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knoturs Asked September 2016

Is there a specific time for Sundowner symptoms to appear?

Between the hours of 10pm until 2am is what I personally call the nightmare hour. Every night is the same, however Friday & Saturday nights it is 3x worse.
He becomes this whole other person it starts off with talking to himself. Wandering around the house "thats right Im an a..h..e", no one gives a rats but about me. Then he starts in on me....calling me the "c" word, a lazy "n" word, constanly putting me down. Then he cusses me out for turning the lights off outside. On Friday & Saturdays he throws objects at me and threatens to injure my dog. The local police has been out to the house on several occations.
At this minute I am sitting in the car parked at the store around the corner from the house crying because I dont want to go home. It is almost 10pm.
Nurses at the hospital has told me those are signs of sundowners. I thought sundowners only occered during the hours the sun goes down between 4pm to 7pm. I could be wrong.
Also Mr.L ha a his mornings and afternoons switched. When it is dinner time, he thinks it is morning and gets angry when I serve him veggies for breakfast. He cant remember what day it is unless he watched the news about 4 hours later he forgets again.

I just dont know how to deal with this behavior....it seems like it is getting worse.

Llamalover47 Dec 2016
I am concerned for the OP. YOU, my dear, CANNOT continue to keep this up...sitting in your car, crying, for fear of your life must CEASE. Contact APS now.

BlackHole Dec 2016
Yes.

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Kkid1231 Dec 2016
For the last couple of years, every night at least once and sometimes up to 4 times, my husband will have a confrontation with the ceiling fan on our bedroom. He'll look at the fan and then at me and say weird things like, what did you do that for or he'll look at it as if it's about to attack him. It took me a long time to realize that he is still asleep. But right after his confrontation with the fan, he'll get up, leave the bedroom, then come back in a couple of minutes. Sometimes he'll get a cookie, sometimes he just walks around the house. About 8 months ago, he decided he didn't want me to sleep in the room anymore because I snored. The husband I always knew would never, no matter what, want me sleeping in another room. It hurt at first, but now I love having my own room and not having to deal with his nightly battles with the fan. He also gets crabby every evening now, as soon as he's in for the day. Are all of these things signs of dementia/Alzheimer's?

freqflyer Oct 2016
Carol, vast majority of elderly people, 90%, who go into the hospital for whatever reason will have a form of delirium. What happens is that the hospital is a new room, new faces, new voices, new lights, new noises, etc. and that can confuse an elder and they become scared.

When my Mom had a bad fall and had to stay overnight in the hospital, she had a really bad case of delirium where she was kicking her feet, like she was trying to run or ride a bike, and she would be reaching up with her arms to the ceiling.

One of nurses said it was high anxiety, and eventually a calming medicine started to work and calmed her down. But it was a pretty scary episode.

jackie18 Oct 2016
carolswilliams,
What was she being hospitalized for? Often an older person will have a change in mental status ( behave in a way not usual for them) when they have a urinary tract infection (UTI). This different behavior can manifest in someone being very nasty or combative. Can you give a bit more information about her diagnosis? Does she have any other diagnoses that may contribute to this behavior? ( such as dementia, or Parkinson's Disease?) Is she on any new medicines? People will have hallucinations with some illnesses, medications or in new surroundings. . People can get hallucinations and see others as trying to hurt them- even if they know the person very well. This is also not uncommon after anesthesia for an older person.
Please elaborate on her situation .

carolswilliams Oct 2016
My 96 year old mother had to be hospitalized a couple of months ago. I had to run home to get her insurance cards. While I was gone, she went wild, slugging the nurses with her fists, kicking at them with her legs, screaming, cursing (which she had never done in her life). When I got back to the hospital, the nursing staff met me in the hall, describing her behavior. When I went in her room, she hit me with her fist and kept trying to kick people. She talked to me like I was a dog. It took four of us (2 males), a nurse and me to subdue her to the point that they could give her a sedative, then put restrains on her arms. Truly the most horrific experience I have gone through, so far. I think the aid that went in her room, when she was trying to get out of the bed, made her mad. Now I live with the thought in mind that this type behavior could happen again, and it scares me half to death. Mother had never hit anybody before, nor curses. Have any of you had this experience?

