What is the best way to handle sundowning?

Talk to the doctor about medication that can help with this as it's only going to get worse, not better. Make sure to understand possible side effects.

Some people are not in favor of medication to calm our folks down, since it sounds like it's just done for convenience, but I think of it differently. I myself would not want to be agitated, naked, combative, belligerent, and a big fat handfull for my family/caretakers. *I* would rather be a little sedated and not go through the daily stress of something like that or inflict it on my family.

I've gone the drug route. At this point my sanity and health is more important than a little sedation. Mom takes Seroquel in late afternoon and Trazadone at night time. The Trazadone worked in ONE dose and has continued. The jury is still out on the Seroguel but seems to be helping. Mom's starts in late afternoon but sometimes wakes up with Sundowners. If she is to stay here in my home, I will have to sleep. I am not a martyr, I am not a nurse, I am not a maid. I have become a maid and a nurse through this experience, but a martyr I refuse to be. Don't even feel badly about drugs. Don't let anyone make you feel badly about it either. My Mom is almost 92, has been pretty much miserable her whole life no matter where she is and I'm just figuring I don't have to be. If she can't stop it and I can't overcome it, she will be going to AL very soon. I have been looking at various ones. You are doing no one a favor to sacrifce your life and health for someone. My opinion.

I finally went the medication route for my dad. When he hallucinates he does not sleep. It goes on for days which means I don't sleep either. I just started the medication about a week ago and so far it doesn't help but I assumed it would be by trial and error. I will move onto the next med if necessary. I tried to handle it without medication but it was just impossible. He will wonder, get undressed, urinate wherever, go through drawers, talk all night and all day....the list goes on. The wondering is what really worried me because of the possibility of him falling. He was given an antipsychotic but like I said it has yet to help. I hope to find something that works.

!!!!!!!!!!! If you find out the answer to this question please let the rest of us know! My Dad has sundowned for some time now, but over the past month it has gotten quite horrible. He wanders and has delusions from at least 5 PM until bedtime at 10 PM, sometimes longer. He is anxious, he worries, he has delusions, he has hallucinations. For the past week he has continuously told us that he needs me or my husband to take him to work, to the doctor, to the hospital, to see this or that person about some unknown problem. Last night he wandered around by his bathroom door, wanting to know about the toilet and where the water goes when its flushed and where the pipes were (this has been ongoing off and on for months). He is worried about his identification card and wants to know where it is and whether its lost and whether it stills works. He saw a snake in the bathroom. The "people" have taken over certain areas of the house, etc. He lost his paperwork. He lost his files. Once you think you've gotten everything answered, he comes up with something else. He turns everything you tell him back on you and conversations go round and round in circles! He won't sit still for a minute! I finally called the neurologist's office and made an appointment for just my Mom and myself to discuss the problem. Hopefully he can make some adjustments in medications and in when they're given, or give us something new to try out. I agree with sandwich42 as far as sedation goes. We would rather have him taking some type of med to calm him down in the evenings than have him go through the stress this must be causing him (and us!). Mom can handle everything else, and the daytime hours aren't that bad. But he starts up right when she needs to sit down and get some rest!

Yes, I agree without meds, melatonin, and exercise during the day. Limit caffeine all together if you can. The disrobing could be a money-maker at a strip club, but perhaps not! Just a little Black Friday humor...

Sundowner’s Syndrome is the name given to an ailment that causes symptoms of confusion after “sundown.” These symptoms appear in people who suffer from Alzheimer’s Disease or other forms of dementia. Not all patients who suffer from dementia or Alzheimer’s exhibit Sundowner’s symptoms, however. Conversely, some people exhibit symptoms of dementia all day which grow worse in the late afternoon and evening, while others may exhibit no symptoms at all until the sun goes down.

bellas - Between Hospice and his doctor we tried several RX's: Quetiapine (Seroquel) 50mg 1 tab by mouth 3x's daily; Hydrocodone-acetaminophen (Norco) 325mg 1-2 tabs by mouth every 6 hrs. as needed for pain; Hydroxyzine (Atarax)25mg 1 tab in a.m. and noon, 2 tabs at bedtime; Metoprolol Tartrate IR (Lopressor) 25mg. take .5 tab by mouth 2x's daily; Lorazepam .5mg; later we had to use the morphine tabs for pain; These are the RX's we used over a period of 7 months - not all at the same time of course, but working to find the correct dosage and combination. You can google them by name and see what the side effects are and their usage. Consistency and regularity are so important with drugs, as they start to wear off the anxiety and agitation is more pronounced. Ask your doctor for the advice and prescribing. Bless you and know you are not alone on this journey. We were fortunate to have a doctor who listened and observed and supported us all the way. Hugs.

You can sometimes tell when a Sundowning episode is coming on if you keep a close eye on what type of day the patient has had. If it's been a rough, hectic day with lots of visitors or doctors appointments bundled on top of each other, medical tests, family events, etc. all of this can trigger the sundowning. You have to be careful with taking the spouse, loved one to social events, Alzheimers' patients are not good in large, loud group settings by any stretch of the word. I've learned the hard way. you do have to sit with them, just go through the process, them your loved one calm and reassured. This can go on for one day to three days at a time. BENADRYL AND OTHER SLEEP AIDS CONFLICT WITH ALZHEIMERS MEDS AND CAUSE MORE CONFUSION, ANXIETY AND ODD BEHAVIOR. DO NOT USE THESE DRUGS. TRAMADOL ALSO WORKS AGAINST ALZHEIMERS MEDS.

When it began with my mother, it happened every single day, no matter what, it was a daily occurrence. It seems like they become agitated because of night time coming on just like when people are ill they may do okay during the day but when evening rolls around they begin feeling ill again. Honestly medication is all that has worked for us.

As a geriatrician, I tell families that sundowning in people with dementia is a little similar to the 5pm "witching hour" that parents often see with babies & young children. It's probably a combination of long shadows, being tired at the end of the day, and who knows what else.

Every family has to do some trial-and-error to figure out a way to manage it. Agree with routine, creative redirection, minimizing stressors during this time of day if possible.

Medications are tricky. Most medications that settle people down have risky side-effects, and usually the clinical trials find that medications don't overall help much. But as many of you have pointed out, at the end of the day, it's very important to keep things managable for the family caregivers and sometimes a little medication seems to offer a reasonable balance of benefits and risks.

My main suggestion to the group would be that if you ask a doctor to prescribe medication, start with the lowest dose possible. I once had a neurologist suggest we try Seroquel 50mg for a 91 year old person with some sundowning; most geriatricians start with 12.5mg (which seemed to do the trick for that 91 year old).

Agree with Fraulein that Benadryl and over-the-counter sleep aids (which all basically contain something like Benadryl) should be avoided at they are "anticholinergic". Good luck!