Does anyone have advice on dealing with sundowners?

As mom approached the end of her life, the Sundowning reached a horrible level. Memory Care wasn't able to help her in any special way, either, b/c let's face it; when they're anxiety ridden & insisting on going home, nothing is going to help them except medication. When hospice got involved, the nurse got approval for .25 mgs of Ativan every 6 hours which helped mom A LOT with the Sundowning. Then as time went on, they increased it to .5 mgs. I consider Ativan to be a lifesaver for Sundowning, I really do. It calmed mom to the point where she was fairly managed and I could speak to her and keep her relatively anxiety-free.

Part of this you DO have to learn to deal with b/c even with meds, your mom is likely to still have her bad times with Sundowning. Hopefully there is enough staff at her AL to help her through the tough times. Mom's MC staff were amazing with her. Have you tried giving her a baby doll? Many women with ALZ are very comforted by taking care of a baby in swaddling, as they did when they were young mothers. Give it a try, what have you got to lose? You can search 'lifelike baby dolls' on eBay and buy one for a reasonable cost online.

Wishing you the best of luck!

I can only add what works for me and mom 86. She's had horrible sundowners for several years, way before she came to live with me. It typically starts 2:30ish with nonstop pacing, checking, rechecking things, worried questions about her pets, where she should sleep tonight, where she should sit so she can get out quickly without anyone noticing, so on. When this starts is my cue to bring her a piece of pumpkin pie (store has it year round). Then in about half hour a cup of warm honey-lemon water. Sometimes we walk outside to mailbox or driveway. As someone mentioned a stack of towels to fold. Then I just let her pace back and forth thru the house to continue checking, rechecking til dinner around 5:30. Then the nighttime routine of TV and bedtime. This keeps her steady about 9 times out of 10. Before she came to live with me her afternoons were endless panic phone calls to me or my brother, I often got 30plus calls. One time she called over a hundred times in one afternoon (phone stopped counting at 99). This way of managing sundowners is only possible for me because she now lives with me and I'm retired. I offer my experience to you only as ideas you may be able to offer to whomever is available to your mom in afternoons.

1. Talk to her doctor about meds.

2. Talk to the ALF about having them check in with her at her usual "panic time".

3. When mom calls, tell her that there people she can talk to in her residence. Encourage her to go to the common area.

I found better lighting helped.
Closing blinds or drapes so he would not see his reflection in the glass at night helped.
Staying on a schedule helped.
Melatonin did little for him.
Each person is different so what works for one may not work for your mom.
It is very possible that your mom would now do better in MC rather than AL. It would have a discussion with administration. It might even be possible for her to spend a few hours in MC for a bit she will get used to staff and get to know some residents. (this might be like her "adult day care" for the time she is there.

I am a firm believer in medication that will help reduce anxiety, there is no need for someone to be in distress when it can be lessened or prevented. This is a discussion for her doctor, and it might take a bit of tweaking to get the right med and right dose.

My 88-year old mother’s sundowners truly came after sunset, so I don’t actually know if this is useful or not.

She was assessed by an elder psychiatrist and he: 1. Diagnosed her with stroke-related dementia and 2. Removed all the anti-depressants that the hospital docs gave her and 3. Prescribed her with olanzapine.

Every night she takes a small dose about 30 minutes before she goes to bed. Then, she sleeps through the night and wakes up around 8am, ready to go.

It really helped my mom to get a correct diagnosis. The caseworkers kept saying things like she was just depressed and needed cheering up. The elder psychiatrist said, “No, this is a result of the stroke and no amount of anti-depressants will help. “ Then, he explained how stroke-related dementia worked, so that I understood. I still think he’s one of the better doctors I worked with while caring for my mom.

I wish you well and hope you have success!

I can share what worked with my dad (now passed) and my mom 86.
I was advised to get them a good, long time outside in the sun each day.

My mother's doctor started her on a med for chronic anxiety which she has had all her life and included panic attacks. She loves her lavender/chamomile tea for the evenings. Her sundowning seemed to be a stage that has now pretty much passed. Mother has an evening sitter that arrives at 5:00 and this also has helped a lot.

Maybe one of your mom's friends could visit in the evening. I am sure AL's staffing is reduced in the evenings. My mom also learned deep breathing techniques to calm her down. Unfortunately her anxiety raises her BP too.

Not a big med fan, BUT in this case, I would ask the doctor about it. There's no reason to allow her to be in such a panic every day. She may need to move to MC as they are MUCH better equipped to deal with such behaviors, and should actually expect them since they are so common with dementia patients.

Maybe plan a visit a couple of times a week around the time that these begins. Or hire an aide that can sit with her for a couple of hours when she usually starts having issues.

Good luck.

Have her checked for infections. If she's taking pain meds, see if you can reduce the dosage. My mom had sundowners until we realized it was an effect from medication. Medical induced delirium is real and often alleviated after the infect or meds are removed, or reduced.

Also have all levels checked. Vitamin D deficiency can also contribute. As another person mentioned, take her out in the sun daily.

I don't think most people realize a lot of 'dementia' comes from other sources that seem to have nothing to do with the mind. That's where I'd start. What meds is she taking? What dosages? (Most doctors OVERDOSE elderly.) Does she have an infection? Even if she has Alz, checking all these can some times reduce the ALZ symptoms. Good luck.

My mom was experiencing severe sundowners. 25-30 phone calls or text messages screaming “‘I want to die”, “ I want to go home”, “ I need my car back”. The AL team put her on 25 mg of seroquel at 6pm. That began to help, but determined her anxiousness began as early as 3pm. So we’ve added a second dose after lunch 12:30. Huge improvement! She is way less anxious, the nightly phone calls have stopped and she admitted she’s sleeping better since she started taking her “ vitamin” as it helps with insomnia. She’s more rested therefore way less episodes of sundowners.

Constance, I neglected to mention something another of our posters here used with his mother who suffered from advanced dementia with very bad Sundowning symptoms in the late afternoons:

He rented a Richway BioMat heating pad for his mother. I will give you a link to read up about it. It is very expensive, but you can rent one to give it a try.

https://www.biomat.com/?gclid=Cj0KCQjw4uaUBhC8ARIsANUuDjUB4Ldbk6DN5PDxugjdXn2z-0TIijhHen2cvnmNWE7rSA0ocqMzuYQaAsAOEALw_wcB

They also make a BioMat Mini which is less expensive and also available to rent. Go to Google and punch in "Rent BioMat mini in *your area*" and see what comes up.

This poster swore by this BioMat and said it turned his mom from a lion into a lamb; that she'd calm down immediately when he'd place it on her recliner, and she'd go right to sleep.

I cannot vouch for the BioMat personally, but just tell you what one of our posters had to say about it. I thought it would be worth mentioning to you.

The other thing I forgot to mention is a weighted blanket............I have a 15 lb one myself and have found that when I'm anxiety ridden, if I lay it on top of my body, it puts me to sleep almost immediately!! Worth a try for a low price.