I need help with managing Sundowners Syndrome. Any suggestions?

So many of these answers sound encouraging, and it sounds like your situation is more than sundowners. When my late husband had sundowners, I was advised that when it was late in the afternoon before sunset, to close the curtains and the blinds and turn the lights on. That way you bypass those hours. Also stay close to him if possible. Talk to him, feed him distract him. Don't let his mind wander. It can be a terrifying thing to lose your brain while you're still using it. I wish you all the best. I know it is not easy.

This is so difficult. My mom wasn't up all night but I managed Sundown syndrome with medication. I started the medication earlier in the evening sometimes as early as 4 pm. I tried all kinds of natural remedies, but nothing worked. My mom was also on an antidepressant which helped alot. The Dr prescribed an anti anxiety medication for the Sundown syndrome. I gave her the medication before anxieties kicked in.. once she reaches the state that your mom gets to it is hard to control. So preventative administration is the way to go. Anther thing that worked was to have quiet and organization within her life and within the household. I found if there was alot of commotion during the late afternoon her Sundown was way worse. Sorry you have to go through this.

Try closing all blinds and then leaving the lights on so she would feel better. My mom kept telling me that she was afraid of the dark. God bless.

Imho, the cause of the many Transient Ischemic Attacks should be addressed by your mother's neurologist as that is a high number in a 2 year period. Prayers sent.

That's an awful lot of strokes in such a short time frame! Hopefully the docs are on top of that, both the cause and some kind of treatment.

If she isn't mobile, her appetite could be diminished as she doesn't need as many calories, but if she's refusing any food, perhaps you can try various items, even if they aren't the healthiest options, to get something into her.

If this sun-downing was sudden onset, has anyone checked her for UTI? When I first joined and would read so many suggestions to test for UTI, I was skeptical. Our mother never had true sun-downing, but did develop this OCD behavior every night before bed. Initially once or twice/night a few nights, but eventually it became a nightly marathon of 1-1.5 hours. She would check the door lock, sidelights, dishwasher and LR, over and over again! We had a camera near the front door, so this was observed (she was living alone in her own condo then.) Couldn't tell what she was checking in the kitchen until OB was visiting one time, and he saw her do it. He would try calling her when she would start this, and tell her to go to bed. First time she said she was just going, but it took several more rounds. Second time she told him he got her out of bed (not true!) I told him calling won't work as she doesn't realize she is doing this and wouldn't believe you if you told her! I suggested he just turn the sound off on his phone until later, when she would go to bed.

To the best of my knowledge, she did not do this after we moved her to MC. However, the first UTI came with full-blown sun-downing and the staff could not redirect her or get her to stop! Along with antibiotics, the doc ordered an anti-anxiety, lowest dose, and she only needed it until the UTI resolved. It was just enough to take the "edge" off and keep her calm. She was never doped up. The nice thing about this med (Lorazepam) is it works first time, every time. No need for it to build up in the system or wean off it when not needed.

That said, what worked for her and what others are suggesting for medications or OTCs might not be right for your mother. There can be interactions. There can be times when it doesn't work or makes things worse. You need to work with her doctors (and pharmacist, regarding side-effects and/or interactions) to find the right medication to help calm her.

Working with her, if possible, to slowly adjust her sleep cycle to be more normal could be helpful. Even if she's still anxious or paranoid, it will be easier on your dad and sister to be able to work with her, reassure her, try to redirect her, etc during NORMAL hours and allow them to get necessary sleep!

Much as I try to avoid medications, sometimes it is needed to help. Trying to keep her more "active" during the day, and not allowing long naps might help adjust her sleep-wake cycle. It won't likely happen overnight, but perhaps in small intervals they can make some progress. Meanwhile, I would reach out to her doctors, to see what they might suggest. If some medication works and keeps her calm and helps dad and sis to relax a bit, it would be a win-win!

(BTW, subsequent UTIs for mom have resulted in night-time bed wetting, not sun-downing. UTIs do odd things to elders, esp those with dementia! If possible, make sure they do a culture, not just the dip stick test. Mom also had her first known stroke earlier this month, but still feisty as ever despite the resulting right side weakness, slurring, etc. She hasn't walked on her own in quite some time, mostly because she didn't get enough "exercise", sitting too much and was too weak to stand/walk and gained weight at the same time! She's now 97, finishing up year 4 at MC.)

Ativan usually works great for anxiety in elderly

I have reservations about the weighted blanket. I don't know if they are all the same, but the one my daughter gave me for Christmas last year is very heavy. She might not be able to turn over or get out from under it.

Our primary care doctor prescribed Trazadone 50mg for my husband....up to two a day. I give him one early evening (around 5:00) along with two Melatonin. That has helped a lot. If he starts yelling during the night, I give him another one. Good luck. I treasure a decent night's sleep so I can make it through the day.

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.....

