I agree with those who are concerned about the effect of medications on the elderly. They just do not metabolize meds the same way younger people do, and unfortunately some physicians overmedicate. Anesthetics, and the shock to the body of surgery can cause confusion and other behaviors associated with sundowners. I am concerned about the lack of education people are getting regarding their elderly, especially as it seems people have not been told that an infection in an elderly person can cause temporary dementia-like symptoms. In regard to behaviors worsening when they are moved about, yes another downer to getting old…a move to a new place can cause confusion/disorientation. Check with your provider regarding the long time use of meds like Ativan..they can lose their effectiveness after even 2 weeks. To all of you who are caretakers, do take care of yourselves..if it seems impossible, find a way..that is extremely important

Susan commented on http://sundownerfacts.com/sundowners-syndrome/

My aunt is 82. She was diagnosed with Alzheimer’s several years ago. I personally didn’t notice it until a couple of years ago when she started hallucinating. I was told by her social worker and doctor that it was no longer safe for her to live alone because of the disease. Everyone who tried to live with her was accused of stealing, so I obtained full guardianship and moved her in an Adult Foster Care. She lived three months in one home and accused the Administrator of putting black pepper on her wash cloth purposely, so it would burn each time she urine. It turned out she had a Vaginal Infection. She also stopped eating because the food didn’t taste good and she just wasn’t satisfied. I moved her to a different AFC home and she claimed the food was good but they didn’t give her enough. In February she had a total knee replacement and had to rehabilitate for a month in a rehab center. I have her here with me now.

While she was in the rehab center, the doctor prescribed a total of 12 prescriptions in addition to the five she was already taking. I refuse to continue all 12 meds; I made an appt w/her PCP to gradually wing her off. Because of all the meds, she’s stuttering, angrier, agitated, and acting stubborn. All she wants to do is sleep. Last night she was arguing with me thinking someone had stolen one hundred dollars from her. I became frustrated and left the room. I refused to try and rationalize with her. I’m also watching my sister’s mother-in-law for one week who has a bad case of sundowner’s syndrome. At 9:00p.m., she becomes confused wondering where she is and asking “do I know you”. This is an awful disease and I pray that I stay closed in my right mind at all times.

Susan commented on http://sundownerfacts.com/sundowners-syndrome/

Anyone who has gone through the trauma of surgery can develop sundowners. My husband at age 47 had it within days of a complicated emergency open heart surgery. He truly believed that at night that they were kidnapping him and holding him against his will.
It cleared up when I just stayed at the hospital, surrounding him with soothing music and familiar objects. His own pillow, family photos kids and pets.
I am presently an in home caregiver and many of my clients of have sundowners. It is exhausting because you are not dealing with a rational mind. Families want to be in denial. I believe that many of these people would benefit from some mild anti-anxiety medication. Face it we are at an all time high of wanting to medically prolong life, we love and feel responsible for our elders. We don’t know how to die or be prepared for death in our culture. For a real eye opener read “The Tibetan Book of Living and Dying” by Sogyal Rinpoche.

Good Luck to you All

I can appreciate all your problems. Lost my dad in Dec. 2008, mom’s in nursing home now. She’s 89. Dad was 93. They had been married 69 years, but dad didn’t recognize her close to the end. The trauma brought on a small stroke in mom, but enough trauma to put her in a nursing home. Prior to that we brought her to our home, but she could not bathe herself, kept falling because she would not use her walker, didn’t want me out of her sight. At doctor’s urging, I checked out nursing homes. First, went to Medicare.gov. There I checked out nursing homes in my area, then went to visit ones interested in. I arrived unannounced, went on a tour, then asked to look around for myself. I looked everywhere. I “smelled” the place. Talked to residents to see if they liked it. Observed how they looked (clean, hair combed, involved, or just sitting around dirty, sleeping in wheelchairs, nothing going on), then I spoke to the employees…asked how long they had been there. (Long term employees indicate a facility with contented employees). Check out the food…how it looks and smells. Watch to see if the residents really eat it. I liked one place very much…until they did not want me to visit the Alzheimer’s Unit. If they steer you from ANY part, do not keep your parent there.

Mom is a resident at a home 2 miles from my house. It has been a Godsend. They are so wonderful to her. She has friends, TONS of activities…at least 2 every day, a beauty shop, meals with tablecloths, cloth napkins, individual waiters, and an incredible re-hab wing.

Exense: Mom is on Medicaid. We had to spend down her savings (all but $999), but then Medicaid took over and has provided her with wonderful care. She has a new hearing aid, has a psychologist visit weekly, nurses watching over her constantly, a beautiful room with a wonderful view…and all paid for.

