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My 88-year-old husband has started it and at bedtime. He needs to get his paper and money together, pack and get to the airport. Has no idea where he's going or why. After daylight this morning, I think he is,at least, temporarily satisfied that this is his HOME.

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At this time the only help for sundowning is medication, so contact his doctor and see what they would recommend.
But remember that as your husband's dementia worsens this too shall pass.
And don't forget that if your husband's care gets to be just too much for you, that it is ok to place him in the appropriate facility.
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Reply to funkygrandma59
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When our LOs sundown, the home they wish to go to is one way back in their long-term memory, like their childhood home, not the home in his adulthood.

One strategy is to make sure you use daylight spectrum lights in the rooms where he'll be in the afternoons and evenings, and turn them one earlier than you normally would, to flood the room with light.

You can try to distract him with tasks, like sorting nuts and bolts and pairing them, pairing colorful socks (lots of them that you buy for this purpose), giving him a simple Lego or Duplo project to assemble, etc.

My very elderly Aunt used to sundown and every afternoon would get agitated and want to go home, even though she was in the home she'd been in since 1975. Before that she lived with me and my Mom in NJ for 20+ years, but that's not the address she recited: it was her childhood home in the Bronx. We even put up large signs opposite her chair with her current address telling her was home. It was no use, because that's not the home in her mind.

You may consider hiring a companion aid for a few hours every afternoon to take him out for errands or entertain him to give you a break.

Dementia is hard on everyone. Make sure you take care of yourself first and foremost. May you receive peace in your heart.
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Reply to Geaton777
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CaringWifeAZ Aug 29, 2024
Geaton, I love the easy tasks you suggested.
I will devise a task to keep my husband busy and involved. He is young and strong, but has limited movement and severe brain damage. He doesn't want to do anything but sit and watch TV all day and night. But he gets extremely agitated at times. I think he's just restless and bored. But is reluctant to do anything. I'll give him a job sorting nuts and bolts for me.
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My wife's case is somewhat different, she sleeps on and off during the day, usually one or two hours at a stretch, will go to bed early and then wake up in the middle of the night, 2, 3 or 4 in the morning. Saying he wants to go home, the kids are missing, what time to go to work. she;ll get dressed. A couple of times I had to get up and put her in the car and just drive around the block when she said she wanted to go home, She's 85, kids are gone, no work. I got some meds from the doctor supposed to help slow down the disease, but when I give them to her, she seems to come up with more delusional behavior. When she is awake during the daylight hours, she seems to at least be home and more rational except for occasional questions as to whether the kids are in the spare room. Can;t remember when last I've had full nights sleep, so taking to naps during the day also.
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Anxietynacy Aug 29, 2024
Andrew I'm so sorry, sounds like your doing an amazing job, but please find a way to get a break, and some sleep, you can't help your wife if you can't help yourself.
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If this just started, get him to his doctor to get checked out. He may have a UTI like Geaton says. That's possible.

It's also possible that he may need to start being medicated. A milligram of lorazepam or diazepam when it starts can work wonders to keep him calm and not wandering all over the house packing his bags and getting his documents together.

Take him to his doctor and tell him what's going on.
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Reply to BurntCaregiver
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In hospital, this is how I deal with it for my patients:
Increased lighting in the afternoon

At least 7 hours of sleep every night (9 hours ideally) - get sleep medications if needed

Create consistent routines and consistent environment - no changing the furniture around for holidays

If person is anxious or agitated - and your hubby seems to be - then ask doctor for medications. Make sure to give medications at first signs of anxiety so they kick in before the person can get very upset.
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Reply to Taarna
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My heart goes out to you. This is one of the many difficult changes that you will endure in this disease. Learn from others who have gone through it: have his doctor prescribe medication for his sundowning. He will need to be medicated BEFORE the sundowning hits to keep him and you, calm. Believe me, it makes a world of difference!
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Reply to LoveLea
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I don't have anything new to add. Just writing to reiterate and agree with the suggestions to increase lighting - disguise the fact that it is evening, including closing the drapes before it gets dark. And Medication to help ease his anxiety.
There are so many options. Work with his doctor to find what type of medication works for him.
For me, with my husband, who gets more agitated from most medications, it was Trazodone that worked like a miracle. He was finally relaxed and sleeping at night, and even stopped the frequent leg tremors.
Continue to be his wife and support his lucid moments, and try and "go along" with his unusual behaviors, anything you can do to help him feel "safe"!
Routine is key! Keep his days simple, and repeat the same activities every day, at the same time. This will help him to feel comfortable. He will start to recognize and associate each "prompt" with what behavior is expected from him.
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Sha1911 Aug 29, 2024
This!

Especially keeping routines.

My mom had showers on certain days. Home health came in and gave just as many but they were on different days than she previously had. You would've thought the entire earth stopped and started spinning in the other direction. She looped over and over and over about the showering and I am ashamed about raising my voice to her with "What does it matter!?" It apparently very much matters inside this increasingly smaller world they live in.

