How can we cope with my dad's severe sundown syndrome?

2 answers | Last updated: Sep 14, 2017
Lolli asked...

My dad gets sundown very severely and it has been happening since he had a battle with pneumonia, sepsis and shingles. He has a very bad back condition which has been aggravated by sitting and lying too much. The shingles were very severe on his bottom and swell up his rectum and front also so he needs a catheter until the swelling goes down. The hospital and rehab centers do not stop giving him antipsychotic drugs and/or Ativan to stop his anger at night which in turn makes him sleep all day. He is ambulatory when awake. The doctor in the hospital now has increased his Namenda to 10 mg twice a day and taken away Aricept due to some afib and they have started him on 125 mg of Depakote three times a day to even out his moods. If he did not have such anger at night we could take him home, any suggestions?

Expert Answers

Beth Spencer is a social worker in Ann Arbor, Michigan, with more than 25 years of experience with families who have a member with dementia. She is coauthor of Understanding Difficult Behaviors and Moving a Relative with Memory Loss: A Family Caregiver's Guide. Previously, she directed Silver Club, early-stage and adult day programs serving individuals with Alzheimer's disease and related illnesses.

Your poor father has a lot on his plate. Most of us would feel angry and frustrated dealing with the pain and discomfort he must be feeling at night. It sounds as though his physical care needs are quite high. Is it realistic at this point to think about caring for him at home? It may make sense to see if the medication prescribed will help his mood swings and to wait until the swelling is gone and he can get along without a catheter. Generally residential care is better able to handle out-of-control anger than family at home, even though they often do it with medications. I would be inclined to wait and see whether his anger subsides with his medical conditions before trying to cope at home.

Community Answers

Jennifer meagher rn answered...

Hi Lolli,

My heart goes out to you! I am a geriatric care manager and RN. most people with dementia become highly irritable and have an increase in their confusion, sometimes to the point of hallucinations, when there is acute pain or infection. Your dad isn't himself right now, and you'll need to wait for his conditions to clear, to find out how much improvement, if any, he will exhibit. The health team is trying to use medication to turn his cycle around. It may be time to call for a care conference and bring up all your worries. You may want to hire a geriatric care manager to be present at this meeting. It helps to have a third party listen in, advocate for you and your dad, and be a voice of reason for everyone.  It may be a couple months or more before he is stabilizing. Good luck to you and your father!