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Mom ( 93, in a good NH, wheelchair bound, CHF, vascular dementia and aphasia from a stroke) displays somewhat differing behaviors for my SIL, who generally visits after work (6-8pm), i visit only on weekends, daylight hours.


My mother always seems to have something she's upset about when SIL gets there. Yesterday, brother stopped in at 4.30 ( still blazing daylight here in the Northeast) and she was agitated about " something" with her wheelchair. Due to the aphasia, she can't speak much. When I visited yesterday in the am, no complaints about wheelchair or anything else.


This seems to be a pattern that I've sent over several months..mom is upset when sil is there, sil emails me, I raise the alarm with staff, and when they ask, mom is happy as a clam, nothing is wrong.


I mentioned to sil yesterday that I thought this was sundowning. She said "oh no, it was only 4.30 when brother was there".


So, can this be sundowning? How do we handle this? What is your experience with you loved one and afternoon agitation?

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Well the right person is there then when the agitation occurs. That's a good thing. Hopefully this will pass.
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97, SIL is a saint. Really. She seems to be the only person my mom wholeheartedly trusts. My brother often says that if mom stops trusting SIL, we're up $hit $ creek.

I don99think sil is stressed when she's there ( I certainly am). Now that we seem to have sil on board with the fact that this leprosy thing is a delusion, I'm hoping that her reassurance will settle mom down.
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Hi Babalou
I read somewhere once that sundowning that usually occurs with lowering lights and shadows can occur at different times of the day for different patients. So the fact that it isn't very dark when your moms agitation occurs may not mean it isn't a form of sundowners.
I also read once that if humans are not affected by the moon then they would be the only organism on the planet that isn't.
I read on Web MD the following.
"If you feel tired or frustrated at the end of a day of caregiving, your loved one may notice, even without you saying anything. This can upset them, too. It’s normal for you, as a caregiver, to have feelings like that. Try to be aware of how you manage those emotions if you think that might make a difference." Your SIL may be stressed when she comes in the afternoon is what I read into this. We don't all react/feel the same when we interact with others. Unless your SIL is feeding or attending your mom in some crucial role, perhaps she might switch her time of visit to see if she gets a different response. I know you've mentioned before that SIL has a different approach than you on some of the medical tests and treatments.
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According to some of the articles I'm reading, afternoon nsps are NOT good for sundowning, they interupt the sleep cycle.

I think this is one of those areas that requires lots of research, clinical studies and the like.

For my mom, i think she may need reassurance alone that we'll take care of whatever the "problem" is.
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GardenArtist, good point about the napping in the afternoon... I know there have been times when I have dozed off watching TV only to wake and wonder what day it was :P

Wouldn't be surprise if elders who show signs of sundowning would do the same thing, but not be able to snap out of it as quickly. The other night around 8pm my Dad called and said his name was put in place to be Vice President.... ok???... so I played along with it as rattling as it was to me.

As for the full moon.... any time my male cat becomes an out of control silly handful I will glance at the calendar and sure enough, full moon time.... never out grew it, he's 15 going on 2 during these lunar events.

Rainmom, the hospitals also have more births during the full moon.
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I was curious about afternoon naps as well. I have asked the staff to put her down for a nap if she goes to her bed and wants to lie down or appears sleepy. I hope that they do. I realize that there is a chance that if the resident sleeps too much during the day that they may not sleep as soundly during the night. So,.....I guess it's something you have to try and see how it works.
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Sunnygirl, I think you hit on a perfectly logical explanation - sensory overload. I'm wondering if people who sundown would still do so if an afternoon nap were taken.
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I don't have studies to support it, but when I worked in law enforcement years ago, there did seem to be a huge increase in calls, violence, accidents, injuries, mental illness calls, etc on a full moon. It was common knowledge in law enforcement.

Regarding Sun downing. I've read all kinds of theories, but the one that makes a lot of sense to me is that the confusion, agitation and behavior changes that occur late in the day MAY be from sensory overload. The dementia patient has limits on what they can process and it may be that they reach that limit at 4:00 p.m. as opposed to 6:00 p.m. It may vary by person as to how much they can handle before they start having issues.

Also, how is the light inside the facility? Depending on how the sun shines on the building, it could cause a difference in the light in the room and that change doesn't set well with her.

Does something about the lights change around that time of the day OR is there a shift change near that time. Maybe, something happens around that time like a staff person who isn't friendly or activity she doesn't like.
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I don't know if it's urban legion or truth - but I've heard many times that emergency rooms are always way busier during full moons.
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As usual, I'm getting an education here. Interestingly, there WAS a full moom this week. GA, thanks for link. I'm going to start charting these isues that mom has.

And when sil emails me with this stuff, im going to say "I'll take care of it".
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Busy, my sister told me the same thing. She was a psych nurse; they often had new patients brought in by the police - people who were affected by the moon and engaged in very strange behavior.

I've wondered often how the shift in water in our bodies could produce such bizarre behavior. Or is it the moon that's causing the changes? Is the fluid in our brains shifted during a full moon, starving our brains in some way?

Thanks for sharing your experiences; it's helpful to know that others have observed similar changes.
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Garden Artist..when I worked in LTC I had a resident asked me to throw her in the ocean..i told her I couldn't do that I would get in trouble for that. I worked 2-10 PM and it was a full moon. The residents always seemed a bit more off the wall when there was a full moon. So I think the moon does affect the mind in some way.
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Just another thought - it's not called moondowning, but there may be some factor or role the moon plays. It does have the power to affect tides, and our bodies are something like 2/3 water.
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I think the issue is the categorization as "sundowning" - it's a misnomer. Something begins to happen as the earth revolves around the sun and the latter's position in the sky changes. I'm not an astronomer or physics student, so I don't have any explanations how the sun's or earth's position relative to the sun affect the human brain, especially the brain with dementia.

I do think it's a fascinating but frustrating subject though and hopefully there will be many more studies that can reveal some insight into this issue. I would think that scientists would be considering (if not already performing) experiments with animals during which sunlight is decreased at times other than in the afternoon or evening to see if that can produce the changes which occur during those times.

The Arctic regions and peoples living there could also provide what probably would be interesting data.

I'm P'Ming you with one interesting link I found.
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Babalou, I noticed a couple of months ago that whenever I talk to Dad on the phone and it is after 4pm he seems to be living in another era, or he is stuck on a subject and won't let go. Prior to 4pm he is still fairly sharp for someone who is 94 years old. It has been so tough for me to wrap my brain around what is happening, it still rattles me big time.

I know it seems strange that sundowning can be present when it is still daylight outside.... at 4pm the sun is blazing into my Dad's apartment. I think sundowning is an internal clock, more set to standard time then day-light savings. Our elders grew up in standard time and much of their younger adult life.
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