Ask Curtis: My Mother’s Alzheimer’s

Dear Curtis,

My mother has lived with me and my wife for the past 3 years. She is in good health and was diagnosed with Alzheimer’s about 4 years ago. The Alzheimer’s has never been much of a problem for us until recently when we began to see her experience large mood swings from morning to night. She is most alert and calm in the mornings; however, by dinnertime she is agitated, can’t sit still or stop talking and has become very demanding. During these times, there is nothing we can really say to calm her down so we just ride it out knowing she will be fine the next morning. Curtis, what in the world is going on?

Ronald T. in Conyers

Dear Ronald,

What you just described is commonly referred to as “sundowning” and approximately 20% of people with dementia experience this. It typically occurs in the middle stage of Alzheimer’s‚ and diminishes in the latter stages. Symptoms can include confusion, restlessness, demanding and paranoid behavior, disorientation and even delusional behavior. It is called Sundowning because it typically occurs late in the afternoon or early evening. Experts have not been able to pinpoint the exact reason for this change of behavior and why it occurs specifically at this particular time of day. However, some speculate that it could be the lack of sensory stimulation after dark, end-of-day exhaustion or even damage to the area of the brain that controls our internal body clock.

Some tricks to try to help decrease sundowning symptoms in your mom are to:

1. Make sure to reduce the amount of caffeine and sweets she gets, especially in the afternoon and evening hours when her symptoms are more prevalent.

2. Keep her room partially lit.This will keep her light levels fairly the same throughout the day and not be so dramatic by the time evening comes.

3. Keep her active during the day,limiting her naps so that she can better sleep at night.

4. When she does sleep, let her sleep where she feels the most com-fortable or safe.

5. If she wants to walk or pace, let her! This is her way of wearing herself down enough to relax to sleep.

6. Arrange bath or showers for morning hours as giving too late in the day may reinvigorate her and thus she is unable to relax and sleep when needed.

7. Rule out any medical conditions such as incontinence or UTI which may be causing the restlessness.

8. Consult with her doctor to go over more ways that could help, including medications that may help in reducing some of the behaviors of sundowning.

If you have questions or suggestions for Curtis, email him at: curtis@ashtonseniorliving.com