Sundowning, frequent bathroom trips and "wanting to go home."

Bandorino

My mom, who just turned 90, has been in Assisted Living/MC since September. She has adjusted well and participates often in activities. While she hasn't been officially diagnosed with Alzheimers, her behaviour and symptoms fit the profile and she likely is in late stage 4. She was able to bring her two beloved cats with her and her apartment is quite cozy. She is in good physical health. Her memory is like Dory's in Finding Nemo. For the past week or two, when I visit, I notice she makes frequent trips to the bathroom. I've asked her if she might have a UTI and she assures me she's fine. When my sister was visiting this weekend, she noticed mom having to visit the bathroom 3 times within about a half hour.

Concurrent to noticing this, mom has called me around 7pm, on Tuesday and again on Thursday last week telling me that she's decided to "go home." Tonight she called again aroud 7pm She is not distressed or agitated, but calmly tells me, "I've decided I'm ready to go home and I need to get out of here." And "I wonder if you can help me get home?" Last week I told her that we (including her) already had plans for the weekend since my sister was coming to visit, which was true. And that ended the conversation.

Would a possible UTI as evidenced by "urge frequency" be connected to this evening desire to "go home?"

I do plan to talk to the nursing staff at her senior community tomorrow to have her checked for a UTI.

So far, redirecting the conversation seems to help... and maybe just having a conversation about anything else is just what she is needing.

I have another question to throw out there: I've read about the "Seven Stages of Alzheimer's" which give us some idea of what to expect, but is there any good advice on how to really prepare yourself for it?

towhee

Can a UTI lead to someone "wanting to go home" ? Yes. It can cause increased confusion, agitation, or simply a feeling of not being well, all of which can start that "want to go home".

If your mom is having memory problems then she probably can no longer put together symptoms from different times or even remember she had a problem 15 minutes ago. She is unlikely to now be an accurate reporter of her own medical condition. We have to start being the medical detectives and initiating medical visits and passing info on symptoms to the doctor. Also, symptoms of an UTI can be different in the elderly. They may not run a fever till they are very ill, there may be no burning sensation, etc. There might also be other causes such as medication changes or some sort of irritation for example. Most ALs are not going to notice medical conditions such as UTIs or constipation in the early stages, especially if the resident does not need bathroom assistance.

Preparing yourself for Alzheimers emotionally- There are a couple of good books on anticipatory grief, I do not remember the titles right now. Otherwise, getting a good emotional support team in place will help as you go along. In person support groups, counseling, friends, etc. We also need to maintain a space in our relationships that dementia does not enter. It is really not healthy for our thoughts to be all dementia, all the time.

Anonymousjpl123

Hi @Bandorino UTIs can definitely heighten confusion, as well as frequent trips to the bathroom. If they can’t give her the test there, you can either get your primary care doctor or even urgent care to do it. It’s worth getting the test for the peace of mind.

I wish I had better advice about the “wanting to go home.” It’s so common in my moms AL/MC residence I initially actually thought it might be really bad (it’s reputed to be among the best). It turns out this is a common feeling among people struggling with alz/dementia. I guess it must be a feeling of wanting to go back to a former life, a time when things made more sense. Redirecting is by far the best strategy, and fiblets. My mother thinks asks about going back to AL and moving in with me. I deflect, and say I’m working with the staff on the move back to AL. It really depends on your mom.

You sound like you are handling it just right. There’s no real way to prepare because everyone is different. For me, I focused on the legal and financial and diagnosis. Everything else has turned out to be so out of my control.