So, sundowning (Alzheimer's)

[W.T.Faulkner]

Anybody have any strategies for dealing with sundowning in patients with Alzheimer's?  

My grandmother is beginning to grow super-anxious at night, forgetting where she is, why she's in her nursing home, etc.  She called my mom in hysterics Sunday night trying to figure out where she was.  Her long-term memory is still intact, but her short-term and immediate are gone.  I know there's no way to really improve her memory, but I'm wondering if there's anything we can do for her to ease her anxiety.

WebMD has diet and nap advice.  Has anything worked for you/yours in the past?

[Deleted]

Has she been in the home long? Establishing a relatively strict routine sometimes helps. I'm sorry I don't have more advice for you. I know it's difficult.

[pinkflats]

My grandma had Alzheimer's terribly, but never had any anxiety issues at night. Because of my grandmother, my CW and I discuss Alzheimer's a lot because her mom was diagnosed within the last year. Her mother experiences quite a bit of anxiety at night, frequent phone calls, hall roaming, she's been found in her closet because she said she is lost and scared, quite a number of alarming things really. They moved her to a twelve person facility that specializes in Alzheimer's care and she has greatly improved (in the anxiety sense). The facility isn't that big and it makes her feel more comfortable and the staff is quite a bit more attentive to her when she is going through anxious moments. I don't know if this is something to consider for your grandmother, or something even available in your area, but it could be something to look in to if it's not like the facility in which she is already living.

[Deleted]

Does she have her own room or does she share a room? Are you using the facilities furniture or have you brought in pieces from her home? What about wall hangings such as cherished family photos, etc?? When we had to move my grandmother into a nursing home we brought in as many furniture pieces from her home that they would allow. We also hung many family photos on the walls. My mom also wrote a very brief letter to my mom letting her know where she was, why she was there and that she could call us if she needed to. She put it in a frame next to her favorite chair so when my grandma would forget where she was she would see the letter and read it as many times as she needed. We also went over and had dinner with her as much as possible during this time. We would eat with her at the facility and help her get ready for bed. We did this for months and it really helped.

[marylennox]

I used to work with alzheimer's patients in long term care...

I found that just taking time to sit with them and talk, ask them questions or strike up conversations about other topics, sometimes helped distract them from being nervous. (A little bit like you would redirect a toddler, I guess?)

I had a lady that would often get very anxious at night and need to call her son/daughter/husband (who was no longer living) about going home. We would continually reassure her - "we already spoke with them and they will be here to pick you up in the morning," "you're just staying here with us tonight, the weather is too bad to drive home," etc (she had pretty severe short term memory loss). I think it's ok in these situations to lie when it comes to their peace of mind and putting their nerves at ease. You have to meet them in their reality.

Or ask her to help with a task (also distracting) like folding towels, etc. Then just keep visiting with her as she helps. keep her mind off of being upset.

[lightbulbsun]

I'm sorry about your grandma.

Light therapy can help with sundowning. Kind of like the light boxes they use for SAD. Since people in nursing homes generally stay inside all day, their circadian rhythm can get messed up, and they become more confused. If she looks at blue light every morning, then she can get back into that natural rhythm. Also, make sure there's not any cool light in her room at night - alarm clocks with a blue/green face, etc - because that can disrupt sleep patterns.

[W.T.Faulkner]

Thanks, guys. I really appreciate your advice.

She's been in that particular nursing home for a little less than a year; she's been in some kind of institution (rehab, hospital, etc.) since June 2012. She has pictures of her family all over the wall, some of her furniture from home, and her TV with her favorite shows on DVD. It's only been fairly recent that she accepted that she can't go "home" (to her house that has been sold.)

I wish there were another, more Alzheimer's-centered place for her to go, but we don't have the money.

[Deleted]

Oct 29, 2013 15:40:35 GMT -5 tarzanswife said:

Does she have her own room or does she share a room? Are you using the facilities furniture or have you brought in pieces from her home? What about wall hangings such as cherished family photos, etc?? When we had to move my grandmother into a nursing home we brought in as many furniture pieces from her home that they would allow. We also hung many family photos on the walls. My mom also wrote a very brief letter to my mom letting her know where she was, why she was there and that she could call us if she needed to. She put it in a frame next to her favorite chair so when my grandma would forget where she was she would see the letter and read it as many times as she needed. We also went over and had dinner with her as much as possible during this time. We would eat with her at the facility and help her get ready for bed. We did this for months and it really helped.

Y'all are all amazing people. Seriously.

(Tackle hugs tarzanswife and her family)

[silva]

Something different to consider is to see if they can provide massage therapy for her. Just a light chair massage does the trick. I've covered a group of volunteers who often do that and the volunteer coordinator says it does wonders.

