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My mama lives in a memory care facility. My best guess is she is in stage 6 dementia. When I see my caller ID light up with the facility's number, always late afternoon or early evening, I cringe at the thought of who is on the other end. The nurse asks if I can speak to my mom and of course I answer, yes. I never know if she is ready to bless me out or just say, hey! Lately, it is much harder tho - she wants to come home. She is tired, doesn't feel good, her suite mate is stealing from her, etc. I'm sure she will never live in the little house she and my daddy shared (he is 92 and still well), but I never know how to answer her. Changing the subject is no good. I am wondering if the staff can give her something to take the edge off during this time of day. Anyone else with this problem?

seroquel... not sure if it's good for anyone or at all..... but that was what was prescribed to my LO..
good luck
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Reply to MAYDAY
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Hello. I have no information or suggestions about meds but do have a suggestion about the facility closing the curtains in your moms room.

this sounds really strange but i have have had an occasional problem for about the last 40 years or so with the outside color change at dusk even when im inside looking out. Ive just tried to ignore it but it’s been hard sometimes if ive had to be outside.

well i read not long ago about a nursing home someplace that closes the patients curtains and turns on lights a couple hours before dusk.

so simple !

does it work with everyone ? I dont know. It’s simple to try tho and doesnt cost money.
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Reply to Betsysue2002
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Definitely ask Dr. for Rx to reduce agitation, it's not safe for mom to be in state of anxiety very long, it could also affect their sleep.
The facility should know how to deal with this also. Check out Teepa Snow on YouTube, she has lots of videos/podcasts & strategies on when they say, "I want to go home"..very enlightening!
I know what you're going through! Sounds like my mom's situation. She's in stage 4/5 and Sundowners' hits at the same time too. My mom would be very combative since she's very still very strong. (Caregiver would get bruises!) She would accuse CG of "beating her up", when it was the other way around.
After many pleas with Geriatrician & many visits to the ER, (UTI checks, etc.) Dr. finally agreed to add additional meds: gabapenten & depakote. The nurse checks in with CG once a month for behavior updates too.
Mom still has Sundowners, despite all her meds, but the CG still calls me to "distract & talk to her". Sometimes it helps for only a little while.
Please do all you can to get help for mom's anxiety, Alz or Dementia is progressive, and agitation isn't safe for them or anyone else.
Sending hugs ((())) !
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Reply to naia2077
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Imho, possibly her physician could rx something for anxiety.
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Reply to Llamalover47
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My husband is 58 with AZ and have seen horrible sundowners!! Grabbing me, banging windows, threats Of hurting me etc.. He is 6 ft 200 lbs and I’m 5 ft 115lbs, very scary!! Psychiatrist prescribed gabapentin and depakote at 3pm and zyprexa at 5pm. Has helped but with the time changing again next week I have seen a change in him. It is very scary but I’m learning how to handle him. I think when I talk stern to him, no yelling, it has helped. Not sure what stage he is in but is definitely advanced. This all started a year ago when COVID kicked in which I think has had much affect in his advancement. Socializing is very important for anyone especially someone who has limited memory. Very sad for everyone involved not just the one with the illness. God bless you, not an easy job we have but we do it out of love.
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Reply to mjsaylor
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My mother has dementia and has lived with me for about three and a half years. Every afternoon or evening she would get sundowners and want to walk home. Her home was 30 miles away and I could not convince her otherwise. We took a lot of rides which helped some. Once she was so agitated she was beating on my glass door. I was very worried she might break the glass and injure herself. I didnt know what to do so I called 911 and they took her to the ER. Still same issues when we got back home though. Sometimes agitation would last on into the evening and nighttime. I called her PCP and told him I needed help or I would not be able to care for her in my home. He prescribed risperidone which really did help to calm her down and make her in a better mood. Didnt entirely do away with the sundowners but I saw a good bit of difference. My mother is now bedridden and on hospice for the last year and a half and still exhibits some sundowners most everyday in the form of fidgeting and rubbing her eye constantly and worrying that I'm going to leave. I still give her a small dose of risperidone daily which does help and for sleep at night lorazepam. Good luck to you. This is some hard stuff to go through.
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Reply to Countrygal55
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Many good suggestions below. My dad was well into stage 6 when he started having episodes of sundowning. It wasn’t an everyday thing, but when it happened he became really wonky. Dad’s sleep schedule got off, so we tried to keep him up more during the day in hopes he’d sleep more at night. Dad was in a handicapped accessible apt. with 24/7 help. He was kind 99% of the time but downright cantankerous and verbally abusive while sundowning. He caused several nite caregivers to quit, which worried me b/c it’s hardest to find them (even through the agency!) We’d tried anti anxiety pills and then CBD, but opted for a CBD/THC capsule taken after dinner. This worked great. A couple weeks before Dad passed, he was struggling to swallow the capsules, so we went to edible chocolate with the same mix. He loved it more b/c it tasted great and was easy to take, He still got anxious once in awhile & I asked his staff to call me. With a short conversation Dad would settle and be just fine-just needed a little reassurance! (He’d get wonky after sleeping a few hours and then wake up confused.)Medical marijuana is legal here, so easy to do. Hospice approves it, but nursing homes and facilities that get federal funding often can’t allow anything with THC, even though it may be legal in a given state, it’s not yet legal nationally. Dad had stage 4 cancer too, so the edibles increased his appetite, calmed him, helped with pain, and allowed him to be alert and with it! You can’t overdose. For us, it was the answer. I hope you too find a workable solution!
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Reply to DadsGurl
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Short answer - yes!

