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Mom has had sundowners for about four months. These episodes require me to physically restrain her to the house. It is so tiring and unpleasant that i am going to have to send her away from the home for care. Dr tred risperadole but only has been on it for about a week. When she is in these episodes nothing calms her down so far. Any people who have seen this before and for how long? I am really tired and am her sole caregiver. Help! tonio

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There were plenty of days when Mom went down at 4:30. Sundowners made her really exhausted so sometimes she would ask to go to bed early. She loved her bed. She'd get up around 6:30 in the morning so it wasn't bad.

With dementia, being clever is an ongoing thing!!! Don't EVER wanna get caught behind the 8-ball on THAT one!
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At this latitude the sun sets in December at about 4:30. Lordy! I'd hate to think of when my loved one would be getting up in the morning if I put him to bed at 4:00 in the afternoon! :-D

It is interesting that bright lights worked for you. That is an easy thing to try. Timing of medications is an important consideratin, too. You were clever in helping your mom. Thanks for sharing.
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I had a holistic way of treating Sundowner's and my Mom because a willing participant in her treatment. I would put a reminder note on Mom's tray next to her clock...and at the time when the sun started dipping low in the sky...that was when every light in the house would get turned on! It was BRIGHT BRIGHT BRIGHT in her whole house. Before it would actually GET dark, I would close all the blinds and keep everything relaxing and LIGHT. Once it got completely dark and she was still OK, then we began to turn off the lights a few at a time to make it cozy. I would also time her small dose of Ativan for late afternoon. It also helped to have some nice distraction during the transition time, like a little visit to say hello and water the plants, see if she wanted a little yogurt snack, etc. If all else fails, make bedtime 30 mins before Sundown. That is guaranteed to work.
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My husband is on Seroquel and Depakote, to help some with delusions and agitation. They have worked pretty well, but he is getting worse -to be expected, from what I read -and is now getting belligerent and uncooperative some days. I've found that it starts earlier in the day now (3 or 4 pm sometimes) and gets really bad about 7 or 8, when he's winding down for bed. You have to try the different meds and keep tweaking the dosages, and there's no guarantee, but he doesn't get me up with crazy nightmares any more, at least.
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I do not think there is an end to the sundowners. Maybe it lets up when they decline even more. I started giving my mother lorazepam at about 11 p.m. because she was staying up most of the night, talking and yelling about crazy things. Sometimes I even give it to her during the day if she is particularly agitated. I think that giving them some sort of drug is the only way to tolerate the problems that come with dementia. I am usually one of those people that wants to do everything naturally, but in this case, I believe in drugs!
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Tonio - if she isn't seeing a gerontologist, then find one and get an appointment for her there. The dementia's are all kinda different and what works for 1 doesn't for another. With my mom, who has Lewy Body, having the different dementia tests done really helped in figuring out how much of her sundowners or agitation was dementia or more environmental. She is on Remeron and now with Seroquel but super low dose.

What was helpful with her when she was in IL was to have torch style floor lamps set on timers. Table lamps she would mess with but not the floor style - why...wthk. Anyway we set it so that room was filled with light at 7AM - 10 AM and then 5:00 - 9:30PM really made a big difference and took about 3 weeks to kick in. Especially good for those days which are gloomy and they get confused.

