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Cappuccino42 Asked March 2021

What contributes to the good and bad days and is there anything one can do to anticipate it?

With Mum, she has extremely good days and others where she is much worse. On the good days she's more switched on and positive, remembers things. On the bad days she’s typically upset and agitated and also much more confused. It’s almosy like there’s 2 of her.


I know that it’s normal to have good and bad days BUT I’m wondering if there’s anything one can do to anticipate or improve the bad days?


Ie. kids are offen grumpy if they haven’t slept well. Is it the same with dementia where adequate sleep etc. contribute to better days? Anything else I can look out for, do to increase the chances of good days?


I am am aware that she is grieving over the loss of her son and I try and put positive thoughts out there. Is the depression affecting her more on these days? Are there any triggers I should be looking out for?


Note, she’s not on any medication apart from cholesterol and a small heart inhibitor. For some reason she actually had improvement when her heart inhibitor was increased.

Llamalover47 Mar 2021
Imho, perhaps you can adapt to a bad day by having a plan akin to light entertainment (hot tea, easy listening or flowers).

Marylepete Mar 2021
I have found the following works for me with my husband and in past with my Mom.
Play music as much as possible. My husband loves old time music and often sings along, when he can’t remember anything else. I have an Amazon Alexa unit and just request the music I want it to play. Wonderful for good and bad days.

I weaned him off caffeine and control amount of sugar intake. Very noticeable the difference in his mood/attitude.

I do not argue with him about anything. Things he says or does is because his brain only allows that and he can not help it. He doesn’t understand anything so anything I say or get upset with will only hurt/upset me. So I save my breath. I can not teach him anything, the brain can no longer learn or remember. So why should I get upset or angry. If I did it would make him more upset so it would be non stop.

Some of the sayings I use often are: That’s ok. Alright. I don’t know. Yes. You are fine. Everything is ok. You look so handsome. I love you. Sunny day. I draw his attention to nature: See the little birds. Notice the clouds moving. What beautiful flowers.

I learned long ago when taking care of Mom to try hard to control my upset/anger. If I show it, it will only make matters worse. And don’t be surprised at anything. Try to smile and laugh but not at the person, only with the person. Take care of myself in any way possible. Some days it might just be that second cup of tea. ❤️

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Sendhelp Mar 2021
Agree with promoting a good night's sleep.

What about a "weighted blanket"? Typically used for persons on the spectrum,
(autism), wondering if it will help dementias?

I observe when there could be a bad day coming, and decrease stressors as soon as possible. There are 'prodromal' symptoms to watch for. One, for example, is 'growling', a kind of grrrr from frustrations. And when asked, admits there is a headache.

GardenArtist Mar 2021
Make plans for good days and bad days, with as much detail for those plans as you feel necessary so that you can implement them quickly as the days' moods and actions change.

I.e., on bad days, what would you typically do?   Listen to music, chat quietly and reassure her of your love and care.     I used to bring flowers for Mom, and it always cheered her up.    Then I gradually switched to artificial ones so that I had some available when needed.   

Same with Dad, but it was more on the level of his advice about something, especially woodworking, which he did for years.  That helped switch his focus to something challenging, requiring detailed planning, and a pastime which he loved.

I think getting a positive thinking mode started helps someone switch and climb out of depression days.  

I have to do that for myself as well.   Gardening magazines and catalogues are my go-to for bad days, plus music, all day long.   Crochet, knitting and embroidery magazines are also uplifting.    Looking through photo albums is depressing though, as so many of the people in the photos are now gone.  It also makes me realize how much life has changed for the worse.

Taarna Mar 2021
If you notice more depression signs, please consult her doctor. Depression is very common in seniors. If she has early dementia, there are some medications that can help her thoughts to be clearer. Unfortunately, the medications do not help as the dementia progresses.

Otherwise, the usual suspects can affect her mood: sleep, hydration, nutrition, and since she is on heart medications low blood pressure (decreases good blood flow to the brain). So good lifestyle habits will increase the number of "good days." You may wish to purchase an automatic blood pressure cuff to check her blood pressure on bad days. Keep a record to show her doctor at usual visits.

garylee Mar 2021
Schedule a routine and try to keep to it.