Since your sweet momma is feeling out of sorts, her doctor can prescribe anti-anxiety medication that can help her to relax. Some folks swear by marijuana products, but I tend to shy away from natural medications since there are no controls in their manufacture. There is no way of knowing the strength of those products and if there are contaminants that would interfere with her other medications. Please talk to her doctor about her behavior.
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Reply to Taarna
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Yes, been there .
1000 MG. DROPPER OF CBD OIL.
Under the tongue or
In a drink.
Around 30 min before sundowners usually starts.
Make sure it is flavored . Hemp taste is aweful.
No side effects, can not overdose.
WORK WONDERS
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Reply to beeje7623
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Geaton777 Mar 8, 2021
There are no robust scientific clinical studies to support anything you have posted. Also, anything given to her mother (even a supplement) must be reported to her doctor or medical team since it CAN interact with other medications. It's still a chemical.
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First of all, why is the staff at the nursing home calling you to take care of the problem when they are supposed to have 24/7 experienced employees to handle similar situations. The staff should direct the problems first to the nurse facility, who should always be there 24/7, in shifts, of course. We pay high dollar for these nursing homes, and I'm paying for all inclusive care for my husband who has Alzheimers. Whenever there was a problem with his behavior, the nurse called me to let me know what was going on. I'm the POA for my husband, and our family physician also communicates with the facility nurses about issues and medications.
There are times when my husband goes through the sundowners syndrome and wants to come home, but I have been telling him about Covid and it is not allowed at this time. By morning he forgets the conversation and is just happy to talk to me. I did get upset at one time when the facility gave me no option but to move him to another facility because of his anger episode. If their staff would have watched him more closely during that time, my opinion they could have medicated him and gotten it under control.
Point is, make sure your facility has qualified and experienced staff working with your loved one. Too many people in the medical field and home care fields are there just for a paycheck, and not caring at all.
Good luck to you. Please advise your facility to have them contact their RN first before calling you to make the decisions.
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Reply to lovepat69
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Like others, a medication change helped with my mother. Seroquel (which is off-label for this purpose) really seemed to help.
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Reply to YellowSubmarine
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Eaglet333 Mar 8, 2021
We tried all combinations of medication. Mom is 93 and has Afib so she can’t take CBD. Seroquel is the perfect medicine for her. She has a Dementia Pharmacist who monitors her prescription. Mom takes small dose in morning as it will make her sleepy. Small dose at noon and a full dose at night to help her sleep.
it’s really helped her.
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I wonder if it would help to tell the staff to just tell your mom that you will be there in the morning to get her. She will forget she was told this but maybe it would calm her. Or if she calls you...you could tell her you can't come right now but you will get her in the morning. I know it used to work for my mom. Everyday she wanted me to drive her the 650 miles back to her hometown so she could stay with her mother whom had been dead for 26 years. I would tell her I didn't feel well but in the morning we would leave when I felt better. She always said ok and she was calmer. She is in MC now and she was getting nasty with the staff. They called me and asked me if it would be ok to have Hospice prescribe seroquel. I said yes. This seems to have helped her.
Nothing about this disease is easy but meds can make a difference.
Personally I don't think MC needs to be calling you..but maybe your mom is insisting on talking to you. And that's why they are calling you? They are supposed to be trained to handle sundowners. I hope you are able to get some answers and relief.
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Reply to evander09
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cweissp Mar 8, 2021
I agree. Dad was in moderate Alzheimer's and didn't sundown much - occasionally - he only asked about returning home a couple of times - which was A/L where mom still is. He was in SNF and not memory care. I was really surprised he didn't get on the elevator and wheel himself back to the apt he'd shared with mom.

