Hi, BT.

As glad as I was to see your post, thereby starting up some activity in this group (I hope), I was sad to read your post's contents. Unfortunately, it appears to be a part of the cognitive impairment that often accompanies PD and may even be, as we previously discussed, PD Dementia (PDD), unfortunately.

Although I haven't been able to totally figure it out yet, the confusion seems most prevalent at the end of my mother's "off" period with Sinemet and within the first 30 minutes of taking it. Her new PD neurologist recently added Mirapex-ER to her drug therapy and, so far, it's really helping to prevent the sharp "on" and "off" periods, according to both parents. I'm not currently visiting them but I can tell a difference in my mother's voice on the phone. Her thinking is sharper and her voice is clearer and, so far, no "babble."

A note about Mirapex-ER: Apparently, it really disagreed with my mother when she first tried it a couple of months ago. I don't know what happened, but she tried it again two weeks ago, and now it seems to be helping her. She started at 0.375 mg dosage and is thinking about increasing to the next higher dosage of 0.5 mg., which is where her new PD neurologist wants to see her.

I'm not a big proponent of "pill popping" (nor were my parents before my mother got PD), but I'm SOOOO grateful for the medications that are available today for people with PD!

I forgot to add.... How are YOU feeling today?

You mentioned that this happened "a couple of NIGHTS ago." There is something called "sundowning" that is a phenomenon for patients with Alzheimer's, Parkinson's dementia, etc. It's called that because it most often manifests as darkness falls--an increased period of confusion or agitation. It's thought to do with the loss of light, and how things may look different/strange, causing fear and paranoia and confusion. But it's not limited to twilight/evening. My Dad started to do it from 1:30 a.m. to 5:30 a.m., sometime around May I guess it was. Then it started happening off and on in broad daylight. He has been on generic Sinemet for several years, on such a low maintenance dose that it isn't even really the normal dose. But before we could get back to the neuro to have him check the dosage and maybe tweak it, he fell and ended up in the hospital (this is like the 4th time he's ended up in the hospital over the years due to the PD) and he's not doing well at all. The confusion is more and more frequent. He (and we) could all deal with the physical problems and the fatigue--that was hard enough. But you're right--the confusion, the babbling on about total nonsense, is very frightening for them as well as for us. How I wish things were different! But I don't have any answers, only sympathy, because I am living it with you. My Dad's neuro is trying REDUCING the Sinemet--that hasn't helped--and has added an anti-psychotic at night to help with the anxiety. It helps Dad sleep better at night without nightmares/hallucinations but I think it makes him more groggy in the daytime. Just breaks my heart. Hang in there!

Thanks SandHarbor and Bridges. Mom's confussion does come and go and it's happening more often now... not only at night but my dad said alot of times in the morning and throughout the day she won't remember where she is or what she was going to do. I'll mention the med idea's... she goes in again next week i think.

SandHarbor, I'm doing soso... lots going on again including me no longer being lead teacher (not so happy about this but it's in God's timing not mine) and my kids are back to school which is good but different... and mom's health and i'm so far away... too far away to help at all with anything at this point.

Thanks again to both of you.
BT

Hi again, BT. Glad you came back and didn't get discouraged!

Did your mother hit your head any of the times she fell? Did she ever have to go to the ER after falling? The usual protocol for patients 65 and older is to take a CAT scan of the head to rule out whether or not the patient hit their head. They need to rule out concussion, blood clots, etc. At the same time, they can tell if the person ever had a stroke. That's what we had done when my Dad fell the beginning of this month. But all the CAT scan showed was an aging (shrinking) brain. Sometimes the elderly can have mini strokes, too. I'm no dr., but to me it sounds like it's the Parkinson's.

I say that because my Dad has had it for 4 years, but he was always totally coherent except when meds were wrong, he was in hospital and disoriented, or he had some kind of dehydration/infection. The only cognitive problems he EVER exhibited during all these years was a kind of "brain fog" like chemo patients get--would forget what he was about to say, but would remember it later. He did forget how to write checks and balance his checkbook, so it was just easier for me to do it and then he would sign. It wasn't until around Memorial Day that the babble started.