BritishCarer Mar 2021
You have some helpful answers here. My own experience of looking after my wife at home with Alzheimer's for the past 12 years, with support from the Home Instead care agency is:

1. Avoid dehydration. Coconut water (not coconut milk) tastes good, has lots of nutrients and is an attractive drink. 50 ml of Kefir and 150 ml of coconut water is an attractive drink, especially between meals.
2. Establish and try to keep to a daily and weekly routine. Moving out of a routine often upsets those with any kind of dementia.
3. Dr Rangan Chatterjee's book, "The Four Pillar Plan: How to Relax, Eat, Move and Sleep Your Way to a Longer, Healthier Life (Penguin Books, 2018) has a lot of helpful advice. It's not about dementia, but he does point out: "Researchers believe that sleep is the time when we clear out the beta-amyloid, which accumulates in the brains of Alzheimer's patients. Sleep also helps us lay down new memories by promoting the growth of new nerve cells" (p. 205). Sleep doesn't remove the beta-amyloid or Tau in the brain, but it seems to give the person with dementia time to regain their ability to relate.
4. Keep a sleep diary and behavioural diary in which you link good and bad days with behaviour. See if there is a pattern between hours of sleep and behaviour. Dr. Chatterjee points out that sleep is in a series of deep sleep for 1 /2 hour throughout the night; and you need four or five periods of deep sleep a night to be rested the next morning. If the person with dementia is waking up a lot, see how that relates to the 1 1/2 hour patterns for deep sleep. That can be helpful to you too to get enough sleep.
5. Seek support, whether paid/unpaid/family/friends. If you try to do things on your own, you will burn out. Someone might be willing to help out once a week with a visit or outing. I have found the Home Instead Senior Care agency quite helpful. It's a US-based franchise, and its local groups are well-trained.
6. Keep alert for new challenges. I made the mistake of leaving two hearing aid batteries on the dining room table. My wife put them in her drink, but I saw it and managed to take them out before she drank. A doctor told me that if she had swallowed them, I would have had to rush her to hospital . . . and if she had drunk them and I had not noticed, I would not have known what to do.
7. Mobility is often an issue. Plan ahead--not too far ahead--but plan ahead what to do if the stairs or getting out to the car become too difficult.
8. Accept the need for "therapeutic lying"--that is, not always telling all the truth. Almost everyone with dementia is a time traveller, going back into the past. Seek to find out where in the past they are and get beside them, accepting that you are to them a different person or a different age. Then distract as much as possible.
9. All dementias are progressive. You need to consider carefully how long you can care for someone with dementia at home, especially with appropriate changes in architecture (stairs, bathroom, gates, personal alarms if someone gets out of bed at night, etc.) Everyone is different. Care homes will find it quite difficult to give your loved one the personal attention they need. Also, everyone has to do the same thing at the same time--eating, sleeping, watching TV, etc. This creates a lot of problems, because we are all unique persons with different habits. Home care can work well, but only with adequate support from others.
10. Train yourself to be resilient. You'll need it! See Matthew Johnstone's "The Little Book of Resilience: How to bounce back from adversity and lead a fulfilling life (Little, Brown Book Group, 2015). Also helpful is Michael Neenan's "Developing Resilience: A Cognitive-Behavioural Approach," (Second Edition, Routledge, 2018).

I hope these suggestions are helpful. Be encouraged--you're already tackling problems as they arise.

Love and Prayer
9. Read books on dementia. That can save you a lot of trouble, so you know what to expect. Tina Pow
BritishCarer Mar 2021
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Smschaff34 Mar 2021
Hi, my mom has Alzheimer's with good and bad days. I noticed that if she weren't hydrated enough she most likely would have a more confused "bad" day. She has a past of UTIs so I always have cranberry juice on hand, along with an electrolyte type drink, and of course water.
I hope this helps.
Suzanne

Ricky6 Mar 2021
It’s like pot luck. You get what you are given. Just keep mum eating healthy with exercise and entertainment to keep her in a good mood.

SusanHeart Mar 2021
There are no patterns that I have been able to identify. It comes and it goes like the waves in the ocean.

A couple things that I noticed with my dad was his water/ liquids intake. He has better days when he drinks more liquids. Older adults forget to drink water and gets dehydrated and his AL staff did mention that a great cause of confusion occurs when my dad refuses to drink water. He still have bad days and good days but the bad are better bad days when he drinks more water. I have been supplying him with Gatorade (less of a struggle to get him to drink it) and reducing the coffee.

Count your blessings on the good days and bite your tongue on bad days. Also seniors for some reason gets UTI’s more often as they age thus you might want to get her geriatric Dr involved as well.

Any changes in their environment affects them as well, if they cannot find something that it is normally in a certain spot, or you change your routine for a day for some reason, etc.

Ultimately there is no rhyme or reason and for your sanity sake start looking for ways to accept the good days as they come and enjoy them to the fullest as they will become fewer and farther in between.

Best wishes
disgustedtoo Mar 2021
"I have been supplying him with Gatorade (less of a struggle to get him to drink it) and reducing the coffee."

Given a choice between the two, Gatorade would be better. Coffee tends to have a diuretic effect. Gatorade has electrolytes, but if one isn't dehydrated, there's no need for those (it shouldn't be all he drinks - one maybe two a day, if it's really necessary!)

