Expert: Cindy Keith, RN, BS, Certified Dementia Practitioner - 11/23/2011

Question
Mom is in the middle stages of Alzheimers and talks almost all day and night, even when she sleeps which is not throughout the night.  She talks about events in her distant past much of it distressing to her. Her doctor has tried several antidepressants, temazapan for sleep, nothing seems to help this incessant talking. Is this common?  Trying to engage her in the conversation agitates her more. Suggestions would be appreciated.

Answer
Hello Connie:  I'm sure this incessant talking is quite distressing to you and your family.  This is likely being caused by a certain area of her brain being damaged and/or stimulated by the disease.  It's a form of perseveration and some people will do repetitive motions, or phrases.  This will go away as her dementia progresses, and some day she may stop talking altogether and you may look back and wish you could hear some of that non-stop chatter again.  I would first of all  listen closely to what she is saying.  Is she focusing on one topic?  If so, maybe she's trying to tell you something about it. Some studies showed that supplying a fleece covered hot water bottle helped calm elders with dementia down because they may have been cold and couldn't express it.  I wonder if one of those stuffed bears with a heartbeat inside would help?   
I don't know how you might be keeping her active during the daytime, but that would be a goal so that she may become tired enough to sleep better.  Her favorite music being played may entice her to sing instead of talk, and again, may make her relax more.  Is she able to focus on anything for any length of time?  For instance, if she loves babies, or dogs or cats, you can purchase videos of nothing but babies, puppies or kittens playing (www.alzstore.com).  There is no plot and elders with dementia will often become engrossed in these videos.  Supplying her with a babydoll, stuffed dog or cat might also help her think they are real and if she enjoys them, she will lavish them with attention and be in a good mood.  I think the key would be to keep her active enough during the day so that she's more relaxed at nighttime.  Do you have a large plastic-protected photo album she can leaf through that would bring her good memories?  Does she enjoy massages?  If so, then before bedtime, a slow, gentle massage with a scented lotion would help to relax her.  I think a good goal for you to have now would be to find those things that bring her joy, and make sure she's exposed to them continually throughout the day and early evening.  Every smile you bring to her will help her relax a bit more, and even if she continues to talk, realize that you've helped enrich her life and bring her some joy. I wish you the best of luck Connie as you journey with your mother through her dementia.