinner from Happy Hemp Buddha or a CBD gummie from FIVE .com - some of them even have melatonin .calms people down and helps with sleep 💤 Maybe it’s time for assisted living
Helpful Answer (1)
Report

Sundowning definition - restlessness, agitation, irritability, or confusion that can begin or worsen as daylight begins to fade.
With you description makes mom sound like she is confused and in denial which seems to me like dementia border ALZ. Just keep and eye on her and make sure she takes her Seroquel - according to your paragraph seems to have worked.
Helpful Answer (3)
Report

Oedgar23: Definition of sundowning per Google - "Neurological phenomenon, associated with dementia, in which patients exhibit confusion, agitation, fatigue and/or restlessness after sundown."

Disclaimer: Definition is not my authoring.
Helpful Answer (0)
Report

Oedgar: I send you my physic support and love as you travel this road.
Helpful Answer (2)
Report
Oedgar23 Jul 2023
Very kind of you thanks
(0)
Report
Here’s a small update. The Seroquel helped with her sleep. We had to up the dosage one more time. It’s also making her seem in a better mood. She is just less edgy, irritable, and angry. This medicine, of course does not change who she is. She still makes bad decisions, is mistrusting, etc. Her latest bad decision is buying a $2000 Tanzanite ring off of jewelry TV, believing them saying that it will be worth 12,000 and that she could sell it for a profit. or the fact that she refused to pay her $100 hospital bill, stating “I can’t crap out $100 payments “. But yet when I took her shopping yesterday, she bought $200 worth of household goods, only some of which she needed, without batting, an eye.
Helpful Answer (1)
Report
Ohwow323 Jul 2023
I know its hard when they make bad decisions. My daddy did too! My suggestion is to get a refillable - limited credit card. Put only a limited amount on the card. This way she still has power to buy yet not spending a whole lot because it will be declined. Also, it will look like her credit card and she won't know the difference. I did this with my daddy, he never received the items and did not miss them. blessings to you!
(1)
Report
My 91 y.o. mother has similar issues, both psychiatric and encroaching dementia. When she has taken 25 mg of Seroquel for sleep, she passes out quickly, but doesn't necessarily stay asleep through the night. But key here is that the Seroquel puts her in a TERRIBLE mood, she is resentful and ANGRY AT EVERYTHING that crosses her path or her mind!

There is a great variety of drugs to help with mood and sleep (says this 58 y.o. chronic insomniac with well-managed depression!). Trazodone is quite frequently used, or the "Z" drugs, like zopiclone, eszopiclone, zaleplon and zolpidem. And the antipsychotics--I think Geodon (ziprasidone) is notoriously sedating, though I don't know if it's used with seniors?

I can only say: research, research, research. Pubmed.gov is the online repository for all published medical research, like a Google for medical articles. And there's always Google! Just make sure you're reading from a reliable source, like the Mayo Clinic, or a University. You are most familiar with the case, so you have to equip yourself with as much information as possible to come up with relevant ideas to treat. Make sure your healthcare professionals are mature enough to work cooperatively with you to find solutions, that their egos aren't so small and mean that they dismiss your contribution.

Best of luck!

P.S. My mother is disorganized and impulsive like yours with money. While I have PoA, I am filing for full Guardianship, because she throws away money we need for her care. I have to get those credit cards, and control of her accounts. She already gave away $75,000 to a fraud who called, claiming to be a rep from Publishers Clearing House. I still don't know why she gave away the money when he promised her millions. But I've taken away her phones. Fair warning--an elder's financial mismanagement can get very ugly.
Helpful Answer (1)
Report

This question has been closed for answers. Ask a New Question.
Ask a Question
Subscribe to
Our Newsletter