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My mother, who lives with my father and older sister, has had 16 strokes in the past 2 years. 14 of the strokes were TIA, with the last 2 being Ischemic. She is only 64 years old. Her mobility is extremely limited. We are now facing a complete lack of appetite along with Sundowners. The medical professionals she has, have not been helpful in managing symptoms. I have scheduled her with a Neuropsychiatrist to evaluate her emotional state and perhaps start her on an anti-depressant/anti-anxiety medication. She is up all night stating she is not safe and demanding that they hold her. I have ordered her a weighted blanket to help ease some of her anxiety. Any suggestions would be greatly appreciated.

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I dont believe that is typical sundowners. Nevertheless, In my now 11 year journey caregiving for my other half who is now starting to stay awake all night arguing with people I cant see, I have found that all but 2 prescribed medications after Namenda and Aricept stopped working, had side effects that exacerbated the behaviors. I have resorted to giving him what I take to help me sleep which I found cheapest on Amazon, doxylamine succinate 25mg, their brand. Face it, we are saying "the long goodbye". We need and want to keep them safe and happy, but we can't do that when we are exhausted. Listen to your own wisdom. Look things up online. It has been my experience that adding drugs to manage side affects is not the answer. Getting rid of the drug and finding something natural is the better alternative. In that vein, have you tried camille tea? St. John's wort? Playing meditation music 528 hz or chakra clearing or guided sleep meditation from YouTube? until the sominex or benadryl take affect. Hot milk, hot cocoa. Hug her with a BIG stuffed animal between you so when she falls asleep you can extricate yourself without waking her. Check out Shaman Oaks healing meditations live. The music works to put me to sleep. Just keep in mind that doctors are still baffled by this disease and we know our loved ones. Empower yourself to care for her and be sure to care for you because without you she is s.o.l.
Namaste
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pronker Oct 2020
Excellent words to heed and I particularly like the large stuffed animal that she can be left with so her arms are not empty upon awakening.
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Try to keep her awake all day.
Meals - follow the old rule of
breakfast like a king
lunch like a prince
dinner like a pauper

AVOID carbs, sugar and caffeine at dinner!
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Hello,rebecca40

My father also has sundowners... I have noticed that sometimes, playing along helps a lot. To them, whatever is happening in their mind is completely real and they can become even more frustrated and nervous if they feel like no one else understands, which can cause more anxiety for them. Unfortunately, it is a cycle... and sometimes it can be really hard, because our reaction can determine, if the episode continues to build.
My dad is on a medication called Sertraline (Zoloft.)
This medication has helped him tremendously …
We also have started, getting him out of his recliner and in the bed earlier in the evening, which tends to help. A nap during the day helps as well. The doctor told us, my dad needed to be on a set schedule for rest. Changing up the schedule in any way, can cause stress on them, resulting in episodes of anxiety, which causes you stress.
I am definitely not an expert, this is just what I do to help my Daddy. It seems to keep him comfortable and the episodes with sundowners isn't too bad now that we have a routine and medication.

If you need anyone to talk to, I am here.
Praying for you! :)
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NobodyGetsIt Oct 2020
Dear "Ballen1012,"

You take such good care of your father!

I really liked your idea of playing along so they feel like someone understands, lessening the anxiety. I'm glad the Sertraline/Zoloft has helped your dad tremendously. I know both my husband and I have tried it but, we both stopped taking it for different reasons.