[W.T.Faulkner]

Oct 29, 2013 15:40:35 GMT -5 tarzanswife said:

Does she have her own room or does she share a room? Are you using the facilities furniture or have you brought in pieces from her home? What about wall hangings such as cherished family photos, etc?? When we had to move my grandmother into a nursing home we brought in as many furniture pieces from her home that they would allow. We also hung many family photos on the walls. My mom also wrote a very brief letter to my mom letting her know where she was, why she was there and that she could call us if she needed to. She put it in a frame next to her favorite chair so when my grandma would forget where she was she would see the letter and read it as many times as she needed. We also went over and had dinner with her as much as possible during this time. We would eat with her at the facility and help her get ready for bed. We did this for months and it really helped.

You guys are wonderful.  I like the letter idea.

My mom has dinner with my grandmother every night, and I visit as much as I can (I live over an hour away).  The good news is that my grandmom never goes a single day without seeing a member of our family -- one of her children, a grandchild, etc.  

[cleo29]

I was going to suggest a light therapy lamp. I also read that forcing them out of their reality can be more harmful than good. Like telling them that someone they think is alive is dead, etc.

I'm sorry you are going through this, it's a vicious disease.

[Deleted]

Oct 29, 2013 16:00:32 GMT -5 @stellasmom said:

Oct 29, 2013 15:40:35 GMT -5 tarzanswife said:

Does she have her own room or does she share a room? Are you using the facilities furniture or have you brought in pieces from her home? What about wall hangings such as cherished family photos, etc?? When we had to move my grandmother into a nursing home we brought in as many furniture pieces from her home that they would allow. We also hung many family photos on the walls. My mom also wrote a very brief letter to my mom letting her know where she was, why she was there and that she could call us if she needed to. She put it in a frame next to her favorite chair so when my grandma would forget where she was she would see the letter and read it as many times as she needed. We also went over and had dinner with her as much as possible during this time. We would eat with her at the facility and help her get ready for bed. We did this for months and it really helped.

Y'all are all amazing people. Seriously.

(Tackle hugs tarzanswife and her family)

Aww thanks Stellas. She was an amazing lady and we tried our best to keep her as comfortable as possible.

[Deleted]

Oct 29, 2013 16:05:54 GMT -5 W.T.Faulkner said:

Oct 29, 2013 15:40:35 GMT -5 tarzanswife said:

Does she have her own room or does she share a room? Are you using the facilities furniture or have you brought in pieces from her home? What about wall hangings such as cherished family photos, etc?? When we had to move my grandmother into a nursing home we brought in as many furniture pieces from her home that they would allow. We also hung many family photos on the walls. My mom also wrote a very brief letter to my mom letting her know where she was, why she was there and that she could call us if she needed to. She put it in a frame next to her favorite chair so when my grandma would forget where she was she would see the letter and read it as many times as she needed. We also went over and had dinner with her as much as possible during this time. We would eat with her at the facility and help her get ready for bed. We did this for months and it really helped.

You guys are wonderful.  I like the letter idea.

My mom has dinner with my grandmother every night, and I visit as much as I can (I live over an hour away).  The good news is that my grandmom never goes a single day without seeing a member of our family -- one of her children, a grandchild, etc.  

My mom just reminded me of a few other things we did. We called her every night at 8p.m.. It was in the letter to her (your daughter will call you at 8p.m.), mostly my mom called but if she was traveling, etc.. one of my uncles, counsins or I would call her.

We also sat down and wrote letters of our favorite memories with Grandma and tried to locate photos of the event, etc.. My mom put them into a binder with plastic inserts so she could remove the photos and touch them and read the cards, stories, etc. At the front of the binder was a "my family" section with a picture of her at a different stage of her life with each of her kids and grandkids.

These ideas came to us over time as my grandma would have horrible anxiety at night. We had to move her thru a few different facilities until we found one that could deal with her. She would escape the facilities at night and would try to "go home". (Home to her was Missouri, she was in AZ at this point). (She escaped out windows, doors are alarmed at most places, not windows)

The other thing we learned was to never, ever change her wardrobe, shoes, etc.. We figured this out the hard way when my mom bought her all new clothes and she refused to wear them as they were not "hers". Many of her clothes she had sewn herself so my mom and I sewed her an entire new wardrobe in as many similar patters and fabrics to her old one. We also found shoes similar to the ones she wore every day and bought as many as we could in her size, in the color she preferred.

It took us quite some time to figure all of this out but it worked in the end. My grandmother struggled with alzheimer's for 13 years and I think it took us every one of those years to figure this much out.