jackie18 Oct 2016
Lindylu,
I understand your situation well. I have been a nurse for more than 40 years with geriatrics both with and without dementia. I love what I do, but realize that even the most well intended people need to let go sometimes.
Like others have indicated, it is time for you to leave this abusive situation. it doesn't matter if "he knows not what he is doing", you are not required nor responsible for this man's well being. Another writer mentioned taking a cell phone video. Doing this will alleviate the problem of his behavior suddenly seeming " normal" when others are around. Yes, APS or 911 are each appropriate. But if I were in your situation I would call 911- Explain to the EMS that he is acting in an erratic/abusive manner and not safe to himself or you
( Show the video if necessary). He can be admitted to a hospital for a psychiatric/ neurological evaluation. He may or may not have a UTI ( urinary tract infection), but that is still not a reason to continue to act in this way. The only way he can receive needed services is by you calling 911. Give the EMS his MD name, list of medications and family contacts, if any. If he gets admitted the hospital social worker will have to make safe arrangements for his future. That is part of his/her job, and they are familiar with services that can help. A diagnosis is needed and then a physician can prescribe medication to make him more comfortable and safe to be with others. He can be placed in a nursing care facility. But usually the only way to get this accomplished is after someone is in the hospital.
You will be doing both of you a kindness and a favor by taking steps to deescalate this situation. Do NOT let any guilt even enter your thoughts.
If you are so inclined you can visit him wherever he is, but you are not his caregiver .
Best of luck, and you are a wonderful person for doing so much
Jackie

nbz96768 Oct 2016
My sister and I have recently discovered that our mother, who is in assisted living, has sundowners. She would call one or both of us and tell us what hateful daughters we are for not letting her come home to live or not letting her get a place of her own. She also calls my sister''s husband names and says everything is his fault. When an employee of her assisted living place mentioned that everyone there was sundowning, we started noting when mom's behavior was happening, and sure enough, it was during mid-afternoon to early evening. The last few hateful messages she sent to my sister we are saving, for her doctor to hear. We also realized that she doesn't remember any of her rants the next day.

moecam Sep 2016
Record a few of these episodes even just use your cell phone on video - everyone is holding cells nowadays - don't tell them you are recording then play to dr. - at another time try saying in midst of rant that you are filming it then you'll record how the 'switch' can happen back to reasonable behavior - use time & date function during recordings - good luck

jinglebts Sep 2016
I'm worried abt YOU. How are you living -- does he support you or pay you? Do you live in his house? Do you have POA (power of attorney)? Certainly the situation is out of hand now ... if you're sitting in your car crying b/c you don't want to go home, your situation is dire. There is no shame in calling 911 the next time he gets like this (which I assume will be tonite?), but do you have any income or another place to go? That's what I'm concerned about.

Can you fill us in on those details?

NJCinderella Sep 2016
my mother sleeps late, then naps in the afternoon. when she wakes up she is disoriented and very confused for a few hours after. She isn't violent but has started to call me to say she has had a big argument with my dad, that he has left her (he hasn't) or that she has left (she hasn't, the caller ID is home phone) etc. Is this sundowning?

Bbtwinks Sep 2016
I am retired now but worked for close to 20 years in a skilled nursing facility. It is my experience that agitation, or sundowning cycles, can start at any time. It is most common at dusk, though. I believe that sundowning is sometimes triggered by the coming darkness and the change in perceptions that it causes the dementia sufferer. Familiar objects can look foreign or scary or may not be able to be seen at all. Also, in my experience, persons with dementia can get their days and nights reversed--staying up all night but sleeping all day.

Llamalover47 Sep 2016
Sundowners can appear as early at 11:00 A.M. or as late as 12 hours later-11:00 P.M.!

Olivia24 Sep 2016
The problem that I'm experiencing with my mother is that she uses the bathroom on my floor which creates a problem for me n yes,I'm aware that she to experience sundown...does anybody else experience this problem?

dmasty Sep 2016
I agree with the previous posters that this is way to much for one person and a threat to your safety. My Mom's sundowning was starting around 6 pm but now seems like 4 pm. Maybe because the days are getting shorter. It's just like a switch flips and you can see the agitation ramping up. But the middle of the night insanity I can relate to also. In my Moms case it's due to psychosis of Parkinsons. She pulls everything out of the drawers, cupboards, freezer and walks around with any sharp object she can find. The last time the police were out they were very direct with me that we HAD to keep working with her Dr to get this controlled with meds. It's not a perfect science as we all know! How often do we feel we could use a tranquilizer dart?? Kidding of course but I'd like to hear anyone who knows how to get a dementia patient to sleep at night.

staceyb Sep 2016
Yes, its time for a major intervention from APS! Soon, he will be hurting you, and you can't have that! He's not related to you, so does he have any family around? There must be someone who can help you! Get out, and get him some help, but you must save yourself first!

BlackHole Sep 2016
Knoturs, call APS and cut him loose. Or call 911 during one of his fits, tell the paramedics he needs to be admitted for medical and nerological evaluation, and do not sign for his discharge or pick him up. (Are you living in his house?? I can't figure out how things escaalted so much with a non-relative.....)