If you're in a state where medical marijuana is an option, maybe you can get her card and give her gummies. THC gummies are easier to consume and dose. For instance, I will only take a quarter of a 10 mg square because I don't like to be stoned, just relaxed.
CBD is another good option, and does not require a medical marijuana card since it's not considered a drug. It just takes a while to build in the system to get any results.

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!

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

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.

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.

Getting in touch with a neurologists is a good way to go, they specialize in nerve trouble, dementia, epilepsy, and other nerve troubles. Your mother may possibly be developing dementia, don't what see a specialist and they can slow it from turning into Alzheimer's.

We found lavender essential oil to be extremely helpful with my mom. You would need to use a good quality, hopefully organic, brand. We use Young Living and Ancient Therapeutics. It has been a HUGE help. You can use it on the wrists (pulse points), on back of neck, but the most absorent skin on the body is the bottom of the feet so it works quicker used there - up and down the arch of the foot a couple times (you need a roller ball bottle) and at base of big toe, which I believe is connected to the brain. Hope this helps you as much as it has us.

The PA handling my husband's dementia suggested using melatonin 10 mg. at night. it is an OYC herbal supplement, that we used for years when we traveled. You can get it at any drug store or vitamin shop. Works for my husband and he is 190 pounds. helped stop the multiple ups at night.

We started my father on Ativan about a month ago and what an amazing difference in his demeanor. Dad has COPD and related moderate cognitive impairment. He was often anxious about being able to reach my sister or myself and had flare ups of angry, confused, meanness in out-bursts that were unpredictable and sudden. With the Ativan he is much more reasonable and calm. It also makes him drowsy and more apt to fall asleep.

She may need a sleeping agent as well as anti-anxiety medication. If she is "up all night", she may be sleeping all day. Family needs to keep her awake during the day and active so she can sleep better at night.

Boy I feel for you. My mom has dementia and I’m staying with her while my dad recovering from stroke in hospital. She got out last night at 3am and aid brought her back. She cried begging to see my dad until 530am has anger outbursts it’s horrible!! Her primary was not helpful. I had her zoom with psychiatrist she put her on .25 mg of Seroquel 3 x day . To me not helping. Another zoom tonight. It’s so difficult for you and family I get it!!! Please keep in touch on what takes place with your mom. My mom 92 dad is 93. I’ll put you in my prayers

My dad, who has Alzheimer’s, is now experiencing more frequent sundowners and has become more combative and verbally abusive to our wonderful night caregivers. The hospice nurse ordered lorazepam (Ativan) as a night dose to help lessen anxiety. We begin it tomorrow. Am hoping it helps. In addition, we don’t give him anything sugary after lunch. We try to keep him up more during the day, though he can take an hour nap if needed (he’s 90). Some nites he sleeps more, but his internal clock has been wonky for the past several years. One response suggested using touch. We will definitely try that! Good luck!

Contact you local Alzheimer's Association, there are studies that show getting a special type of lighting in your home will sometime stop the sundowning. The Alzheimer's Association could fill you in on those details.

Please try CBD oil. 1000 mg. Under tongue or in liquid.
Start with half of dropper.
Give it to her about 60 minutes before her sundowners usualy starts.
No side effects. Works wonders.

i feel your pain although my moms sundowning seems to have eased up quite a bit. Your moms symptoms seem severe...has her neuro suggested any type of benzo, anti-anxiety. She sounds like she needs that badly for her paranoia & SLEEP! or seroquel (quetiapine) for sleep.
I really feel for your Dad & sister! For you as well but them b/c they’re right there. Sundowners is a real frightening experience for caregivers to go through! Unlike anything I’ve ever experienced. That & UTI’s.
How were you able to know that she’s had that many TIA’s & 2 ischemic?
my mom had a hemorrhagic stroke & the dr’s did state she’d likely have mini strokes, or those tia’s, moving forward until she has another big one of which she will not survive.
I am so sorry for you, your Mom’s so young.
godspeed.

My dad loves music. We put an Echo/Alexa device in his room. He has been taught how to ask Echo for smooth Jazz or Love Songs. He can also call my cell through it from his bed. Try music. I also use lotion on his feet and arms before he goes to bed. The lotion calms him down. I also pray with him too.

Weighted blanket helps, hospital bed with rails, adjustable height & bed alarm, melatonin gummies at least 10 mg (strawberry 🍓 @Walmart.com), calming lavender essential oil to rub on wrist and behind ear as well as in diffuser, sound machine are all things that helped with my dad. Keeping him awake in daytime with minimal naps and activities helped as well.

when they sleep most of the day they will be up all night.

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.

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

Great suggestions below. My dad suffered from sundowners at the end of his life. Getting exposed to sunlight during the day or at least sitting by a window was one suggestion. He was placed on an anxiety med along with melatonin and a sleep med for nights. Day naps were shortened so he could sleep some during the night. Glad you are seeing a new doctor.