Where does she go to? You might want to let her go and then shadow her so you have an idea of what her "plan" is. For whatever reason, a lot of them will go to a bus stop - even if they were not the type to take the bus as an adult. We had a neighbor whose dad always went to the water fountain at the nearby school, happy as a clam too. Good luck and keep a sense of humor.
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My mom has been having major anxiety issues the past couple of weeks and was so scared. They started her on remerol at night 7.5 and increased her celexa from 20 mg to 40 mg. It has worked so well in a short period of time. Remerol is an older drug and helps mommy relax and sleep and not get anxious and it's very cheap because it's generic. Might want to ask you doctor for this. I read up on respidone and that is very scary drug for the elderly. I would not allow my mom to be given that drug. Good luck.....
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Seroquel and Trazodone worked for my father. He took seroquel 3 times a day. I think we started at 25 mg. Then we upped the night time dose to 50 mg. He was also on 100 mg of Trazodone. They try to scare you about side effects, but this combination did nothing "bad" to him and allowed us to keep him at home til the end two years later. Before the seroquel, he had sundowner's syndrome, then he would get agitated during the day and life was unbearable. The medications was a miracle.
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So far, Seroquel has worked the best with my father. The sundowning has been going on since 2008 and was getting worse. The doc gave Zyprexa and my father experienced the paradoxical effect~his symptoms were exascerbated. He wasn't sleeping a wink either. So..the doctor then tried Seroquel...and WOW! what a difference! He sleeps at night (ALL night!!!) and wakes refreshed. He's 97 with dementia~ this drug has been an enormous help.
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My mom has been experiencing this also for a long time now. Her dillusions get more violent as time goes on. Nothing has been able to stop them but she is now taking Risperidone and Lorazepam which seems to be helping. They always need to be adjusted, however. She was prescribed these medications by a Geriatric Phychiatrist ---which I highly recommend -----She was the only one who could get this somewhat controlled..........Wishing you good luck...........
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Melatonin has worked for us. I saw a positive change on the second night. I started her on 3mg. As a test, I didn't give it to her last night and sure enough she was up at 3am pacing and agitated rifling through papers. My relative may not be experiencing Sundowning to the degree your mom is, but you may want to try it.
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My mom has had them for 2 yrs now. She is on lorazepam, a tranquilizer and Risperidone, an antipsychotic. Taken together they decrease the sundown symptoms. She must take them every 4 hrs in order to balance all the symptoms. When we wait too long for the medications, she starts the delusions and wants to go "home". I also involve my mom sometimes in activities like folding clothes or do the dishes, just a few glasses or spoons to keep her occupied. You can also sit in the patio, or look at pictures together. Ask her to set the table at dinner, or to stir the gravy, etc. Just some suggestions. I hope this helps.
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Have you tried Melatonin? It has not relieved all of my husbands sundowning symptoms but it has helped some and definitely helped him sleep better. There are no side effects and you can experiment with dosage. I currently give my husband 10mg. good luck I know how hard this is!
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I agree with the others and seroquel works good for my mom. But you need what works best for your situation.risperdone was not helpful when my stepdad was on it. It made him more agitated and even mean at times. Sundowning is so hard. Mom has only had it a couple of times. God bless you!
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Risperdone did help my mother, but is not intended as a long term treatment. After a few weeks, our doctor switched her to trazodone (a sleeping pill) at bedtime, and while we have other issues, the sundowner is not one of them at this time. Thank goodness!
So I agree with lorain, talk to your doctor about switching her med and get a good rest at night.
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Risperdone did NOT help my Mom...She takes seroquel 3 times a day and trazodone at bedtime...and it works!!! Ask your doctor about switching her meds.
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Poor Mom! Poor Tonio! I know what you mean that this could be the deal-breaker about being able to keep Mom living with you. You MUST get your own sleep. A zombie caring for a demented person is not a safe situation! (Been there. Hated that.)

Is the doctor who is treating Mom a specialist in dementia, or in treating the elderly? I ask because there are cautions about using risperidone in elderly dementia patients. That doesn't mean it should never be done -- but I'd have more confidence in such a prescription if it were given by a specialist who weighs the risks and benefits in this particular population frequently than if given by one who seldoms deals with elderly dementia patients.

If this med doesn't work or has unacceptable side effects, there are others that can be tried. The situation isn't hopeless. It really helps to be working with a specialist! If you aren't now, I recommend that as a first step.

Does your mother's agitation start in the early evening or after she is in bed?

With my husband, it was after he was in bed, and the solution that has enabled him to live at hom for the 9 years since he was diagnosed is seroquel, at a small dosage. (Recently we were without seroquel for several days and that confirmed how helpful the drug really is for us, and that it was still needed!) I'm not suggesting that is what your mother should have -- just that there are many drugs that could be tried and there is hope that one of them will help you both!

I hope the doctor has also directed you to literature about non-drug approaches, such as lighting that banishes shadows, having a consistent routine, etc. I don't think that there is anything that is known to work all the time for every patient, but it is well worth trying the hints experts have come up with.

Again, hugs to you as you deal with this very vexing aspect of dementia.
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