What do we do about mom and her outbursts/anger at night?

Question

What do we do about mom and her outbursts/anger at night?

Follow

Share

Mom is in a facility so we don't see what happens when we aren't there. She is fine during the day but at night, her personality changes, from what I am told. She doesn't have a mean bone in her body. But this dementia, or the people who have worse memory issues than she does, is either making her worse or something. I was told that she could have sundowners. She doesn't wear her glasses, which is fine. Now she won't wear her hearing aids again. They are new. I don't think that the employees know how to deal with people like her. Although, I do like one of them. One of the care givers tonight when I stopped over, told me that she hit one of the caregivers when she either tried to give her the morning meds or tried to put on her hearing aids. She doesn't have any problems with me. Does anyone else deal with situations like this? I would love for her to live with us but I think that I would be in for a larger responsibility than I can handle.

Alzheimer's & Dementia Care Decisions Sundowner's Syndrome Violent Behavior

This question has been closed for answers. Ask a New Question.

31 Answers

Most
Helpful Newest
First Oldest
First

1 2

Lots of elders with dementia and Alzheimer's have great difficulty as the sun begins to set, aka Sundowners. You don't say what type of place your mom is in, ie: Memory Care Assisted Living or Skilled Nursing, etc, but the staff should definitely be very familiar with behavioral changes among residents in the evening hours, including aggression. My mother is in a Memory Care community where most of the residents are in worse shape than she is, mentally. So........they can get knocking on her door, thinking it's their room, which sets my mother off into a fit of fury like I've never witnessed before. She screams and yells and calls them horrible names instead of simply letting them know they're in the wrong place. Dementia has no rhyme or reason to it, does it? Please do NOT consider taking your mom home to live with you...........it's just too much to deal with as they progress down this road and worsen.

If your mother is refusing to wear her glasses and her hearing aids, then she's likely to be having even more behavioral troubles as she will have difficulty knowing where she is in space. Poor eyesight & poor hearing = trouble. If the care givers can find an effective way to help her on with both of these items, she'll be much better off.

Here is a link to some useful info about Sundowners:
https://www.seniorliving.org/health/sundown-syndrome/

Be sure to speak to the staff at your mom's community to make sure they DO have experience with memory issues/dementia/Alzheimer's, so you can feel assured she's being properly cared for and doesn't have to placed elsewhere.

Best of luck!

Helpful Answer (8)

Report

Thanks! She is in memory care. Just like your mom. There are some people there that are calm. I talked to my mom's doctor about it and she told me that she might have to adjust some of her medicine.
I was told that if she starts creating any problems, that she will be asked to leave. She knows not to hit me. I don't want her to leave and I know that my brother doesn't either.
I would prefer she be moved to assisted living. But they need to show her again how to do some of the things for herself but they won't. Just like a little kid, if you don't show them, they won't learn?
I don't feel that they really know how to deal with people who have anger issues there. It seems all that they want are people that are calm all the time.
I was told that they told her that she should wear her hearing aids. She was told that she only needs to wear her glasses when she reads but she doesn't do that. I will talk to her again about her wearing her hearing aids. I made a sign for her about what she should do. I can just as easily get back to her in a nice way.
And don't worry,I won't bring her home with me. Still working full time and no time to take care of her properly. Plus she is with other people and with us she would be with just the cats during the day and us during the night.

(3)

Report

See 3 more replies

You may want to ask that Mom be tested for a urinary tract infection (UTI). My mom became angry, confused and combative when she had them. We had her tested monthly for them at her facility. They are common in the elderly.

Helpful Answer (10)

Report

I will have her doctor write another order. Or just tell the director of memory care to have another one done. Thanks! But would it cause that behavior at night and not during the day?

(2)

Report

See 1 more reply

Judy, has your mother been evaluated by a Geriatric Psychiatrist?

In my mom's journey with Vascular Dementia, the GeriPsych folks and the advanced practise nurses who worked with them were the best source of information and treatment. They were able to get mom on a regimen of meds that kept her calm but not knocked out.

Helpful Answer (5)

Report

No she hasn't. She was evaluated by a neuro psych doctor because she was wandering out of her apartment 3 times. And she was was confused about some things. Her doctor said that she might have to adjust her meds. She is planning on going to see her next week. Will try and let you know what I find out.