Do not beat yourself up, thinking you must keep your parent at home! If you can, it’s wonderful, but if it affects your health, your marriage, it’s not working. It’s not working for you…OR your parent. Mom has been at Delmar Gardens for almost a year now. She is content most of the time, has friends, is very busy and, now that the Dementia is taking a firmer hold, as well as the Sundowners, she has people who are trained to watch over her. And they do it with with great love, understanding and medical know-how.

I know I have more compassion and time with mom now than ever before. I go over at least 3 or 4 times a week. I do her hair, her nails, we sit and talk or we attend one of the activities, do a project or just sit together. I do not feel guilty, in fact I know she’s better off.

Let yourself consider the option of a nursing home without feeling guilty at all. If you go visit, and you find something that interests you, they should have a Social Services Director who could give you information regarding the cost and how you can afford it. I did not know this until the Soc. Services rep. at the hospital told me about it.

God bless you all. I feel for you. You are indeed, not alone.
Pattie

Shirely commented on http://sundownerfacts.com/_treatments/

My Mother has had a rough year and a half. She is 83 years old and started having a problems with fluid retention (lining of lungs, legs) due to a leaky valve problem with her heart. After visiting a really great cardiologist we thought we had it licked. Unfortunately, some things happened in my Mom’s life that caused her to develop slight depression which is is now being treated for with a very small dose of Lexapro. Due to the depression she became pretty much immobile, her salt intake wasn’t monitored closely enough and the fluid issue arose again a few weeks ago. I needed to bring her to the ER because she was having difficulty catching her breath when she walked even short distances and it was found that her oxygen saturation levels were very low. They admitted her into the hospital where she first began showing signs of sundowning. The nurse at the hospital told me that this happens sometimes with the elderly when they are taken out of there normal environmental.

It’s the scariest thing that I’ve ever had to deal with. When it was agreed that my Mom needed to go for PT at a short-term skilled facility she seemed to get a little better. She knew of the facility where she was going to be going and knew it was only for a short period of time and it’t the one she picked out. Well, the first night the symptoms came back only more violently. She is on medication to help reduce the symptoms but as soon as late afternoon arrives my Mom changes. I haven’t been able to contact her PCP due to the Thanksgiving Holiday weekend and the doctor at the facility has yet to contact me. The nurse at the facility told me that once someone has dementia it doesn’t go away. I am going to call her PCP first thing Monday morning and have left a message for the facility doctor to call me asap. My Mom didn’t show any signs of sundowning until she was in the hospital so I am clinging to that.

I feel for all of you because it is so hard to see your parent go through this and to believe that they are believing, truly believing what they “think” they are seeing.

Take care all of you.

My heart goes out to all of you. I know what you are going thru with the AD and the Sundown Syndrome. I just got a phone call from the nursing home yesterday saying that my mom is exhibiting symptoms of Sundowner’s. She has AD, for the last 14 years. They don’t seem to have any idea what causes it, nor does there seem to be an adequate treatment for it. Valerian or St. John’s wort are the two herbs suggested, light boxes (also used to treat seasonal affectedness disorder), closing the drapes, redirecting…all were suggested via information gathered on the internet. Factoids all and nothing in depth. I will need to do more research.

For those of you who “promised” a dying parent to “take care” of the remaining parent. Your dying parent would never have wanted you to die as a result of taking care of your remaining parent. Sometimes, you need to be realistic and many times, the caregiver DIES first. You will still be “taking care” of your parent, just in a different way. And yes, it is a lot of work having a parent in a nursing home because face it…you will NEVER find a facility who will give your parent the individual and KNOWING care that you can. That is why you NEED to go to the nursing home frequently, you need to call, you need to monitor their meds, you need to check for bumps, cuts, and bruises and if you find any, you need to ask how they occurred. You will need to advocate for your parent. Trust me, you will still be taking care of your parent. In more ways than you can imagine.

I am starting to think that the upsurge of AD has to be environmental. There are 8 people in my husband’s family who have AD, his mother and father included. So while it is on both sides of the family and COULD be genetic, for two of the siblings, their spouses also have AD. Now here’s the major thing…. They ALL grew up within 3 miles of each other, went to the same schools, went to the same church AND all ate vegetables from gardens planted in the same area. So is it consumption of produce grown in soil that maybe was tainted?? Was it some “thing” that was used during WWII?? Since it is generally more female than male, was it lead in the red lipstick they used?? And WHY is my mom the only one of her siblings with AD?? We don’t know yet. But I don’t think it is some conspiracy.

God help us all and pray for a cure. Volunteer for your local Alzheimer’s Association, find support groups, do your research, be informed and ADVOCATE ADVOCATE ADVOCATE!!

