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applesed1 Asked August 2013

Dealing with Sundowners every day from 4 to 7. Any suggestions?

Every day my mom becomes restless and agitated and argumentative. You can no longer have a conversation with her at all about anything dealing with money, the house, her bills, doctors visits etc. It wears my family down every day. We try not and get caught up in these situations, but she keeps talking to you and bringing it up; when you try and tell her the truth, she becomes more agitated. At this point my husband and my kids just want her out of the house. They don't even remember what my mom/their grandmother used to be like; it is quite sad.

Her doctor will not give her anything to take for it. She becomes combative and argumentative and the assisted living center we are trying to get her in is worried. They have suggested an evaluation by a psychiatric center where they will evaluate her to see which medicines work for her; it almost sounds like an experimental center and a little scary. I am at a loss as to what to do. Here at home we are worn out.

My brother and I are now her co-guardians and I am her conservator and the little money she has must be used to prepay funeral expenses and assisted living care according to the court. We are getting ready to extract the savings and take care of this soon with the lawyer's assistance by establishing a trust to take care of this.

Since my dad died a year ago, it has taken quite a toll on my family. My husband lost his job and stays home with her so I can work. We need to make a decision soon to get testing done so we can move forward. Any suggestions?

Sylvial Aug 2013
Your situation sounds very familiar,, my father also passed away eight months ago and I moved my mom into my rental home and she started sundowning every evening around five and got really mean and nasty with everyone, she was also horrible about money and thinking everyone was stealing,, the small amount she had in savings we prepaid for her funeral services which was 7,200 and that is just the service alone the plot was purchased by my father years ago..My mother would sundown and then go to bed for an hour and not sleep for hours.. Usually when she was real bad it was the result of a uti,, one thing I can suggest is here in phoenix we have a geriatric psych ward and they were wonderful, they kept her for two weeks and ended up placing her on seroquel and that seemed to help alot,, she liked it there and came out acting alot better,, they stabilize the medication and it helped alot.. Hope this helps.

Stressed52 Aug 2013
I am so glad that this question came up as I have read several people talk about sundowning and I never really knew what they were referring to.

My mother was hospitalized 4-5 days ago for very rapid heart beat and chest pain. She was in the hospital for about 3 days and sent home with new medication dosages to control it. I noticed in the hospital and now at home that this sundowning has begun with her. At dinner and after she cannot sit still to save her life, she becomes argumentative or just plain old agitated. In the hospital they gave her a shot to clam her and hopefully help her sleep but here at home now, we have nothing and two days to go before her follow up visit. I really hope her doctor will give us something to help her. Watching her makes me nervous because it is very much like an anxiety attack and it affects her breathing as well, last night she was literally wheezing as though she had asthma...which she does not have.

I have to wonder about your doctor and his refusal to provide medication to help her calm down. I can tell you from my personal experience with anxiety that if you do not get something to help you calm down it gets progressively worse to the point that you feel like you are going insane and so does everyone around you! I had ongoing panic and anxiety attacks during my pregnancy and wound up losing the first child and the second time around I was sitting in a psychiatrists office begging for help and that is the only thing that saved me and my daughter. You will run across idiots that do not think this is "real" and they give your family advice to "yell at you and tell you that you are alright, and to just knock it off!!" I am not kidding a doctor literally told my family to do this to me!!!!! Knowing how horrible this is, I would even seek help from another doctor if your Mom's doctor refuses to help with medication, unless giving her this medication would kill her or harm her. In my book there is no reason to make a person suffer.

If you have ever been ill or your kids, you may notice that they seem to feel a bit better during the day and then come evening they too begin to feel worse...there have been studies done on this. I sometimes wonder if when evening arrives and it is getting dark, they may become anxious because everyone is getting ready for bed and turning off lights and it gets scary and they may fear or dread this because they are worried they may need you or your help and you will be asleep and unavailable......just fearful.

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virtualhorizon Aug 2013
It's called 'sundowning' because the activity normally starts in the evenings, after the sun goes down. I've read in several places some steps to take to maybe make it a little better; the ones I remember involve trying to keep the patient from becoming over-stimulated (like watching crime shows, etc. on TV at night! or even scheduling bathing in the evenings) and trying to keep the room they're in lighted well to prevent shadows, which often confuse a person with AD. The less agitation and the more familiarity they have the better. Of course nothing really seems to work with my Dad -- he'll wander and be anxious about something for hours, until his clothes are wet with sweat.

Carlos Aug 2013
I guess so that she needs to go to a neurologist with expertise in demen tias , once he can gives small doses of medicine drugs that can calm her ,and makes things easier.
I guess so that to not argue with her, and to not tell the "truth" , once in stage of dementia that she is , she can not deal anymore with the "truth" and it will only makes her more agitated as you are seeing.

