This generally occurs daily around 3 PM. The previous resident died a couple of months ago and there is now a new resident. Mom is constantly going into the room. The staff have tried patience in letting her look around the room and then try to remove her; tried stopping her before she enters the room and still she becomes aggressive. She was put on an anti-psychotic drug 3 weeks ago however we were advised it could take up to 6 weeks before we see a change. If we can't curb this behaviour she will be permanently kicked out of the Home. She just returned after 18 days in hospital where they stabilized her meds since the NP at the Home made the decision to reduce her prescribed dose of Seraquel.
It sounds to me like the hospital did NOT get her stabilized if the aggression is continuing. Consult the psychiatrist.
Sundowning is a descriptive term rather than a diagnosis.
Alzheimer's Compendium (endquote)
At the onset of sundowning. The demons of anxiety, anger, fear, hallucinations and paranoia come out. Sundowning is unpredictable, up and down cycles are present during day and night.
It is difficult for carers to accept a clent's mind is damaged by Alzheimer's Disease. Not only is memory damaged their ability to process thoughts is impaired. This is true for all stages, we never know until the damage is revealed unexpectedly.
Alzheimer's Compendium(QUOTE) Broadly speaking, sundowning is a cyclical increase in agitation (which may include restlessness, confusion, disorientation, wandering, searching, escape behaviors, tapping or banging, vocalization, combativeness, and/or hallucinations) that takes place at roughly the same time every day. Despite its name, and the wide-spread belief that sundowning occurs in the late afternoon and early evening, studies have found that the peak of sundowning activity is more likely to occur in the early- to mid-afternoon (e.g., around 1:00pm), while in some patients, it may occur late at night. It may even peak in the early morning in a fairly high percentage of patients.
Learning person-centered care techniques sounds like a lot of hard work and effort. Actually, the sooner the caregiver begins learning “how to speak Alzheimer’s”, the better off everyone will be, and the less likely that behavioral problems will crop up. Studies have repeatedly shown that caregivers trained in non-drug interventions can not only reduce the frequency and severity of behavioral symptoms and produce higher quality of care.
(endquote)
For all my life past about years old, my Mom was combative and paranoid and in the middle of night be heard maniacally humming and rhythmically rubbing her kitchen counter in a circular motion. It was so frigthening to me, and always, always blame but I could see her snake-frightened eyes. Now you've given a new idea -- that my Mom had some sort of brain damage that emulated this sundowning in Alzheimers. Anyways, the anonymous poem at alzcompend.info shot a dagger in my heart, cathartic. Thank you so much.