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Mom is in AL and now under hospice care, her sundowner episodes are becomming more frequent and are very hard on me. She can be very very hurtful. About mid to late afternoon mom becomes very different and very agitated and confused. It is killing me to watch. I can have a good conversation with mom in the morning. But afternoons, wow ,,, it hurts to watch her go through this and she calls and blames everything wrong on me... I explain that I am very sorry that she is confused , her reponse is , yes your sorry your always sorry. So hurtful. It is literally killing me..... What can you do .. I listen and hurt and it is getting worse everyday, I told her I am suffering with her...and I really am

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My dad went thru this when he lived with me. He would get very paranoid and act like things were going on that we didn't want him to know about. His whole demeanor changed. Even his facial expressions changed. It was always the same thing. He just knew I was stealing his money. If I tried to say anything he would hold up his hand and say "Don't talk to me". He always said he had somebody coming over who was going to get all this straightened out. Sometimes he got loud and used abusive language and tried to come at me as if to hit me. He managed to hit me with his quad cane a couple times when he first started acting like this. After the nurse told me it was sundowners I researched it and one tip I used to help with this was to turn on lights in the rooms dad used as soon as it started to get dark. I closed all the blinds and curtains so he didn't see outside. It helped some. Apparently they get confused and frightened as it turns from day to nite. Dad is in a nursing home now and they don't have this problem. His blinds get shut before it gets dark and his room lights are left on all day and only turned down when they ask him if he's ready to go to sleep. Talk to the staff at your moms AL and they will have suggestions and will intervene with her so that she is otherwise occupied at the times she would be calling you. That is their job and they are getting paid to care for her so don't be hesitant about asking for their help.
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Mom is here with me and I am not above giving her the Klonipin prescribed for her. At night she takes Trazadone to sleep and stop the night wandering. Sometime drugs are the best bet. It's too difficult for them and us without the drugs.
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I feel for you. I went through this with my Mother in my home for a year. She turned into someone I didnt know and pulled on the locked doors trying to get out yelling at me it was awful. She ended up going on depakote sprinkles and she, and we, were fine after that. She slept a lot at first but once it got in her system for a month or so the sleeping stopped. This was 3 years ago for us. Talk to her Doctor because if you think You dont like it, how do you think she feels? Its no fun being aggitated and confused like that. My mother was so much calmer and happier on meds also, so worth it.
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Another thought occurs to me: since she is in Assisted Living they should be providing some kind of distraction for her. Like light walking exercises if she is ambulatory. Perhaps they are not allowing her "catnaps" in the day or allowing her to sleep too much so she isn't sufficiently tired at night, or providing enough exercises or activities to decrease agitation. Also, leaving a light on at this time of day helps.
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Sacline, it sounds like it is very hard on you, and undoubtedly it is, and for any family member going through this. I always tell my families that you can't change them; this disease process doesn't get better unfortunately, it progresses until the end. The best thing for you to do, and I know it sounds easier said than done, is to control your reaction to it. I'm sure you know your mother loves you, and in her right mind, would never blame you for something like this, this is all a part of the disease process. Please, please, please don't take it personal.

If you see her getting mean, set boundaries--tell her you want to visit and talk to her, but if she's going to be mean, you will leave, then do it. If she is just scared during these episodes, soothe her as best you can. Distract her, bring her pictures that you can talk about. If she says she wants to go home, talk about the good ol' days when she was at home with you, cooking, baking, etc. As someone mentioned above, take her for a walk if possible (I know you said she was on hospice, so might not be able to), and lastly, if all of this doesn't help her agitation, you might want to talk to the hospice staff, as well as the nursing staff, about maybe getting something in a low dose to calm her down (Ativan, etc.). If she is on hospice and at the end of her life, these continued agitated episodes without relief is not good for her quality of life, and she should definitely have that at this time.

Good luck.
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Does she still know how to use the phone or does she require assistance? You might consider having the phone from her unit removed. Maybe it is time for a secure unit? We started my mother on Seroquel just over a year ago, initially 12.5 mg that I gave to her about 4:00. This has helped tremendously. Many of those with Alzheimer's take this drug, up to 400 mg a day to help with the hallucinations and unpredictable behaviors. We are now up to 62.5 mg/day, but still at about 4.
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And if the drug makes them more comfortable, there is nothing wrong with that. So many are concerned about the behaviors and how to control them. These behaviors are hard on those with Alzheimer's as well, the drugs help to control the behaviors, making everyone more comfortable.
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Try to distract her. Tell her about your day.
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Low dose Ativan Rx. Talk to your Mom's doctor or a Hospice RN for more advice.
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See if her doctor will prescribe an anti-anxiety med for her. Since she is already in hospice, both of your suffering will end soon. My prayers are with you.
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