What are some of the actual symptoms of sundowning?
My Dad has what I expect is terrible "sundowning". It begins usually around 5 PM (just after his supper) and can extend to beyond bedtime. He wanders through the house and becomes very confused. He begins to obsess about certain things -- last night he wanted to know where his ID card was and was it safe; he was on his hands and knees on the floor, searching for a "communications wire" along the floorboards; he saw an arrow on the floor and wanted to know what it was for; he lost something and couldn't find it because "everything is the same color". The evening began with my Mom getting him on the bed to rest a little. Next thing she knew he had all his clothes off and was messing around by the front door. She got him dressed again and he began wandering and talking about things she couldn't understand. I've read a lot of articles about sundowning, but they all seem to say the same thing -- patient gets restless and confused, and this is what needs to be done to minimize it. But the articles never seem to have real-life examples of what's going on and what the "sundowner" is actually doing! The next morning Dad seldom remembers what he did the night before. Any others have a "sundowner" and examples of their behavior?
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The members of the Alzheimer's and Dementia Support Group have provided some really helpful advice on sundowning over the years. We recently combed through the forum and collected a number of these different tips and ideas from members and put them into an article to make them easier to find. I hope you and other members find it helpful!
How to Cope with Sundowning: Tips from Family Caregivers
https://www.agingcare.com/articles/How-to-Cope-with-Sundowning-Tips-from-Family-Caregivers-200000.htm
Best of luck to you all!
Seeing my Dad like this is so hard for me to understand has he was always a brilliant person [a mix of Leonard and Sheldon, for those who are familiar with the TV show Big Bang Theory]. And Dad even knows that something is wrong with his brain in the evening hours. Methink I will set up an appointment with Dad's primary doctor and see what can we do next, meds or not. I want Dad to be comfortable in his later years.
My wife is young for a dementia sufferer of 10 years, she is 62 now and she has many other medical problems. Her sundowning lasts all day
Our family have been preparing for the end for some time now and will not be a shock, but I would like some views on my original question
Thanks
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That supplements in a empiric way ,are helping to control sundowning , delusions, hallucinations , agressiviness, etc, making very calm , easier to cope, etc.
The food supplements (nutraceutical supplements) that we are giving to her are (we open the capsules with each supplement and put in her juice or milk):
CARNOSINE : it is a peroxinitrite scavenger, antiglycating supplement, mild heavy metal chelator, and it natural source is in chicken breast.There are dozens of scientific articles about carnosine use in dementias.
We gives very small doses of 50 mg (fifty miligrams) at breakfast at lunch and at dinner. (Only under permission of the physician of the patient).
ACETYL L CARNITINE - There are dozens of scientific articles about it use in dementias , as a mitochondrial function enhancer, a peroxinitrite scavenger, an alternative fuel to the brain, with synergistic effects with extra virgin coconut oil toincrease neuron energy, enhancing speech, attention, cognition, mood, strengh, etc, in small doses of 50 (fifty) mmiligrams at meals , together with carnosine (acetyl L carnitine in small doses have synergistic effects with small doses of carnosine and with very small doses of extra virgin coconut oil).
We gives too small doses of extra virgin coconut oil (a TEA spoon 1 to 3 times a day.)
We associate to very small doses of the joint supplement called glucosamin sulphate (for example two hundred miligrams at meals three times a day).
With that food supplements above , we are seeing the control of dementia symptons (including sundowning), with the empirical use of the supplements above, but only under the PERMISSION of the PHYSICIAN of the patient.
That supplements in a empiric way ,are helping to control sundowning , delusions, hallucinations , agressiviness, etc, making very calm , easier to cope, etc.
The food supplements (nutraceutical supplements) that we are giving to her are (we open the capsules with each supplement and put in her juice or milk):
CARNOSINE : it is a peroxinitrite scavenger, antiglycating supplement, mild heavy metal chelator, and it natural source is in chicken breast.There are dozens of scientific articles about carnosine use in dementias.
We gives very small doses of 50 mg (fifty miligrams) at breakfast at lunch and at dinner. (Only under permission of the physician of the patient).
ACETYL L CARNITINE - There are dozens of scientific articles about it use in dementias , as a mitochondrial function enhancer, a peroxinitrite scavenger, an alternative fuel to the brain, with synergistic effects with extra virgin coconut oil toincrease neuron energy, enhancing speech, attention, cognition, mood, strengh, etc, in small doses of 50 (fifty) mmiligrams at meals , together with carnosine (acetyl L carnitine in small doses have synergistic effects with small doses of carnosine and with very small doses of extra virgin coconut oil).
We gives too small doses of extra virgin coconut oil (a TEA spoon 1 to 3 times a day.)
We associate to very small doses of the joint supplement called glucosamin sulphate (for example two hundred miligrams at meals three times a day).
With that food supplements above , we are seeing the control of dementia symptons (including sundowning), with the empirical use of the supplements above, but only under the PERMISSION of the PHYSICIAN of the patient.
1) ask your TV program provider how to block the shopping channels on your system. When your husband asks you about it, play dumb. Say, there must be something temporarily wrong with the cable and that you'll check it out. Of course, there's nothing to check out but you can pretend and eventually he'll just forget about it. He must be pretty advanced in his forgetfulness to forget the package is he orders.
