Hi.
My mother seems to be in AD 5/6, is still continent, and cheerfully goes off to senior center (don't you dare call it day care) 3x/week, 6 hrs. a day, and then crashes, exhausted, on the couch in front of Oprah and the news.
The problem is the non-sr. ctr. days, especially early evenings. It's sundown syndrome, I know, plus she's bored (doesn't read anymore) and not worn out by Bingo and Yahtzee and all the fun stuff they do at Club Dementia.
Anyway, I'm considering asking for a tranquilizer when she has a dr. appt. next week (these tantrums are getting hard to take!). Any medication suggestions?
thanks

Juliana,

It can be challenging caring for someone that has Alzheimer’s disease. You mention that your mother cheerfully goes off to the senior center and on the days she doesn’t attend, she experiences sundowning. Sundowning can disrupt the body’s sleep-wake cycle, causing more behavioral problems. The following are some tips to manage sundowning:

• Be mindful of your own mental and physical exhaustion. If you’re feeling stressed by the late afternoon, the person may pick up on it and become agitated or confused. Try to get plenty of rest at night so you have more energy during the day.
• Plan more challenging activities (like doctor appointments, trips, and bathing) in the morning or early afternoon hours when the person is more alert.
• Make notes about what happens before sundowning events and try to identify triggers.
• Limit the amount of environmental distractions during the evening hours (TV playing, children arriving, doing chores, loud music playing, etc). These distractions may add to the person’s confusion.
• Have a large meal at lunch and keep the evening meal simple.
• Keep the home well lit in the evening. Adequate lighting may reduce the person’s confusion.
• Don’t physically restrain the person. It makes agitation worse.
• If the person needs to pace back and forth, allow this to continue under your supervision. Take a walk outdoors if the weather permits-this may reduce restlessness.
• Talk to the physician about best times of day for taking medication.

When behavioral interventions and environmental changes do not work, some people with Alzheimer’s may need medication for their agitation during the late afternoon and evening hours. This should be discussed with the doctor. Many persons with Alzheimer’s are prescribed psychotropic medication to help manage challenging behaviors such as restlessness or aggression. Attached you’ll find a useful source on managing behavioral and psychiatric symptoms of Alzheimer’s disease.

It’s a tough job being a caregiver and I know that you’re doing what’s best in your mother’s interest. Please contact us again if you have any questions or call our 24hour helpline at 1-800-272-3900.

Sincerely,