My mother has been on Donepezil (5mg) for over 3 years. She is 100 years old and still mobile with her upright walker. However she is very unsteady. She gets up at night 4 or more times despite a bed rail. She is headstrong and removes the nightgown clip on bed alarm the caretaker tries to use. She is now experiencing more dementia episodes of living in her past memories and maybe even sundowning. Trazodone 100 mg does not make her sleep all night!What medication do you recommend at this point? An anti-anxiety? If so, which one? I’m so afraid she is going to fall!
my mom is 87 and not doing as well as your mom mobility wise.
She has been experiencing sundowning probably for the last year and a half or two.
Just two weeks ago with a new doctor we put her on an anti-anxiety pill called REXULTI. It seems to be helping some. The doctor explained that some of the medication’s used for anxiety can cause unsteadiness and heart problems. With your mom being 100 years old, I know you don’t want to hurt her but at some point, they are going to go I guess. There is a woman turning 103 in my mom‘s memory care Home. Another is 100.
I don’t think my mom will live that long, I certainly hope not because it won’t be any way to live. She’s almost wheelchair bound now.
Anyway, good luck with your mother and I hope she can get some help from her doctor. My mom was getting up three times a night to use the bathroom so I think this anti-anxiety is helping her to get through the night better.
There are medications that her doctor can prescribe for her sundowning if that is what she's experiencing, however I don't know their names as I never had to use any of them with my late husband.
Perhaps you need to put a bed alarm on her bed to alert her caregivers when she's trying to get up and out of her bed.
But realistically your mom at 100 is now a fall risk and you could have someone standing right next to her and she would still fall. And to be honest, sometimes a fall which often can be the beginning of the end can be a blessing in disguise, as we don't have to see our loved ones suffering anymore with the horrific disease of dementia.
My mom was prescribed donepezil 10mgs when first diagnosed and when she entered hospice I reached put to her gerentologist and we decided to discontinue the medication and even though it was a low dose my mom awakened became more communicative and shiwed a improvement in her QOL.
Medications react differently with each individual.....finding the right combination is the key.
And it has. Mom still wakes up sometimes, but she is not so upset as she was before and usually goes back to sleep.
Also, if your mother is taking Rivastigmine, make sure she is not taking it any later than her evening mealtime. MC staff was giving that to my Mom at bedtime until I read online at Mayo Clinic and Alz.org that it should not be given to Alzheimer patients at night. I told the MC staff, and they did not know that, so they changed the time she receives it. That was a huge game changer for Mom.
Haldol as needed helps my dad when he gets agitated.
I agree it does seem like the Donepezil your mom has been taking has ceased to produce any improvement after such a long time.
I had to work with my parents’ physician, then their neurologist, to get them to understand which meds helped and which ones did nothing. Finally I switched to a geriatrician as I felt their prior doctors were just prescribing medication without taking dementia into consideration. (They are both now on hospice, and the hospice nurse handles all meds.)
My dad had a motion detection monitor on the floor by his bed that set off an alarm when he tried to get out of bed. That way he could not remove any device.
I understand the frustrations you describe. Hoping you find something that helps.
so our nurse and doctor finally got it right… Seroquel, 25 ML at noon and then 50 ML at bedtime along with 50 ML of trazodone. This has been a huge change and we can all sleep better at night.
Of course, ask your doctor, this is what is working for us! 💤😴
When I first saw your request for recommendations for sundowning, I thought,
"I Do have suggestions for sundowning!".
But, what you describe is outside my level of experience!
For sundowning, I would have recommend Trazodone, which doesn't seem to be effective here. Also, to ease anxiety in the late afternoon/ early evenings, you can keep her space well lit and close all the drapes, so she can't see that it's dark outside. I don't know if that will help with her overnight waking.
Her Caregiver may need to sleep closer, or stay awake nights, to assist when she gets out of bed. It's funny she disables the alarm. Or hire a second shift person to be awake nights.
If you have a hospital bed that lowers to the floor level, and place a soft mat next to the bed, at least she can't fall trying to get out of bed. Although, if she is strong enough, she may still be able to pull herself up to standing and try walking and fall anyway.
It might be time for her to be in a nursing home, although they still can't prevent falls. There's not a lot you can do, really, to prevent a stubborn elder with dementia from trying to walk and falling. She may just have to suffer the consequences of a fall that could send her to the hospital.
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