So yes, routine is so important. Even when you think it shouldn't matter, it really does to them.
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See: https://www.aarp.org/caregiving/health/info-2017/ways-to-manage-sundown-syndrome.html

In part, it says:

Sundowning: Avoiding Late-Day Confusion

Stick to a schedule.
Arrange a time to go outside or sit by a window to get sunlight each day.
Aim to be physically active each day, but don't plan too many activities.
Avoid alcoholic drinks and beverages with caffeine, such as coffee or cola, late in the day.

What makes sundowning worse?

Tiredness, hunger, pain or other unmet physical needs. not enough exposure to sunlight during the day. overstimulation during the day, such as from a noisy or busy environment. disturbance to the person's 'body clock' caused by damage to the brain.

1. Observe and minimize triggers-Watch for fatigue and other things that seem to bring on this behavior. Afternoon transitions and activities can be anxiety producing, i.e., tv loud/intense, caregiver shift change.
- Nutritional triggers. Cut back on caffeine and sugar; limit liquids later in the day (avoid excessive toilet nds).

2. Maintain routines and structured  activities-Maximize activity earlier in the day and minimize napping (especially if your loved one isn’t sleeping well at night). Try to avoid challenging, stressful tasks around dusk and at night. Keep to a regular daily routine — there’s security in the familiar.

3. Simplify surroundings-Environmental chaos can be difficult for a person with dementia to process. Too much sensory stimulation can cause anxiety and confusion, worsened by changing light. Remember: Their brain is being damaged by dementia and it can be very challenging for the brain to view and process visual information. It may feel completely overwhelming to see a lot of “stuff” in a room, and this can cause sundowning behaviors as the person struggles to understand and organize that visual stimulation. 

4. Modify the sleep environment-Try to minimize physical, visual and auditory clutter in your loved one’s bedroom.​​

At night, keep the room calm and comfortable for sleeping (experts often suggest a temperature between 60 and 67 degrees), and dark (try light-blocking curtains or an eye mask, plus dim night-lights for safe navigation). Evaluate your loved one for sleep disturbances such as sleep apnea.​​

5. Validate and distract-Simply trying to reason with someone in the midst of sundowning probably won’t work. Instead, try to validate your loved one’s feelings (even if they don’t make sense to you) to let them know you are listening. Try to draw them away from troubling thoughts and anxieties by diverting or redirecting attention to favorite activities, foods, animals and people.​​
For example, maybe they are soothed by watching a favorite TV show, taking a walk, snuggling with a pet or reminiscing. My dad loved The Lawrence Welk Show; we would give him TV earphones to amplify the volume and limit other sounds. It was almost always an effective distraction.​​

This is a very long article. For the full article, please google: https://www.aarp.org/caregiving/health/info-2017/ways-to-manage-sundown-syndrome.html

Gena / Touch Matters
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Reply to TouchMatters
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Ativan .5 mgs worked well to help my mother with her anxiety during Sundowning hours. Lights and everything else did nothing to stop her from insisting on riding the subway to see her parents and siblings. All deceased. She was regressed in time to a young girl living in NYC with her parents and 7 siblings. That's how dementia works.....they regress in time, mentally, as the disease progresses. Which is why they sometimes don't recognize a husband, for instance, who's now 85. She's looking for him at 25 and he's looking a whole lot different now!
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Reply to lealonnie1
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Xanax, percs and special k for everybody. U all did ur work, put it lives together. Its down time but now these things arise..... get to flying. "one for me. One for u....ok. 2.more for me, 3 for u". Why not? Dont eat handfuls and ull be fine. Ive seen dozens of people dose that way for years, and as long as they don't move to harder things, or take things too close together, its all good. Party all night and sleep all day. U dont have to be on a business hour schedule anymore. The idea of a "schedule" is something to stick with. We mostly do mornings because we worked, took kids to school and they were all morning hour things but as long as you have the set times things are done, they can be at anytime..its 1:30am for me now, i handle all my life online at night. Everything from scheduling dr appts, to banking can be online and most appts can be on zoom meetings. Just be blasted. Nothing is more comforting then a Xanax. U can handle it all and have no memory of it the next day. U and ur spouses can both be like "haaaa. I have no clue. Which one said that? I don't remember doing that" . Just whatever u need to enjoy ur twilight together before we return to the true self in the next life. This is a classroom here so im sure u all completed most assignments. Its just a wind down. Like the end of the school year when they keep lights off because they dont have ac, most kids werent even in class, fans everywhere and outside was beautiful... Thats the feeling u could have again everyday. I promise its not a sin.... they are there for a treatment and ur allowed to acknowledge that u could use some help. If they are sins (i dont think such a thing exists at all) then every single person is in trouble..moms used to give babies herion in bottles and swig themselves too. Coke was in soda. Its just bringing back an ancient cure..like opium which is all fentanyl so never get from streets but a DOC would give any one of u what u ask for because they would all tell u exactly what i am. They just arent allowed too but they do give u all a lot and i think they just hope u figure it out. Let the worry and control go. But ull be good enough to still take care of everything anyway. Maybe your spouses neuro conditions will slow down, if anything. But at least u all can have some peace and less anxiety
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