My Dad's % of lucidity vs. confusion has flipped now since his hospitalization. It used to be he was mostly coherent, and only sometimes incoherent. Then he ended up in the hospital, where it was almost all incoherent. Then after they took away the anxiety med, he started to become more coherent, but still more incoherent than coherent.

Bridges, she had hit her head 2 times and both times my dad (who's an RN) checked for all signs but never had CAT scan or anything done. She has been doing this for about 4 months now (since the left their place down south to come up north) and my dad is wondering if it's just too much change for her going back and forth. She can't handle the northern winters but, dad's trying to "weigh out" if the winters (and having her shut in) would be better than the confussion or if it'd be better to sell their place up north and stay down south.
Tough choices.
I know meds can make a mess of one's body! Hopefully things will "iron out" for your dad.
Prayers
BT

Change of location will DEFINITELY increase confusion! My parents have been living with me since July 2009 and still somewhat disoriented--even my Mom, who doesn't have cognitive problems. She simply can't find anything anymore.

Why all the moving around? Are your parents "snowbirds"? If they can't handle the northern winters, maybe they are better off staying down south instead of staying up north?

Yeah, my parents are snow birds and my dad would do fine but my mom just doesn't handle winters well but, they have a condo in the north and 2 mobile homes (they are trying to sell one) in the south so, it makes it tough.
My parents came about 2 weekends ago and I was talking to my dad about how mom was doing. He said alot of things which scared me / made me wonder. Some of the things he said were, " she's told me that she isn't sure how much longer she will be able to handle going down south" and dad also said, "when I look at her most of the time it's like "no one is home" and even if I talk to her I'll get no response sometimes".
Mom is definately failing and it's tough to see that happening which seems so quickly. Every time I see her, I see more (drastic) changes in her physically, mentally and for sure emotionally. Dad says she's getting overly sentimental and can't handle alot of noise or comotion.
She doesn't attend many family gatherings (lunch with my brother and sister in law and their family which they used to do each Sunday) any more because it's just "too much" for mom.
Dad is doing all he's able to tend to mom's needs which is great to see but he says that he's getting overwhelmed. He says that he just needs a break. I told him that I'd come up there this summer and he could go to my brothers for a few days or however long he wanted. (i have off during the summers) I can't really go down south at this point because I have too little income for such a thing. I am thinking of going down over spring break but must start saving now to do so.
Anyhow, thanks for reading and responding.

I can identify with everything you're saying. Yes, their world grows smaller as the disease progresses. You see it dramatically because you don't see her very often, while to your father the changes are almost imperceptible because he is with her every day. Don't be surprised if he refuses to take you up on your offer. Caregivers often have a kind of "Stockholm syndrome" in which they are bound to their patient and won't leave even if offered a reasonable, competent, caring alternative. It's loyalty and love, yes, but it's something more that I can't quite put my finger on. When my dad was in the rehab ctr, my mom had the opportunity to "crash" so to speak and, knowing he was in good hands, could have just caught up on sleep or housekeeping or just vegged to recover and get back a little peace and quiet. But no. She wanted to go there every day and just sit with him, even if he was sleeping or off to physical therapy or something. I don't understand it--I don't think I would be that way if my hubby got sick that way. Either I don't love him as much as she loves daddy or she is just abnormal.

P.S. (hit the button too soon): My Dad is back in the hospital again. He and my Mom caught some kind of bug and were running constantly to the bathroom, sometimes at the same time to different bathrooms. Anyway, she wasn't there to help him and he got wobbly and fell against his lounge chair. He didn't hit his head or anything but got all bruised up. And he got so weak that he couldn't walk any more and my husband spent all weekend helping him back and forth to the bathroom. But he wouldn't let us call the dr. By Sunday night he was very dehydrated and we called the insurance company's nurse hotline and she said best call the dr. so Dad relented and when we did he said to take him to the ER. So off we went via ambulance yet again.

I'm a little scared now because it hasn't even been 60 days since he got out of the nursing home and I think there is some kind of minimum. This stay he may end up having to pay for himself. If he can get well and is ambulatory, Mom will be able to care for him at home once he gets out but I don't know if they will give him the time to get well.