I've looked at several posts, but haven't seen anything helpful to my situation yet. Dad (79) was diagnosed with Alzheimers about 4 years ago. Takes Namenda and Aricept and until about 2-3 months ago, has gotten along well. He and mom (also 79) live in their own apartment in a retirement community surrounded by several friends and family. All three children live within a few miles, but it's usually left up to me to help with day-to-day problems. Mom has A-Fib, had a pacemaker put in 4 months ago and is still recuperating. She still has attacks (had one last night for 10 hours) which leaves her weak and tired. Dad has recently started getting very agitated in the afternoons (sometimes in the morning as well). He says that someone told him they have something for him and he wants to go get it. He can't tell us what they have or who "they" are but he is adamant that we take him. Once he's in the car, he wants to ride all over town looking. After awhile he calms down and we can take him home. Sometimes (not always) he starts up again after being home for a few minutes. We've tried distracting him with food, walks to the office to get the mail, tv, music, etc. but nothing helps. Today he held his cane up to mom like he was going to hit her. (He's 6'4", she's 5'5") Other than these episodes, he's usually very docile, loving, and gentle, but now I'm scared for mom. Any suggestions would be appreciated.

I'll just jump in and give you my thoughts. It appears he may need medication for his agitation and beginning aggressiveness. I would speak with his neurologist immediately and see if they can't get him started on an anti-anxiety medication. There are several that will not make him drugged, but will help decrease the anxiety he is feeling, which is one of the main things we want for our LO's-not to feel distraught and anxious. Best of luck.
Marie

Hi GinGuy,

Welcome to this supportive Online Community. I am glad you have found us but so sorry for what has brought you here. Sundowning and the behavioral symptoms related to Alzheimer's can be so difficult and complex, I hope I can help.

It sounds like you have done a very good job with working out how to calm you Dad down, when it seems he just needs to go look for that someone. As you may be aware, with Alzheimer's disease, it is very common for the person to live in their own reality. One that you and I do not understand as it is not real, but it surely is to your dad, for example. It seems to me you really understand this, and you are finding ways to re-direct him, and comfort him with a drive around town to settle his worries. Both very good ideas at this point it seems.

Sadly there often comes time when these behaviors affect the safety of your dad and those around him. As he becomes more and more agitated, and delusional it will be important to assess the situation on an ongoing basis. This way you and your mom can feel out if he may act out, (hit your mom with a cane) hurt himself or someone else. If this is the case, and you or your mom feel threatened by your dad because of these new changes, please do the following.

1. Call 9-11

2. Tell the operator that your dad has a diagnosis of Alzheimer's disease and recently has been more agitated. Let him/her know you are concerned he will hurt you, your mom, or whoever is in danger. Ask for assistance to help calm him down and remain safe from harm.

3. When the EMT arrive, inform them also of the situation, in as much detail as possible, so they know better how to handle the situation. They will then evaluate if your father needs to go in to the hospital so to regulate his condition and assess if there are other medical factors at play.

In the meantime, I would strongly encourage you to set up an appointment with the doctor who is following your dad's dementia care. Often in these circumstances, when agitation, and anger affecting the persons daily life, doctors will prescribe either an anti depressant or anti psychotic medication to help regulate his mood. Also the doctor can run tests to uncover if there is another health problem causing these symptoms. Sometimes infections can be the culprit of increase mood change in Alzheimer’s

Here is a link to a document with more information about these psychiatric symptoms related to Alzheimer’ http://www.alz.org/national/do...heet_behavepsych.pdf

Another suggestion I would make, is to keep an eye out for patterns in your dad’s mood changes. Does it happen after meals or before? Is it when he just wakes up or when he is close to bed? Does it happen after an activity, like getting dressed or talking to someone for a while? If possible, see if you and your mom could keep a log of when these behaviors occur, and look if there are patterns. If you see a pattern, try to alter his routine, activities, or whatever you noted based on the pattern you recognized, and see if that helps deter the agitation.

GinGuy, it is also very important that you think of yourself in all of this. You are caring for your dad and at times your mom as well. This is a lot to give of yourself. There are ways to make sure you care for yourself as well. This may be a support group, respite, a vacation, a new book club, etc. Please do not hesitate to call our helpline to talk anytime you need us. Please call us if you have further questions about this or need some guidance when your dad is very upset. We can talk with you and guide you through this anytime 24/7 Call 800.272.3900.

Bests,

Thanks to both of you. Suggestions are most appreciated. We did speak with his primary care physician today and he has prescribed Xanex to be given every 6 hours (he's already taking Prozak). Mom has given him that today and it made him sleep, but when he woke up he started right back up. She had to take him for a ride in the car to calm him down. I went to the library and check out several books which may offer some help. I like the suggestion of keeping a log of when these behaviors happen; maybe that will shed some light on the problem. I'm feeling better today, not as overwhelmed. Have talked to my brother and I think he finally understands how bad the situation is. Having someone else to share with helps a lot. Thanks! Ginger

GinGuy, I'm Stage 4 AD, 54 y.o., with a sundowning kind of pattern. I'm also 6'4" and have worked out most of my life, some strength measuring was done on me and I'm top 5% strong for my age. So for me, getting medicated has been literal life & death.

I take Seroquel, total of 800 mg/day. I can also chew up an extra dose, if I catch myself in early agitation. Warning: Chewing Seroquel tastes like I think fox urine must taste.

I was also having auditory hallucinations, also mostly late in a day. Nothing big and dramatic, but I didn't enjoy them. Seroquel has cut the hallucinating down at least 90%.

The black box warning needs further research. The death rate associated with Seroquel is with people much older than me, and is only 2 or 3% higher than with placebo. I wouldn't be living at home without Seroquel, that's worth a small risk.

The deceptive thing about calling it "Sundowning" is that if we get really worn out, the extra symptoms can linger for days. When I get burnt out and all symptomatic, it can take 3 days to get back to my normal.

GinGin,
Glad you have found our site and welcome.

So sorry for your reason for being here but Alan as always has good suggestion as did Jaimie.

Alan I have wondered why Mother "liked" to chew her meds...must be that delightful flavor. lol

Gin my mother did not calm down on Xanax..At the very first it did work but by time she was moving to stage 6 no help. The seroquel is best so far with Mother. She is on 25mg three times a day. She takes Depakote sprinkles also. spelling may be wrong on that one.
Mother has never gotten physical but close few times but she is not as strong as your dad probably is. Take care and let us know what doctor gives him...Sundowners is a very real situation in this disease and first thing in AM Mother is usually more distressed also.

Once again welcome to a site that has many members walking in your shoes, but each loved one has their own symptoms. We are here in these forum threads and in chat room so come on in anytime for support from our caring members.
Sheryl

Dad walked out on mom last night and when she found him, he had fallen and couldn't get up. She had to call 911 and they took him to the ER. Thankfully, nothing was broken; just bruised. We have follow-up with primary care dr today. I will definitely ask about the Seroquel. Never heard of it, but it sounds promising. Thanks so much to both of you! This site has been a blessing! Ginger