And actually, it's recommended that all of us have set sleeping habits regardless of age or whether or not we are even having health issues.
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My husband, age 68, has moderate stage Alzheimers, and is now placed in a memory care facility. He had been suffering for at least 3 years, but it all started about 6 years ago with memory loss. He was getting highly agitated here at home, with confusion and boredom, and not being able to comprehend tv shows, reading, games, etc. Our primary doctor suggested activity outside the home, but due to Covid, our socializing is restricted, thus making him more irritable, especially with me. Anyway, since being at the memory facility for these past two months, they have put him on an antidepressant, Zoloft, and he's doing much better with his moods, and especially since he's around people and has some activities. Covid is limiting visitation, except for outside window visits, which is difficult because of the cold weather now. Anyway, I would suggest Zoloft, which I think with help with the sundown syndrome. Just wish that I could take something for myself, but my health limits some meds due to side effects. Stress is terrible, as well as guilt for not being able to control the situation nor take care of him myself. Best of luck to you. Pray, too
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InFamilyService Oct 2020
For yourself you could try chamomile tea and low dose melatonin. Try some CBD gummies, it def will take the edge off. Ask your doctor first of course. Good luck and I wish you peace.
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Take her to Both a geriatric dr and a geriatric psychiatrist. Seroquel eased my grammas symptoms. Of course everyone is different but my gramma was 98 yrs old on 150mg. 25 is the lowest of which she started on and went up to 150mg as her body became use to the 25 mg after 3 years and that’s normal. So meds should be adjusted as needed. She was also on 10mg of melatonin. Seroquel also helped w/her appetite and delusional thoughts. Sounds like you need some night help until you get her symptoms more or less under control. If u can keep her up later like 10p is better and if she must take a nap do so early around 10a. She may never sleep 8hrs straight so don’t drive yourself crazy chasing 8hrs. 6 or 5hrs is the most u may get at one time and that’s plenty for her with an occasional nap for an 1hr. Furthermore You Will need permanent night help as her symptoms progress so you can get Your rest, please know there is no cure for sundowners. Her mind will never be right again and eventually you’ll have to just let her sleep when her mind let’s her sleep whatever time that is, that’s why it’s so important to get night help as her disease progresses.
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my2cents Oct 2020
I was going to suggest geriatric dr, too. I have found that the general med dr my mom used all the time is not in tune with elder care so much. Quite often, his response is to remind me how old she is. Really?? I know exactly how hold she is. And if my goal is to keep her moving so I can take care of her (with the possibility of her living to be 100+ like her mom), I need more than a reminder of her age. Geriatric doctors, especially at a teaching hospital, can provide more.
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Increase lighting.
LED's are great they give a nice bright light.
Close blinds and curtains as it gets darker so you do not not get the "mirror effect" when looking at a window.
Keep the same schedule as best you can getting her up at the same time, bed at the same time.
There are herbal teas that might help calm her those might help until she sees a doctor. And if you try one inform the doctor as some herbals can interact with medications just like anything else.
Antianxiety medications might help. It might also take time to find the right med and the right dose so be patient.
*side note on the weighted blanket. I tried one myself and it was terrible, it was so heavy I could not move in bed.
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Rebecca, we had limited experience with sundowning, but did make some changes.   I think they helped but they didn't resolve the situation, because I don't think that's possible.

We made sure that nothing was started around the time of the setting sun; we started earlier and carried whatever we were doing through the dinner hour and into the evening, not necessarily creating an overwhelming schedule but making sure that something was always available to do so there wasn't time to become upset and distressed over an issue that didn't exist. 

If your mother is awake all night, does she sleep during the day?   If so, I would gradually start changing that schedule so that she's awake during the day and can sleep at night.

I think also with so many strokes that just plain anxiety for another stroke, and what might happen then, is a major factor.    Strokes can be devastating, and if someone already has dementia, the combination can create a very unsettling scenario and panic mode. 

Two other thoughts:    the lack of appetite might be caused by meds.    Check out the side effects of the ones she's taking and see if appetite loss is a side effect.  Or it could be a combination of meds, with one affecting another.    But a complete loss of appetite sounds like something serious, such as med side effect or something more seriously amiss in her basic health.

Ambien can cause delusions.   If she's taking that, it might account for the evening anxiety.
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NobodyGetsIt Oct 2020
"GardenArtist,"

Good insight about having had so many strokes that she may have anxiety about having another one and like you said, if combined with dementia it most certainly could create a feeling of panic and be very unsettling for her.
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We have been fortunate with regard to sundowning. It is typically a symptom for him, generally of a UTI, a couple of times a fungal infection. When we treated the infection the sundowning went away completely.
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Good morning.
Ive had this situation with my client. She would put furniture in front of doors, see images in furniture and shadows and more. Along with owning a personal senior care service I do what is called Raindrop Therapy, its used with particular oils. After taking chemistry on the compounds of the oils I gained understanding what pure unadulterated is. So the following is done with YL oils.
Lavender, Peace and Calming, CBD oil -
Ive used to diffuse, put drop on pillow, put a drop or two on brain stem, massage feet with one of the oils mixed with coconut oil. Also if she was extea active I would empty a drawer, kinda making a mess on her bed...she would organize and then go to bed.
Now when I arrive there is no chair against the front and side door no nightstand against her bedroom door, she has stopped taking shadowds thinking its a person. Also bedroom is a relaxing atmisphere, and I watch what she watches before bedtime. I also have her eat dinner a hour or so before bed, I make sure she does not need to go to the bathroom.
I no longer have this issue and she has advanced dementia. When I arrive her bedroom door is open and she is very peaceful. Science has proven what happens when we smell different things and what it does to the brain. Bless you, I hope this helps.
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Starting back in April or so, Richard had started complaining he could not sleep at night, but he would sleep too much during the day. Looking back I see now that was the beginning of his final decline. Kaiser doctor gave him 15 mg Temazepam, that would knock him out too much, started affecting his balance. I told the doctor I wanted him off it, they imstead renewed it at half the dose, 7,5 mg. I woul don,ly give him one when he absolutely demanded it. As time went on he stopped wanting to eat, slowly stopped being able to get from the bed to the bathroom, had several falls. Try to keep your loved one active during the day, do not just let her sleep, wake her up, give her a shower or a bed bath every day, sit her up as much as possible, do activities, go through old photographs or albums, have her do chair or bed exercises of moving her legs and arms, range of motion things with her hands, anything you can to help her body use some energy. Open the curtains, bring the light inside, put her in a wheelchair and take her out in the sunshine, or carry an umbrella and go for a walk in the rain. Try and spend good time with her.....
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