sundowners syndromeDear Sheila,
My 80-year-old mother has early stage Alzheimer’s disease. She’s doing pretty well on her own but she doesn’t cook or drive anymore for safety reasons. I stop by to see her every day on the way to my full-time job, get her breakfast and lunch, and then I stop by again on my way home. In the morning, she’s pleasant and able to enjoy our conversation. But by 6:00 pm it’s like she’s become another person – angry and confused. I just want to give her dinner and help her shower but she’s completely uncooperative. Then she’s fine again in the morning. The result of all this is that I’m stressed, late getting home and my family is unhappy and dinner’s delayed. I don’t know what is going on with her. What do you think?
~Stressed Caregiver

Dear Stressed,
It sounds like your mom is experiencing “Sundowners Syndrome.” We see this a lot in people who are somewhere in the mid to late stages of dementia, where confusion, disorientation, and/or agitation increases late in the day or at sundown. There are various ways to respond. You can try to redirect your mom to something she enjoys such as listening to music, taking a walk or another activity. What typically doesn’t work is trying to get the already agitated person to follow directions to do something they may not want to do, like take a shower. Frankly I’m concerned about you. It sounds like you’re trying to do more than two full-time jobs. Your schedule is hectic and you won’t be much good to anyone if you run yourself into the ground. I really want you to get some help caring for your mom. If you want to keep her at home you could hire a home care worker to take over the morning or evening routines or both. This will make the time you spend together less task oriented and more enjoyable. Alternatively, you could look for an assisted living community that also has a memory care unit. If you continue to care for your mom at home I suggest that you offer the shower and personal care in the morning when your mother is more approachable and willing to cooperate. You might also try preparing a snack or meal in the morning for the evening (which doesn’t require heating). You can prompt your mother to eat with a phone call. I know this is a lot to think about, and change is difficult, but you don’t have to do this on your own. You can contact a home care agency or geriatric care manager for assistance. A geriatric care manager can help you and your mother explore her options and figure out the best approach to get you help, and get your mom the care she needs.
~Sheila

photo credit: via photopin (license)