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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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So, often we hesitate to give them a drug that will ease symptoms because many of us do not want to induce a stupor or begin an addiction. But, what we need to remember is that the drugs make them more comfortable as well. They do not enjoy the many effects that sundowning can have on themselves either, these are very stressful times of day for them. The variety of drugs that are prescribed, and it may take some testing to determine what will work best, help them relax and calm down. Another side effect is that it makes caregiving easier for you and there is absolutely nothing wrong with that! And never, ever, give caffeine whether it is soft drinks, coffee or tea, that will compound the difficulties. If you want to try a mile approach at first try chamomile tea, but it sounds like a drug is in order, but you never know.

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.
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Yes, that's sundowning and my mother, 95, showed the same symptoms. Her dementia has progressed to the point she was agitated all day, paced around the house trying to open the key-locked outside doors, talked constantly, yelled at me, didn't sleep much and so on.

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.
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Wikipedia has a full description of sundowning along with causes and treatments. You may want to go there online and check it out. Without much doubt, as you describe your dads behavior, he is definitely a sundowner.

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.
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I will make again an anedoctal report without scientific base , about some food supplements that are giving great results to control some dementia symptons of my aunt that have advanced dementia.
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.
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my mother has this problem also. at night when she is tired it is worse. she doesn't think that the house where she has lived for 52 yrs is hers and that she lives in the country which she doesn't. the dr. put her on Namenda but it hasn't helped much yet.
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Great question~ Thanks for asking, virtualhorizon! My Mom is not sundowning every evening yet. She went through a phase a few months ago where she would get very tired in the evenings and her memory would deteriorate dramatically. Then I'd get her to bed just to find her up later, pacing and "searching" for unknown lost objects. Often this is when she would accuse me of various bad deeds, which hurt a lot until I realized that the next day, she had no recollection of these episodes. For some unknown reason (God's mercy?) these episodes have diminished and she is mostly in good humor now - sleeping well through the night. I wonder if others loved ones have had episodic bouts of sundowning or if it is something that typically sets in and remains a part of their dementia... Anyway, thanks for asking about this.
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Barb - I have a couple of ideas for you about the unwanted purchases:

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.
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Oh yes. Mom came down w/a UTI and it went straight to her head! She was up at 2am and it lasted for about 36 hrs. She was saying/doing all the kooky stuff, talking about events, people and places long gone. It was so annoying b/c she wouldn't sit still or lie down for more than 15 mins and was totally disassociated from reality. By daybreak, she had settled down. That following night, she slept 12 hours and woke up not remembering any of it. (Lucky her, right?) Since then, I make sure she's up during daylight hours, eating enough and then to bed at dark. As long as she gets enough sleep, all is well. Sure, she still get's up around 2a but will walk to the kitchen and back to bed so I let her do it, listening the whole time. Hope this helps. I cannot imagine facing this again. If so, she's going to AL. Sending hugsfor better days, RachelA
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Glad I found this thread as my Dad [94] is just starting the sundowning. What I found interesting is that I had been reading up on this subject prior to Dad getting it, but reading it and experiencing it is so different.

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.
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Hi freqflyer,

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!
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