2) if that fails, give him a credit card that doesn't work. When he tries to order, they will not accept it as payment. He doesn't sound like you would be able to figure out those things himself so he would like to come to you to "fix" the problem. You say you will look right into it, but of course you don't, and you delay and distract with other things until he forgets about it that time.
Returning are refusing packages is not going to reverse the shipping charges which will ultimately cost you a lot of money in the long run. Better to solve this problem by beginning to use "theraputic lying" (you can google this) as a tool in your arsenal to make your daily living easier.
moonbeam -- My Dad also has problems re: his house as your Mom does. He sometimes thinks he's in a motel and wants to know when he'll be going home; he continually asks about their former house, sold about 16 years ago, and is concerned as to whether the insurance and taxes are being paid, etc. This type of thing seems to be a recurring one in Alzheimer's patients.
gladimhere -- I totally agree with your comments and we will be speaking with his doctor regarding meds next week. Dad doesn't have an appointment until the end of November, but I called and made an appointment for my Mom and I to talk to the doctor. Its really hard to discuss meds and many of the other things that go with the disease when Dad is sitting there listening and still understanding a lot of it. Even mentioning a med can get him going. It's amazing what he can comprehend without seeming to have the ability to do so anymore! At his last visit with the doctor (neuro) in July we spoke about the sundowning and night time activities. That's when we were prescribed the Zyprexa. His doctor doesn't really want to over-prescribe meds; he doesn't want Dad to be so drugged up that he doesn't know what's going on and sleeps all the time. Mom and I don't want that either. But as you said, the sundowning and constant agitation is very uncomfortable and scary for the patient as well as his caregivers. And the alternative is a care facility. We don't want that, at least until it becomes absolutely necessary. Mom wants Dad to be at home until he passes if possible. So we'll be discussing meds, changes in meds, etc. with the doctor to see if we can make some changes that might work. The doctor has never mentioned giving him the Seroquel at the time your Mom takes it in the late afternoon, and that's one of the things I already have written down to talk to him about. I would think that if that time of day is the worse, heading into the evening, that he could start taking it at that time and perhaps we could try increasing it again. I also want to ask whether we might crush or break up the Zyprexa and give him a minute amount. The entire pill totally knocked him out for the entire night. Perhaps just a small dose in the late afternoon might be possible.
My Mom is 83 and, as I said, wants to keep Dad at home. The physical part of caring for him doesn't bother her. She gets him to the toilet even when he doesn't know what the toilet is, she showers and shaves him, etc. It's the constant sundowning that is wearing on her physical and emotional health. And certainly it would be better for Dad to be at home, even "drugged up" a little more than he is, than to be in a nursing home environment...especially when he still knows what's going on...
I also wonder -- does the sundowning gradually go away? Or does it remain in place until the final stages?
Again, thanks for all your replies. Hope to here more!
My mom takes 75 mg of Seroquel daily about 4:30, she started with 12.5 mg almost two years ago. The dosage gradually increases, and makes sundowning much easier on her and me. She was constantly checking doors and windows to see if they were locked, seeing people that weren't there, would become angry if something wasn't as she thought it would be. Does it still happen? Yes, but not nearly with the frequency that it had before the drug.
Good luck and do not feel guilty about medicating them, remember they don't like feeling that way, the paranoia and everything else either and it is a huge help to you.
After 10 years as her caregiver and resisting what I think of as the *strong* drugs, I took her doctor's advice and accepted prescriptions for Seroquel and Aricept.
At first I was alarmed at the idea of putting her on a drug used to treat schizophrenia (the Seroquel), although I realize now that I've seen some of those symptoms in her all my life. The doctor explained this particular medicine is effective for agitation and aggression in the elderly, based on documentation in the field and his own extensive experience.
The purpose of Aricept is to make the patient a bit sharper mentally and the doctor said it could make Mom more cooperative.
His advice proved valuable in Mom’s case. She is calmer, sleeps more (at first, she slept a lot) and I'm seeing her sense of humor more often. She still has the same difficult personality (narcissistic) but now is easier to redirect. The meds have been a big help to both of us, thank God, and just in time for me because I was close to losing it.
The doctor said that as the patient gets used to it, the dosage on Seroquel probably will need to be increased. I can see this is the case and will ask him about giving two of the tiny pills (25 mg) at night because one doesn’t last until morning.
These may not be the right meds for your father, but some trial-and-error could prove helpful to improve the quality of life for both of you. God bless.
Research is leaning in the direction of sundowning being related to circadian rhythm which may be helped with melatonin. While the average dose recommended is between one and three milligrams, many folks report that melatonin doesn't seem to help them.
The Life Extension research group may be coming up with an answer to this as their studies are indicating that higher doses of between 6 and 24 milligrams are required to achieve proper sleeping with some. These studies are on the general population, not dementia patients, and it is unknown at this time whether this applies across the board. Don't increase usage to this level without professional advice.
IMO, another reason that even lower doses of melatonin may not work for many folks is due to the form of melatonin purchased. Pills that are swallowed take quite a while to be processed systemicly, even the ones that are termed "fast dissolving". What should be sought are either liquid drops put directly into the mouth or tablets specifically designated as "sub-lingual". Each of these go into effect virtually immediately through capillary osmosis from the mouth into the bloodstream, completely by passing any digestive delays.