I'm sure you had -- and still have -- good intentions. But this is all too much. You're not safe. He's not safe. It is not wrong or a failure to make him a ward of the state, if he has no family. (Or no interested family, which is sometimes the case.)

His needs exceed any one layperson's capability. Even a rotation of laypeople are not a match for his issues. It's time for professionals to take over. You did right by him for as long as it was feasible and then some. It's time for you to get your life back.

anonymous326422 Sep 2016
Hi Knoturs, I had to laugh at your last paragraph! That is funny (and terrible!)

From what we've observed in our family, and from what other people commonly report on here, it really does seem like the person in care often antagonizes the primary caregiver the most. Maybe that is just who they feel comfortable around, like how little kids have temper fits when they get home from a stressful day of school and take it out on mom. I don't know. But it is very stressful for the caregiver. And when the dementia patient hides that and act "normal" around others, it really slows down the process of trying to get appropriate medical care for them.

Are you the person who takes him to medical appointments? If so, sometimes it helps to call and talk to a nurse or doctor about your concerns before the next appointment.

I feel bad for you. It's a tough position to be in, especially if there are not other family or friends who observe the same behaviors.

knoturs Sep 2016
@lindylu & katiekate....
thank u for taking the time out to read and reply to my question.
The both of you mentioned a few things that made me think and say to meself "yup thats EXACTLY what he does"!!
The clinging....he has a fit when I close the door to the bathroom, he grabs his litttle phone book starts at page 1 and calls EVERYONE before 4am. Indeed when other people are around he is as sharp as a tack! However, when he fwels im not giving him enough attention he "gets even" by making up stories telling half truths about me anything he can think of to get me in trouble.
HE IS Constantly awake at night..right now it is after midnight he is singing to himself and pulling all the dishes out of the cupboards & washing them.
Sometimes during his rantings in the middle of cussing me out and name calling he will have the poop eating grin on his face saying " are you mad yet", " are you mad enough to hit me ", " im trying hard to provoke into hitting me".
UGH!!!
katekate....correction...he is not my dad. We are not related in any way. He was just a neighbor that asked me for some help with his owl statue in his backyard.....5 years later i am a prisoner in his home. (it feels like im a prisoner.)

Katiekate Sep 2016
I have noticed that it really starts about 4pm. His attitude is more effected by how much (or little) attention he feels he is getting.

dad has always been rather selfish....its always had to be about him. But, since Mom had a stroke she has in home therapy every day. The final therapy each day is at 5 pm. By then he is usually ranting and saying nasty things about people..just loud enough to be heard. But, I think he never gets really horrible until the strangers are out of the house. So this has to tell you...he is aware of how unacceptable his behavior is....at least he knows it at some level.

Today has been the worst here. I think this was because I took Mom out to get a Flu shot. When we got back (about 3pm) he was in "full sundown".

I know how hard it is to deal with this. You have my great sympathy! Try to remember, this is not the person of your Dad....his brain is so distorted that it just isn't really him. I have to remind myself all the time to not argue with him...agree and go on about what You need to do. When he calls you nasty names, just pretend this is some tape recording and has nothing to do with you.

I would draw the line at throwing things. Whatever he throws...disappears forever. Tell him you will remove anything he throws..and then do it. As his environment becomes more and more empty, the threat will be enough to stop him. I have done this myself. Now, I just say to him. "Remember, you throw it, you lose it" and he stops. Calls me another name, but stops throwing.

Do something special for yourself....come here anytime if you need to bend an ear!

anonymous326422 Sep 2016
Knoturs, our experience with Sundowners was that it occurred literally around the time the sun went down. I thought the change in light had something to do with it, but maybe it's just their waking hours. However, we found that his disorientation started much earlier in the winter and he has done better in summer evenings, in general. In our case, it meant confusion in general but especially about what time of day it was, and then also increased clinginess with several (anywhere from 2-8) calls an hour till he went to bed. There are probably different ways it can manifest and you will probably get lots of replies, but our experience was closer to what your understanding of it was.

Some people with dementia do spend a lot of time up at night. Ours would get up often to use the restroom but then as the dementia progressed, he would rifle through drawers, etc. Now he is in a nursing home and they are giving him melatonin to assist with sleeping.

Before anything else, I would look at his medication list and google all the drugs -- see if any have agitation or insomnia as side effects. Otherwise, unfortunately it might be part of the dementia. Oh, also if this is a new behavior, does he have UTI symptoms? Ours got very agitated when he had a UTI.

His dr might be able to prescribe something to assist with sleeping but you have to watch side effects for those too.

I am sorry he is being so vicious toward you. That kind of nastiness is very hurtful; even if he doesn't "mean" it, it hurts to hear.

I wish you luck with this. It is really difficult when you are doing an exhausting job, then cannot sleep at night on top of it!

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