When Mom is angry, there is no reasoning with her: Alzheimer’s has robbed her of that intellectual function. Come the late afternoon, Mom’s righteous anger and indignant demands to leave the apartment are hard to defuse. We think she’s being affected by Sundowning Syndrome.
It is common for Alzheimer’s patients to become agitated, aggressive, anxious or confused when the sun begins its descent. It seems that the fading light and increased shadows disrupt the internal body clocks of people who have mid- or advanced dementia.
“Sundowning isn’t a disease, but a group of symptoms that occur at a specific time of the day…. The exact cause of this behavior is unknown,” writes Dr. Glen Smith on the Mayo Clinic’s website.
Great. And how do you keep your mother inside on a sweltering day when the temperature soars to 40° Celsius? That’s 104° Fahrenheit!
Mom insisted she had to go out and meet her friends. Daddy was so frustrated that he called me to confer. The argument that they were going out later didn’t help. Neither did Mom comprehend he severity of the heat wave we were experiencing.
When I spoke to Mom, she angrily told me that she was locked up against her will and that she was being deliberately prevented from going out. She then yelled about needing to meet someone outside. At that point, the conversation became nonsensical.
Mom was right about being locked in. Their door has an extra top lock that she doesn’t have a key for and can’t unlock. I’ve seen her try to unlock the door before. Sometimes she puts the wrong key in the lock and rages when it won’t open. Other times she stands there and rattles the door with all her might. What would happen if she got out without our knowledge? It would be disastrous if she went out by herself. Not only is there the possibility of her getting lost—or hurt—but if we couldn’t find her, she would undoubtedly panic. I can’t even imagine the level of fear and stress she would experience.
I suggested that Daddy put on Mom’s favorite concert video of Danny Kaye conducting or some equally whimsical movie. I also thought that going outside with her wouldn’t be so horrible. Despite the extreme heat, they could walk around the building or walk down the block and then go back up to their apartment. On a cooler afternoon, there is nothing wrong with taking a stroll along the cliff top overlooking the sea.
Tips for preventing Sundowning include reducing afternoon naps, refraining from caffeine, exposing Mom to more sunlight during the day, playing soothing music, sticking with familiar patterns and routines, and reducing background noise.
I have no doubt that Mom would benefit from receiving more attention. I am not close enough to where they live to pop over and sing with Mom, but I imagine that that would appease her. Unfortunately, she repels the attention and assistance offered by their caregiver.
In the meantime, Daddy is doing his best to keep her safe. The night he called, after watching a little bit of the Danny Kaye concert, they ate dinner early—a good distraction—then really did go out. By the time they sat down to dinner, Mom had forgotten about the whole incident.
It is unclear how often Mom will have these reactions or how long this sundowning behavior with continue. It is not easy, but we must try to focus on the fading yet vibrant multi-hued beauty of Mom’s sunset.
I seem to be on a cauliflower kick. Maybe because this vegetable looks so much like a brain. I wish that dealing with Mom were as easy as manipulating cauliflower into any number of recipes. Sadly, Alzheimer’s brains are harder to whip into shape.
Cauliflower Patties
When our friend Sharón needed a place to stay for the night, we were happy to put her up and feed her dinner. As Sharón is a vegetarian, I didn’t think she’d enjoy the meat dish I was making. Here’s what she ate instead.
½ head cauliflower, cut into florets
1 egg
¼ cup parsley, chopped
2 cloves garlic, minced
¼ cup crushed walnuts
Salt and pepper to taste
1 Tbsp olive oil for frying
Directions:
In a small pot, steam cauliflower until soft. Mash cauliflower, then add remaining ingredients. Spread a thin layer of olive oil in frying pan. Form mixture into patties and place in frying pan, browning on both sides, approximately 15 minutes. Remove from heat. Eat!