My mother is moving from first stage dementia into middle stage and has been showing signs of Sundown syndrome. She gets very agitated, antsy/nervous, like she has had way too much sugar or caffeine (which she hasn't). Also, no new medications.
I have been reading on ways to try and alleviate it or make it easier, but was wondering if anyone else has experienced this and may have some tips.
Regardless I used fall mats near the bed and floor alarms--the moment she put her feet on the floor it would go off.
During her 10 years of Alzheimer's disease (now she is very end stage and no longer able to walk), I have *never* given her a single bit of narcotic or psychiatric drug. I controlled her behavior strictly with exercise, and keeping her up during the day. That took a lot of effort. DON'T LET THEM SLEEP DURING THE DAY. Occasional naps are okay--but it is when they get their days and nights mixed up you will run into Sundowning and let me assure you that is very dangerous due to impulsiveness and falls. I gave mom coffee during the morning and afternoons. Coffee, I would say, helped her a lot.
Sometimes this works sometimes it doesnt.
Every day is an adventure with some calm days (very few) and most of them very challenging.
on our way back to the CH where she resides. She starts asking about her brothers and her Dad (all deceased) over and over. When I tell her they've passed, she's shocked, why no one told her, etc., but I gently remind her she was there at the funerals but she just forgot.
My mom's sundowners could mean she's tired, since we usually go out 1-2 times a week for about 4-5 hours doing lunch and store shopping (her favorite activity), and really enjoys herself.
Anyway, I've started carrying a water bottle & encourage her to drink thru out the day, especially when the sundowners comes on, and then I change the subject to something more pleasant.
My mom is on meds, and about 3pm when it starts to wear off, behavior agitation sets in & the CG has to give the next dose.
Occasionally 5mg. of Melatonin in addition to her medication helps her settle down at bedtime if she's still restless.
Best wishes.
The term "sundowning" refers to a state of confusion occurring in the late afternoon and spanning into the night. Sundowning can cause a variety of behaviors, such as confusion, anxiety, aggression or ignoring directions. Sundowning can also lead to pacing or wandering.
Sundowning isn't a disease, but a group of symptoms that occur at a specific time of the day that may affect people with dementia, such as Alzheimer's disease. The exact cause of this behavior is unknown.
Factors that may aggravate late-day confusion include:
Fatigue
Low lighting
Increased shadows
Disruption of the body's "internal clock"
Difficulty separating reality from dreams
Presence of an infection such as urinary tract infection
Tips for reducing sundowning:
Try to maintain a predictable routine for bedtime, waking, meals and activities.
Plan for activities and exposure to light during the day to encourage nighttime sleepiness.
Limit daytime napping.
Limit caffeine and sugar to morning hours.
Keep a night light on to reduce agitation that occurs when surroundings are dark or unfamiliar.
In the evening, try to reduce background noise and stimulating activities, including TV viewing, which can sometimes be upsetting.
In a strange or unfamiliar setting, bring familiar items — such as photographs — to create a more relaxed, familiar setting.
Play familiar gentle music in the evening or relaxing sounds of nature, such as the sound of waves.
Talk with your loved one's doctor if you suspect that an underlying condition, such as a urinary tract infection or sleep apnea, might be worsening sundowning behavior, especially if sundowning develops quickly.
Some research suggests that a low dose of melatonin — a naturally occurring hormone that induces sleepiness — alone or in combination with exposure to bright light during the day may help ease sundowning.
When sundowning occurs in a care facility, it may be related to the flurry of activity during staff shift changes or the lack of structured activities in the late afternoon and evening. Staff arriving and leaving may cue some people with Alzheimer's to want to go home or to check on their children — or other behaviors that were appropriate in the late afternoon in their past. It may help to occupy their time with another activity during that period.
With
Jonathan Graff-Radford, M.D.
Best of luck!!
The best thing I could do was to eliminate every source of stress after noon. Appointments were morning only...etc.
this way he could have whatever he liked for early dinner and fall asleep in front of the TV or with his coloring books.
any excitement (even a phone call) could set it off.