He only called me once late in the evening and I presume he insisted he had to talk to me or they would have gotten him redirected. He was agitated because he needed money - now. My answer was that it was late and the bank was closed but I would bring the money first thing the next morning hoping/knowing that he wouldn't remember and of course he didn't call the next morning. I never considered it lying, just visiting his delusion and provide comfort to his agitation.
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Be sure to check for UTI or blood imbalances. They can wreak havoc on elders even without dementia, but with it, oh boy!

My mother had not really developed sun-downer's. She did have some OCD behavior just before going to bed (living alone, we had a few cameras and could observe this, which became a nightly marathon!) There was no mention of this after she moved into MC. I will say they ordered Lorazepam for the initial move in, so it could be that helped or it could be that the things she was checking were no longer there to check (door, sidelights, dishwasher and something in the LR.) I know they never refilled because I managed her meds and payments.

She was fine up until her first UTI. They called me and wanted me to come deal with her - seriously? I never lived with her as an adult and certainly not after dementia kicked in. Plus she's never been "out of control" before, so what exactly am I supposed to do?

I agree with other comments, they shouldn't be calling you when she's in this state. If they can't redirect her, change her focus onto something else, then they should consult with you and her doctor(s) about medication to tone this down. Mom had to take this med again while being treated for the UTI. It was the lowest dose, worked first time, every time and didn't need to be weaned off. I was there several nights after dinner, and after she had the medication - she was not doped up or "out of it." It was just enough to take the "edge" off.

So, if they can't control her, ask her doctor about getting Rx for something to tone it down. One doc didn't want to give a refill, as these meds can create a fall risk, HOWEVER in all the time before and after being on this medication, the only tumbles she had was when she was NOT on the medication! She was still mobile without any walker or cane, and did not fall because of this med. My argument with the doc was finally won when I said she is more likely to hurt herself when she's in this rage every afternoon/evening that any tumble she might have!!! Plus it isn't fair to her or the staff to have to put up with this every day when there is something that might help!
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Reply to disgustedtoo
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How long has she lived there? If recent, I would ask the staff to handle the situation. Mom has to learn to depend on them. Calling you is not allowing her to get used to and except her now home.
Ask if Mom can be given something to calm her during this time of the day. As a memory care unit the staff should be trained on caring for Dementia residents. Tell them since the calls are the same old, same old that you don't think they help Mom. Nor is there anything you can do. So they just need to redirect her.
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Reply to JoAnn29
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Can you discuss with the admin if they offer an activity at that time of day which she could participate in? If she is distracted, that may work the best. It's right before their dinner so not sure if it's possible. This is a good question for your mom's doctor or a geriatric specialist who is more familiar with med management in the elderly and how they react. Is your mom on any other medications?
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