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On Sundowners. I have read the articles here on Sundowners. We believe my mom, who is in assisted living, is now experiencing this in the evening. Yesterday I called about 3:30 pm and she was very confused when previously it started getting worse after 6pm. My question is, do our phone calls make it worse and heighten her confusion because she has someone she trusts to talk to? Does our physical presence make it worse for the same reasons? Do I need to start visiting her after supper? This is the worse time of day for me as I get grumpy and less patient in the evening. Just the truth.


For context: Daytime - Right now she is still mobile, and we take her out for car rides, meals etc. She has the normal dementia symptoms during the day. She “loops” if we spend time with her in her room but doesn’t “loop” when we are riding as we think it provides distractions. Once we get back in her room the loop questions start.


I haven't talked to staff and Dr. about Sundowner suspicions, yet. When I generally ask how she is going they say she is doing fine. My Mom is very compliant and won’t leave her room to interact outside meals. She lies in bed all day unless it is mealtime. This I know as that has been the case since, she arrived up to now (for 4 years). That is just her way. We have tried everything to get her to participate in activities there. She took to the bed before she moved to assisted living and I understand from this forum that is a common thing as it is a safe and comforting place.


Thoughts and advice appreciated. It feels cruel to know she is laying there distressed. I don’t believe I’ll be at my best with her in the evening.

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Unless you get the cooperation of the admins and staff, there aren't many other solutions for Sundowning, but you should also be aware that confusion can be a symptom of a UTI, which are very common in elderly women and often the only symptom is not a complaint of pain or urgency, but changes in behaviors and personality. You can also talk to the staff about this.

Have you approached her doctor about anti-anxiety meds for her? They have helped my MIL a lot. I also have an Aunt with advanced dementia who is on meds and sometimes she Sundowns and other days does not. The best "cure" is distraction. See if the staff can pay her a visit or offer to take her to some activity or event in her building. Maybe they have visiting therapy pets or musicians? Otherwise you will need to come to peace with the fact that she goes through this on her own unless you wish to hire an aid to go there in the afternoons to hang out with her. Even this may not work. IMO you do not need to go there every afternoon.

FYI when she went into AL my MIL started to refuse to get out of bed and join others in activities. This broke our hearts because she was a very social person prior and physically she was (and still is) very healthy. Once we moved her to a different facility the staff was able to get her to at least get up and out to meals. Now she's wheeled out to the commons area every day and they take her to activities. She has forgotten that she refuses to get out of bed. She even reads books now, something she never did prior to moving into AL (and not she's in LTC because she lost all her muscle tone from inactivity and requires 2 people to lift her).
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Thanks you for your time and thoughtful reply. They have therapy pets but not every day, and lots of music (and other) activities but she won’t join in.

We haven’t done anything yet, other than check in with the staff and caregivers and if they have noticed anything. They have not. We know she must stay dehydrated and we all work to encourage her to drink, but no one can make her drink if she doesn’t want to. Ice cream is a good treat.

We are contemplating talking with her dr and meds. We know sometimes they work and sometimes not, and this could be a phase. We have considered getting someone to sit with her at night for a while as well.
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You have already thought of a lot of great ideas. Trying to get them to drink enough is ridiculously difficult. I would talk to her doc about possible meds to help with sundowning. My MIL is on trazadone now and seems a bit better. Having someone sit with her for a bit isn't a bad idea either.

Does your calling seem to help or not? The staff at my MILs facility have called my hubby to have him try to get her to calm down a bit and they continue to do so since it was working. Now that the med is kicking in more, less calls. Everyone responds differently.

Good luck.
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Is your mom in AL or in Memory Care AL? It sounds like she needs to be in Memory Care AL. Sundowners is part and parcel of dementia, as it advances, Sundowning becomes more prevalent. Only YOU can say whether your mom gets worse with your phone calls and visits; we on the forum would have no way to answer that question! There should be no 'suspicion' of Sundowning either; mom either gets more confused as the day progresses or she doesn't. That's the definition of Sundowning: more confusion as the sun goes down. My mother had good results with Ativan .25 mgs and then it was increased to .5 mgs as needed.

In my mother's Memory Care ALF, the residents were taken out of their rooms by 10 am every day, so they weren't allowed to lay in bed all day long. Muscles can atrophy that way, and avoiding social interaction with others can cause depression and worsen dementia symptoms in general. I knew that the staff would take mom out of her room and socialize her every day when I moved her into Memory Care, so I was 100% on board with that policy. Otherwise, mom may have hibernated in her room all day as well, which wouldn't have been a good thing for her.

If you feel it's a cruel thing to have her laying there distressed in her bed, then look into moving your mom to a Memory Care ALF that gets the residents up and out of their rooms, that doesn't allow lingering in bed all day long (unless they're on hospice or sick), and encourages socializing for everyone. In my experience, an elder with dementia & serious Sundowning issues needs a Memory Care environment where the staff is dedicated to interacting with the residents and can get them socializing with one another so they're not isolating by themselves all day. That doesn't mean she's 'forced' into doing activities, but just brought out into the activity room so she's hearing chatter and listening to movies and invited to outdoor activities on the mini bus. My mother's MC would take them on trips into the mountains for scenic drives once a week. They didn't even have to get off the bus, just enjoy the scenery and the fresh air coming through the windows. Same with the outdoor garden; the caregivers would wheel my mother outside into the garden every day to enjoy the sunshine (in her wheelchair); mom grew to love that and look forward to it. They had a whole routine which they involved her in, which is crucial for dementia residents to have: a strict routine.

Wishing you the best of luck.
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