Our father recently fell and broke his hip. While he had experienced mild memory loss and has been a little paranoid all his life) prior to the surgery to repair his injury from the fall, after the surgery he became horrified that he was in prison and that someone was going to hurt him. He has never taken serious medication, only aspirin and once in a great while, a mild prescription pain reliever for toothaches. He has been in perfect health. He is 69 and still athletic. Now his whole world has been turned upside down. The fall and surgery happened less than a week ago. Yesterday, he was discharged from the hospital to a rehabilitation center for physical therapy. In the middle of the night, he threw his walker through a window because he wanted out. The staff heavily sedated him and sent him to a psychiatric facility. This is terrifying to our family. He has been such an intelligent, reasonable man all of his life. Is it possible the pain medication has heightened the memory loss issue and is causing the great increase in paranoia?

Does anyone have any suggestions or words of advice for us? We are in uncharted territory without a clue! Thank you for listening and our prayers are with all of you who are suffering along with us. Please, Father in Heaven, heal our loved ones and bring a cure soon!

The Washington D.C.-based National Council on Aging is making it easier for aging Americans or their caregivers to find information about food assistance programs nationwide.

The enhanced online help may be of particular use to those caring for an Alzheimer’s disease patient. Alzheimer’s is an irreversible decline of cognitive ability caused by the build up of plaque in the brain. Symptoms include dementia, loss of speech, deteriorating motor skills and, eventually, death. Alzheimer’s patients require increasing levels of care, eventually reaching full-time care, which can be an emotional and financial burden on the caregiver, often a family member.

The National Council on Aging has improved its Benefits Check Up service with an enhanced website making it easier to find information about food stamp programs in every state. Those programs are now called SNAP, or Supplemental Nutrition Assistance Program.

The improved web presence is timely, according to the National Council on Aging, as the current economic situation is forcing cut backs in human service programs nationwide. To help, NCOA has added the SNAP Application Forms Service to its Benefits Check Up site. In addition to food programs, the site offers help for older Americans who want to find other benefits programs for heating bills, housing, property tax relief and prescription and medical costs. The service is free.

The enhanced service allows users to find information on food programs state by state and includes eligibility requirements and application forms. Access to the information is user-friendly with an interactive map of the United States that lets you point and click to your state.

The Benefits Check Up site went live in 2001.

Researchers have found that women with a particular variation in their genes may be more likely to develop late-onset Alzheimer’s disease.

Scientists at the Mayo Clinic conducted a study of Alzheimer’s patients in two stages researching all of the subjects’ genomes. They found that women born with two copies of a variation of the PCDH11X gene, which is on the X chromosome, have a markedly increased risk of Alzheimer’s development. There was a lesser risk for those women with the variation on one of the two X chromosomes. That risk was also increased for men with the variation on their one X chromosome.

While saying more study is needed, the researchers called this among the clearest risk factors identified so far.

Dr. Steven Younkin, who is a consultant and researcher at the Florida location of the Mayo Clinic, was the lead on the project. His team found the variation in the gene by viewing the entire genome of 844 Alzheimer’s disease patients and 1,255 control subjects who did not have the disease. They then did a second-stage study to verify results with 1,547 Alzheimer’s patients and a control group of 1,209.

Researchers found the gene variation in 79 percent of unaffected women, with 50 percent of the test subjects having one copy and 29 percent having two. The next step will be to do additional study of the gene to understand how the variation in it contributes to Alzheimer’s.

The study was funded in part by the Robert and Clarice Smith Postdoctoral Fellowship; the Robert and Clarice Smith and Abigail Van Buren Alzheimer’s Disease Research Program; and the Palumbo Professorship in Alzheimer’s Disease Research.

Florida scientists say MRI scans can clinically diagnose Alzheimer’s disease by locating changes in the brain, particularly reduced size in the mid-brain region.

“We advocate, based on these findings, that the criteria for the diagnosis of Alzheimer’s disease should include MRI scans,” said Dr. Ranjan Duara, who was the lead author of a study by Florida’s Alzheimer’s Disease Research Center. “By incorporating MRIs into the assessment of patients with memory problems, early diagnosis can be standardized and done far more accurately.”

Duara works at Miami’s Wien Center for Alzheimer’s Disease and Memory Disorders at Mount Sinai Medical Center where he is medical director.

As the most common cause of dementia, Alzheimer’s disease is often indicated by memory loss, disorientation, and deterioration of reading and speaking skills. Because other syndromes or disease’s share these symptoms, often the only way, previously, to confirm Alzheimer’s disease in a patient was by autopsy, which would show the affected brain area.

Previously doctors only used a brain scan to rule out other possible causes of the Alzheimer’s symptoms, such as a stroke.

Researchers studied 260 people in the Miami and Tampa, Florida, areas who were suffering some memory loss. The MRI showed atrophy in the brain regions commonly associated with Alzheimer’s and helped researchers accurately diagnose that the memory loss was from the disease and not from other sources.

Additionally, the study showed that MRIs can spot shrinkage in the brain of people not yet showing signs of Alzheimer’s. These patients began showing this signs as little as two years later, suggesting the scans can be an early predictor of the disease.

The study was funded in part by a National Institute on Aging grant.

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