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ArleneAM Asked August 2021

My Mom has been diagnosed with dementia/Sundowner's. What medication do you use for Sundowner's?

Hi! I am new to this forum. My first of many questions since I am new to being a caregiver. My husband was my caregiver when I had ovarian cancer and it has matastisized 3 times since 2015 as I have the BRACA1 gene mutation. My CA125 has gone up to 31 so I am concerned how I will care for Mom.


Anyway, enough about me!


My question is what medication do you use for Sundowner's when you start seeing signs of Sundowner's?

sjplegacy Aug 2021
There is no medication for Sundowning as such, but it can cause certain behaviors for which there may be meds. Sundowning can cause anxiety, agitation, delusions, and even aggression. AD also affects one's circadian clock, which completely distorts the meaning of time. Even though it's 2 AM, your mom may think it's time to get dressed and get the day started. The lack of sleep and the feeling of complete exhaustion by caregivers is a major reason they check out care facilities for their LO.

Websites like https://www.nia.nih.gov/health/tips-coping-sundowning, and many others, can offer some insight for you. Just Google “sundowning”.

Beatty Aug 2021
Sundowner's is tough.

Some of the main reasons may be;
* Being overly tired or
* Unmet needs: hunger, thirst, pain, boredom

My son would turn in circles in the late evenings. Bored but no attention to engage in any task properly. Tired, hungry, fussy, clingy.

Sundowner's looks very similar to me.

Having a familiar routine, a familiar place of comfort is all I could provide then & is what I'd try now.

If tired, a favorite chair, throw rug, favorites photos to look at, calm music.

If mobility is good & wanting to wander & go, a short walk together outside looking at the garden?

What specfic problems happen at this time?

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Geaton777 Aug 2021
Welcome to the forum! There's a lot to learn about dementia, and I learned a ton from watching Teepa Snow videos on YouTube. "Sundowning" is not a type of dementia but a behavior that dementia can cause. There are ways to try to deal with it so you'll get several different suggestions. My suggestion is that first it may be a drug interaction with another medication she is taking (if she's taking any). So I would discount this as a cause by discussing with her doctor.

If this behavior has "suddenly" appeared (and any other new behavior) she should probably be taken to her doc or urgent care to check for a UTI, which elderly women get very frequently and mostly presents no other symptoms except behavior changes, confusion and agitation that can be described as happening rapidly or suddenly. An untreated UTI can turn into sepsis, a life-threatening infection.

If she is taking any OTC sleep aids (like Tylenol PM) she could be reacting to this in an unexpected,, non-typical way so I would take her off it (and still consult with doc).

Then I would assess whether she's napping/sleeping during the day at all so that she's just not tired enough. What my family has done successfully is to keep our LO "active" by asking her to help fold towels, sort plastic utensils, organize playing cards, sorting and pairing socks, etc. This engages them both physically and mentally with the added bonus of being an activity they do by themselves. There is no "right" way for them to do any of the tasks, just so that they're doing them. My LO does this several times a day an sleeps through the night. We give her these activities to do in the late afternoon when she starts wanting to "go home" and sundowns.

I would consider prescription medication from her doctor a "last resort" since it can be trickier to find one that works, may take a while to find it and can interact with anything else she is taking. But many on this forum will give testimony to the beneficial effects of prescription meds to address dementia behaviors.

Do continue to research dementia from reputable medical and non-profit organizations so that you can understand what your LO is experiencing, why and how dementia changes them and how you can better engage with them so that your household and daily life is the least stressed as possible. Wishing much peace in your heart on this journey!

JoAnn29 Aug 2021
As said it depends on how severe the Sundowners is. This is really something that should be discussed with her neurologist. Sundowners is not curable. The symptoms can be helped if severe.

I too agree, you will not be able to care for Mom. If she has money, then place her in a nice Assisted Living. If no money find a nice LTC facility and get her on Medicaid.

gladimhere Aug 2021
Arlene welcome to the site. First question for you is what is plan b should you not be able to care for mom?

Sundowning is a symptom for many with dementia. It can be a range of behaviors. For my mom it was agitation. To help with the symptom, mom's doc prescribed seroquel at 25 mg daily at about 4:00 pm. The dosage gradually increased to 75 mg, still once a day, over the course of three years. Then she was moved to a facility and I was not kept in the loop.

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