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virtualhorizon Asked August 2013

What do you do when your loved one wears himself out sundowning due to anxiety?

Yesterday, basically all day, Dad wandered through the house in circles, worried about things he didn't need to worry about. When I went over to the house just before dinner I found Dad on the floor and Mom in the process of calling me to help her get him up. He had wandered through their house all afternoon, anxious about "who's going to make the car payments?" (the car was paid for almost 4 years ago), "where is the paperwork?" (what kind of paperwork?), and who knows what else, because if you try to ask him he either doesn't want to talk about it or can't remember or says "you know". He never actually falls down when this happens, just sort of slithers down because as he walks and worries, he hunches forward further and further until he can't do anything BUT slip to the floor. We got him up, fed him and got him to sit down and rest, as he looked like he was about to go to sleep any minute. His shirt and undershirt were soaked with sweat and had to be changed, and we had to dry his skin off to find a dry spot for his patch. When I went over at noon today my Mom told me he started back up and did the same wandering during the evening, before finally laying on his bed and going to sleep (after wanting HER to go to be at 8 PM!). He appears to be in better shape today! For some reason this kind of thing seems to go in cycles -- it won't happen for two or three weeks, then he's at it again, probably because something set him off and it gets fixed in his brain for a while. Does anyone else have this problem with their loved one? Have you come up with a way to try to take their mind off these anxieties? (Other than more pills!)

pamstegma Aug 2013
Double check the medications he is on, especially drug interactions, and definitely discuss the sweating episodes with his MD.

OncehatedDIL Aug 2013
Afternoon naps can help with sundowning- just getting the nap habit started is difficult for non-nappers.

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Katydid148 Aug 2013
Sure is helpful to read these posts :) Thanks everyone

virtualhorizon Aug 2013
Thanks for your thoughts ID, and hugs to you and for your Mom. Dad takes Seroquel also, twice a day for the anxiety, hallucinations, etc. of AD. He's on the Exelon patch for AD (don't know that it's working at all anymore, even at the 13.3 mg) and takes a carbidopa/levodopa combination for Parkinson's symptoms. We've tried him on several other combinations in the past but he's had such adverse side effects to anything else that we don't want to do anything else as far as meds are concerned. I just hate the medication side of this disease. At some point it just seems that enough is enough! For weeks Dad can be at a certain level, then we can see him sink a bit lower. Then he'll level off, and then the same thing will happen. This is such a cruel disease, to have to watch a person die little bit by little bit, with no way to do anything for them. My thoughts and prayers go out to you and your Mom at this stage...

virtualhorizon Aug 2013
Thanks for both of your replies! Regarding anti-anxiety meds...he already takes 3 meds for his Alzheimer's/Parkinson's. He doesn't need any more. We don't want him to be medicated to the point where he's a zombie (already went through that once and don't want to see it again). I don't think that adding meds to a person's regimen is a cure-all or help-all. As for redirecting...that might have helped at one time, as I think there are stages of AD when this in an aid, but he's beyond that at this point. Once his mind is set on something, that's it until he finally just forgets it on his own. Dad is in the latter stages, and actually I think the sundowning is beginning to wind down, it only gets this bad on occasion, but he is just very restless sometimes. I know this goes with the disease, but I was just wondering how it affects other families. As far as letting Dad "help" pay the bills...he wouldn't know what was going on. He's just going through some ups and downs as he becomes more and more confused, to go along with arthritis, back pain, etc. It's really sad that a person can lose so much of themselves when it comes to the mind and the brain, yet still be able to become anxious at things that you wouldn't even think he'd remember or think of! Thanks again for both replies. It helps to just talk about it.

jd9189 Aug 2013
My mother has had severe sundowning with the progression of her AD. We have been thru more pills and combos than I can count. She is currently on Haldol and Xanax and Seroquel for the severe anxiety and sundowning.. Seems like a lot to most people but most days it doesn't even touch it...and she doesn't sleep well either. She is now on hospice at this late stage and for the first time today, I was told to try the Morphine in the Comfort care kit provided by them. A very small dosage...Will see how this helps today...Good luck. It is so very frustrating and difficult to watch and redirecting does nothing for my mom. Praying for us all...Peace

wordy2shoes Aug 2013
Hi Virtualhorizon. Would it help to give him some old checks to fill out and have him "pay the bills"? Having something to do that makes him think he's fixing it might help. Or maybe have him sit with you or your mom when he gets that way and "work together" to pay bills and go through paperwork.

My Dad doesn't sundown but in the past he has sorted through a lot of my paperwork, telling me about accounts and clients as though he were still running his business. I lost a real bill a couple of times but it kept him occupied and made him feel useful.

NancyH Aug 2013
It'll only happen more and more often as his Alz gets worse. He needs to be on anti-anxiety meds I'd say. Those will help, but the sun-downing only gets more frequent so you'll have to redirect his thinking. My mother-in-law has been sun-downing more often too, and sometimes the asst. living where she lives will call me and have me talk her 'off the ledge' so to speak. She will not remember ANYTHING basically, no husband, no kids, why are I here? etc etc etc. The only person she seems to listen to is me, since I spend so much time with her. Usually her asst living aides can redirect her attention onto something different, but when the can't..I'm the one that gets the call. My husband can't deal with the frantic phone calls, but I can it seems. If it were up to me, I'd drug her out of her mind when she gets like that, but I guess that's not gonna happen. Oh well... As for you, your dad is used to having to think about those things that you mentioned, so now he still thinks about them but doesn't know what to do. I just repeat myself in a calm manner to my mother-in-law and answer all her questions till she gets onto another subject. It stinks I know.

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