Sundowning, or sundown syndrome, affects some people who have Alzheimer's disease and dementia. People with dementia who "sundown" get confused and agitated as the sun goes down -- and sometimes through the night.
Sundowning may prevent people with dementia from sleeping well. It may also make them more likely to wander. Due to the stress it puts on caregivers, sundowning is a common cause of caregiver burnout.
1. Are there any medications that someone with Alzheimer's disease should avoid?
A person with Alzheimer's disease may be taking medicines to treat symptoms of the disease as well as other health problems. However, when a person takes many medications there is an increased risk of having an adverse reaction, including confusion, agitation, sleepiness or sleeplessness, mood swings, memory problems, and/or stomach upset.
While it may become necessary for a person to take medicine to treat the severe symptoms of Alzheimer's disease -- such as hallucinations or aggressive behavior -- some of these medications can worsen other symptoms of the disease. For example:
Some drugs such as tranquilizers can cause confusion, increased memory impairment, and slowed reactions, which can lead to falls.
Certain medicines to treat depression, such as tricyclic antidepressants, can cause sedation and other side effects.
These drugs also can react with medicines used to treat Alzheimer's disease, including Aricept, Exelon, Namenda, and Razadyne.
Some medicine used to treat hallucinations can cause sedation, confusion, and drops in blood pressure. They also can react with medicines used to treat Alzheimer's disease.
It is important to discuss the pros and cons of these treatment options with your doctor before making a decision regarding medication. In addition, it is important to consider the possible side effects of over-the-counter medications, including cough and cold remedies, and sleep medicines. These drugs may also react with other medications taken by the person with Alzheimer's disease. It is best to consult your doctor before using any over-the-counter medication.
2. I'm thinking about taking a trip with my father, who has Alzheimer's disease. Is there anything special I should do?
When traveling with someone who has Alzheimer's disease, it's important to plan ahead and try to anticipate the person's needs so you'll be ready for any changes or problems. As you plan, be sure to consider the stage of the person's illness and any behaviors that may be affected by traveling away from home. You may want to try taking a short trip to see how your loved one reacts to traveling. Here are a few other tips to consider:
Plan some activities for the person with Alzheimer's disease to do when traveling. Simple things -- such as reading a magazine, playing with a deck of cards, or listening to music -- can help keep your loved one calm when traveling.
Never leave a person with dementia alone in a car. When moving, be sure to keep the seat belt buckled and the doors locked.
Plan regular rest stops.
Bring an extra driver if your trip involves more than six hours of driving time.
If the person becomes agitated while traveling in a car, stop at the first available place. Don't try to calm the person while driving.
Consider planning your vacation at a place that is familiar to the person with Alzheimer's disease; for example, at a lake cabin that he or she has visited in the past.
If your loved one is easily agitated, it may be wise to avoid places that are very crowded. You may also want to avoid fast-paced sightseeing trips.
If your loved one has never been on a plane, it may be wise to consider driving, if possible.
Alert the airlines and hotel staff that you are traveling with a person who is memory-impaired and make sure the person is carrying or wearing some sort of identification.
Don't forget that your caregiving responsibilities continue even though you are on vacation. It may help to bring someone along who can help you with these duties.