My father hasn't been diagnosed with dementia, but clearly has some form of it and is gradually/slowly declining. I understand sundowning, and that some general fluctuations in cognitive function is normal. However the difference between his "best" and "worst" is startling to me. How can someone who spends hours staring off into space, goes a month or more without changing clothes or bathing, misplaces everything, tries to answer the phone with a TV remote, puts dirty dishes away in the cupboard, and spends hours polishing the same niknak every single day...also have an in-depth conversation about complex philosophical things without missing a beat??? It's hard to reconcile between feeling like he's a shell of his former self and very dependent, while also very much still himself with little to no deficit.
Forget about trying to convince other family members of the magnitude of his cognitive challenges....that's a lost cause. But it's very hard to come to terms with my own perception and understanding.
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Go with the flow.
There are good times of day, bad times of day and sometimes worst times of day.
A lot of what is going on will depend on what part of the brain has been effected and what type of dementia we are dealing with.
If he has not had a full exam it might be time to schedule one so you know what you should expect later. (and that may change..ya just never know)
Look for a Neuropsychologist that will do a good exam.
In his "good" moments discuss with him what might be happening and what he would like his plans to be. It might also be a good idea to have a talk with an Elder Care Attorney to sort out all the legal ins and outs. (POA, Will, Trust if needed, End of Life wishes...)
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It may be helpful for you to make a few notes when you see both the good and the more troubling moments in his behavior. Be sure to record dates and times, so that if and when patterns emerge, your records can become part of a more formal diagnostic process when needed.
If his legal records are in place (POA, MEDICAL DIRECTIVE?) make sure they’re up to date.
For your peace of mind, take a look at services in your area, just to know where you can reach out if the time comes.
Be sure what you’re thinking about includes plenty of options for your own self care. Even basic managing the care of another adult can become challenging. You need to be sure to be good to yourself, too.
It seems like there is a common observation about mental ability or the widly inconsistent lack of coherent thought that affects those with dementia. It's ok for you to be distressed, try not too get too wrapped up in it. But frankly, medical professionals themselves studying dementia really can't figure this out either.
"Ignore your health, and it will go away".....self care, so important, sites like this one, zoom meetings and chats with a social worker are a few of my support systems.