It is a good thing to go to a physician to make blood and urinary tests (search for urinary infections).

It is interesting to read articles in sites about caregivers experience to deal with agitation , sundowning , etc.( the site called alzheimer Reading room have very good tips about how to deal with dementia patients).

I can tell you about an anedoctal report of some supplements that we gives to my aunt in an empirical way , wwithout none scientific foundation , but that is working to control some of her dementia symptons as agitation, agressiviness, delusions, etc.
But only the PHYSICIAN of the patient can gives permission to prescribes these food supplements and knows the doses, drug interactions, etc.

I have no doubt that sundowning it is a chemical disorder and that can be controlled , in an empirical way, using natural supplements .

My aunt have advanced dementia and if she do not takes every day the following supplements ,she starts again with her "old"and odds behavior (as before we started to gives the supplements) ,with hallucinations ,delusions, agressiviness ,agitation , cyings, yells, etc , most the time of the day and most the time of the night .

We are using in an absolute empirical way ,and this is only an anedoctal report.

Only the doctor of the patient can gives permission and have to gives supervision in the use of the following supplements that are controlling not only sundowning , but her agressiviness,delusions ,agitation , hallucionations , insomnia , cryings , yells,etc.

In an empirical way we are giving:

1) L-CARNOSINE : 60 miligrams three times a day.( it is CARNOSINE and it is NOT L-carnitine).(only these small doses).

2) L-GLUCURONOLACTONE : 200 miligrams 2 to 4 times a day.

3) GLUCOSAMINE SULPHATE : 200 miligrams 3 to 4 times a day.
I know GLUCOSAMINE it is a supplement for joints.
But when she started to use GLUCOSAMINE for her joints we saw an amazing calmness and control of agressiviness and agitation.
We can find in the medical site PubMed SCIENTIFIC ARTICLES that shows that glucosamine stabilizes tau in the microtubules in the neurons, and works as an alternative fuel to the neurons too .

4) ACETYL L CARNITINE (ALCAR) - 30 to 50, miligrams (up to 100 miligrams) three times a day.(it is NOT l-carnitine , but is ACETYL L-CARNITINE)( only these small doses).

5) EXTRA VIRGIN COCONUT OIL - One tea spoon two times a day.(if the patient have diarrhea even with these small doses , the caregivers makes massages with the oil in the thin skin of the arms with the tea spoon of the oil ,once the coconut oil have a comproved fast transcutaneous absortion (according articles in PubMed).

A lot of friends of mine , after my report , are giving to their relatives with different types of dementia ,with the same amazing effects to enhances cognition,mood and to control the odd behaviors.

But this is only an anedoctal report , without none scientific foundation, based in empiric observation only.

Only the doctor of the patient can gives permissions,and knows the right sup´plements and the right doses to each supplement. The responsability for the use or the administration of the supplements and drugs above it is in the hands of who takes or gives it to any patient. Talk to the doctor of the patient about it.

NancyH Aug 2013
I wonder why it's called 'sun downers'? I know my mother-in-law has dementia/alz and she also does that, but WHY is it only in the evenings? Has anyone ever experimented with lights that would mimic sunlight to see if it helps? Just wondering out loud. As for us, Seroquel is what she takes to help with the agitation, otherwise it's Namenda she takes for the actual Alz. Sometimes I'd just like to bring a tranquilizer gun and zap her when she gets like that. But the memory care facility we just moved her into, says NO. ha Oh well. ♥

virtualhorizon Aug 2013
Sundowning is just one of many symptoms of Alzlheimer's Disease. My Dad sundowns at least every other night from about 6 PM (right after supper) until he goes to bed, and sometimes he gets up after that. He becomes anxious and agitated about the smallest things and can't let go of them. Unfortunately, that's just the way it is.

You don't say whether your Mom is currently taking any medications at all. I assume she has been diagnosed with Alzheimer's or another type of dementia? If she has been diagnosed, I'm surprised her doctor (hopefully a neurologist) hasn't prescribed something for her. While meds may not be able to cut down on the sundowning (unless they make her a complete zombie, which you don't want) they would probably be able to cut down on some of her other symptoms and make her a little easier to live with. My Dad was diagnosed with AD almost 4 years ago. He didn't go to a psychiatric center to be evaluated for meds. He was prescribed a number of them and we finally found a couple that help him out a little bit. Meds won't cure sundowning or dementia. They just make it bearable for the patient and the caregiver(s). If your Mom's doctor is a neurologist I would suggest sitting down with him at her next appointment to discuss her symptoms and ask him to prescribe something. If her doctor is not a neurologist then you should make an appointment with one and take your Mom to see him/her.

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