On the flip side, one CAN drink too many fluids. The old "Eight 8 oz glasses of water a day" is actually wrong. The original study said we need, on average 64oz of fluids/day, BUT that includes fluids one gets from food as well. My mother ended up in the hospital because she WAS drinking too many fluids and ended up washing out her system. When she was "replenished" she returned to her normal grumpy self. I did initially provide her with sports drinks, which the "experts" poo-poohed, but there was no harm in her having these.
Lilfarmer67 Mar 2021
No particular pattern here (my FIL has vascular dementia), but I do know that any diversion from his normal routine or not being able to find something pretty much guarantees a tailspin

JoAnn29 Mar 2021
There is no ryhmn or reason when it comes to a Dementia. Thats why I did not do well with it. You have to just go with the flow which I don't do well with either.

I found in my research that Statins, Cholesterol meds, contribute to the cause of Dementias. Seems they effect the brains cholesterol and the brain needs it. It has been discussed, a while back, on this forum that when Statins are stopped, the persons cognitively seems better. Not a cure, just seems better. If Mom has been on statins for years, you may want to have her liver enzymes checked. If high, she should be taken off them. When my Moms Thyroid Doctor found out she was put back on them after a high enzyme count he said it should not have happened. Because the Thyroid med Mom was on effected the liver, he took her off.
sjplegacy Mar 2021
JoAnn, your research on cholesterol meds is interesting. I have not personally read any such research, but, as you know, those meds are prescribed for people with high cholesterol levels; but high cholesterol is also a contributor to vascular dementia. So I don't get how, Lipitor, for instance, could cause dementia when it is administered to possibly prevent dementia. What are people to do? Other drugs, too, like dyphenhydramine, are linked to dementia, but the research never says what kind of dementia. Too confusing.
funkygrandma59 Mar 2021
If your mum is grieving the loss of her son, I can only imagine that that would certainly affect her moods. I am in the grief process myself, after losing my husband 6 months ago, and I have good days and bad ones. I can't even imagine if it were one of my children, as that I believe would be even worse.
Now that being said, when I was caring for my husband who had vascular dementia along with many other issues, I noticed that he would often mimic or mirror whatever my mood was. So if I was short and ornery with him, he was short and ornery with me as well, but if I was sweet and kind, he was sweet and kind too. And of course there were just days when he was not in a good mood for whatever reason, and I had to just make the best of it.
I would allow her time to grieve the loss of her son, and if needed perhaps talk to her Dr about getting her on a antidepressant. And just keep doing the great job you're doing with her. God bless you.

Grandma1954 Mar 2021
The best thing I did was realize that a "Good day" was actually a GREAT DAY!
As my Husband declined the days that I thought were "bad days" in the past were actually "good days".
The bar is ever changing when it comes to "good and bad" days.
You learn to accept the day as it is and sorta go with the flow.
Don't sweat the small stuff (and most of it is small stuff)
Pick your battles.
Keep your stress level down that in turn will keep her stress level down.
Talk in a quiet voice, lower your tone.
Laugh. When you get frustrated over something, laugh. It turns the tide on a potential argument and will catch her off guard and she will forget about whatever is going on. (at least it worked for my Husband) If for no other reasons than it releases endorphins and will make you feel better in spite of what is going on.
lindabf Mar 2021
Great reply. Especially the “laugh” and get him laughing, too. So much of the whole process of caregiving is about making useful choices constantly. If my choices are “get frustrated” or “laugh”, I just need to remind myself that it is a choice and I’m going to get the logical consequences of the choice I make. Caveat: Laughing and getting them to laugh absolutely DOES NOT include causing them to think we are laughing AT them instead of WITH them. No ridicule, ever!
HomelyandBald Mar 2021
When my wife was diagnosed with Alzheimer's, I immediately joined a caregiver support group. The first thing they taught me was don't look for a pattern. Every day is different and you will drive yourself crazy trying to figure it out. Sorry, I know this doesn't help but this is a dreadful disease and it never gets easier. So sorry for your pain.
disgustedtoo Mar 2021
Additionally, the journey for each person will be different. Yes, there are similar patterns and symptoms, but not everyone has them nor do they all happen on a given timeline.

The best we can do is know what *might* happen and learn what techniques have worked for others. Then it becomes trial and error to see what ones might work for our own LOs. It's like playbooks for sports - sometimes the outcome is what we want/expect and other times it isn't. For medical issues, often the docs can do A, B and/or C and expect outcome D. With dementia, all bets are off!

Learning all you can about it and trying various tricks and tools that have worked for others is our best defense for this horrific condition.

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