Patient care

HeyGirl23 · April 20

Hey guys im new here but j have been working with dementia patients for almost while now. However last year i took a full time caregiving shift and would like to know if anyone else has or is experiencing this. So its two caregivers, when the morning caregiver leaves and i come in my patient starts asking for sweets and treats and is very forgetful. The morning caregiver says she had a good day but to me it seems she was very confused. Also my patient has been evaluated but by time we got results the dementia had gotten worser. When her son gets home she is very excited to see him but he has long days at work at rejects her quite often because she think he is her husband. Instead of her asking me for help she goes past me to see if he is around to help. Her behavior has tremendously changed when i say she cant have something or do she need anything she gets mad or tries to ignore because she knows she wants her son to do it but im here at night for a reason. ANY SUGGESTIONS?

SDianeL · April 21

welcome. Her son needs to hide all the sweets and have healthy snacks handy. Many Dementia patients crave sweets. It’s common for dementia patients to mistake family members because they are remembering the past. She is having sundowning. Read the book “The 36 Hour Day” and search online for dementia caregiving videos by Tam Cummings and Teepa Snow which are very helpful. Could her son help until she goes to bed?

harshedbuzz · April 21

@HeyGirl23

Hi and welcome. I am sorry for the reason you are here but pleased you found this place.

It's not often that a professional visits here; reaching out shows real care. Are you an independent caregiver or do you work for an agency? Just curious because if it's the former, most claim that their staff are trained and experienced in dementia. If you're a professional and this is the first you've run into these common behaviors, you might want to do some research around common dementia behaviors and best practices. This is a good place to ask, Teepa Snow and Tam Cummings and UCLA Health have excellent content on You Tube. The book recommended is a good one even if it is intended for family caregivers specifically; there are strategies that would be useful for a professional.

A couple common behaviors you are seeing.

Sundowning. For many PWD, their symptoms and behaviors become more intense in the late afternoon/evening and night. This could explain why the day person is reporting "a good day" while you're seeing more confusion and agitation.

In addition to the above, many PWD have a "preferred person" who they will seek out for attention. The day person may be accepted more readily because the son isn't in the house. Not only dad my dad only want "care" (and I mean sometimes bring a sandwich to him to give mom a break) from mom, if I stopped by to visit her, he was jealous of her attention and would constantly interrupt us.

The snack situation is a common one. Because of their poor short-term memory and inability to entertain themselves otherwise, some PWD will demand "treats" forgetting they've already had a reasonable number of cookies, bowls of ice cream or in dad's case wine. This is worth discussing with the son. If she's far enough along and losing weight, he may be happy to get any calories in or perhaps swap out the treats for a nutritional shake or something else. Keeping her engaged in an activity might put a damper on snack seeking if it's driven by boredom.

Good luck. This family is fortunate to have a caregiver like you.
HB

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