(4)

Report

My mother who had vascular dementia in her last few months of life was quite well in the day time but at night time developed these really angry outbursts against care givers, hallucinating,, was terrified, distrustful & confused. and would loose hearing aids tablets, glasses, them be reasonably fine in the day time. Our dr gave an oral medicine - Buccal Midazalone which helped calm her to a certain level and it was easy for everyone to give. He said it was the normal progression of dementia, people stay at a level for months /years and then deteriorate without explaination, Talk to the Dr/Geriatrcian regarding meds he is dependant on feedback as they don't witnesswhat was going on and meds may help her. As someone said check for any signs of infection, chest urine as sepsis will cause a lot of confusion and distress Best wishes on getting good support

Helpful Answer (9)

Report

Judy, your mom is in Memory Care? And you think she may be asked to leave if she has a behavioral issue?

That DOESN'T sound like Memeory Care.

Helpful Answer (4)

Report

My mom's Memory Care community WILL ask residents to leave if they develop a pattern of hitting care givers or especially other residents. They need to provide a safe environment for everyone.

(5)

Report

See 2 more replies

So, in MC units I've had experience with, patients will ne transferred, temporarily to a geripsych unit or "senior behavioral unit" to get meds adjusted.

Helpful Answer (5)

Report

Ok, that makes sense. The MC my mother is at, and the one I work at, neither are large enough to have other units. Moms place houses 26 residents and my job houses 56.

(1)

Report

See 3 more replies

I would be speaking to the SW and DON about these issues right away if one of the caregivers said she would be asked to leave.

Helpful Answer (2)

Report

DON?

(1)

Report

See 2 more replies

Thank you. Just hope that her doctor can figure out what meds need to be adjusted. Aricept wouldn't affect her behavior,would it? I was told that is just to help with her memory. Again, I'm learning here. That is why I ask a lot of questions.

Helpful Answer (2)

Report

My sister with her dementia was immediately placed on Namenda, and after about a year passed her neurologist added Ariceft and he started her right off on 10 mg. I’d say it did help my sisters behavior a bit. But did it help her memory from slipping further away, I couldn’t even try to answer that.

(3)

Report

Director of Nursing. I don't know much about Aricept, my mom never took it.

Judy, are you familiar with Alz.og? Even if your mom doesn't have Alzheimer's, they have loads of good articles.

https://www.alz.org/alzheimers-dementia/treatments/treatments-for-behavior

Helpful Answer (4)

Report

It definitely sounds like Sundowner's. Following your question there is a blueish green symbol with the word sundowner's syndrome. If you click it it goes to a page on this site with all of the information about the topic. I think if you read it, it will become clear that you should really take to heart your last sentence that you'd love for her to live with you but it could be more than you can handle. It seems very clear when reading more about sundowners that trying to handle this stage at home is often the proverbial straw that breaks the camel's back. If she is in a good facility you are doing the right thing by keeping her there and trying to add services/ meds there to get this resolved. Sundowning is commonly associated with Alz. If she's in memory care, employees should be equipped to deal with her and your Dr. should be able to treat based on what the care team is reporting.

Helpful Answer (7)

Report

It's the neurologist that wanted her kept on Aricept. He is going to up it to 10 mg. Not sure why, or if she even needs to. Going to start it on the 26th and see how she does. Her doctor saw that he is moving the mg up to 10. Thanks for all of your help and suggestions. This is all so new for me.......

Helpful Answer (2)

Report

You are looking for trouble if you take her home. I made that mistake & she hits, punches curses , scratches, bites me & the private pay caregiver. She also curses her. Hard to hold onto caregivers but one stays. One caregiver quit because of the physical & verbal abuse. The SNF warned me this dementia gets worse. I have to give her medicine to control agitation, but lots of times she refuses..so I have to find other ways to give it...like in ice cream or a little piece of chocolate. That she never refuses. Please don’t ruin your life by taking her home. She don’t walk or stand so we use stand assist lift. She also now don’t know when she has to do number 2. She is incontinent. You have to change her diapers. I also have had to do wound care. So this is a full time job that pays nothing & get abused to boot. Sept 24 will be 2.5 years I discharged her from SNF. I thought she was going to not live long since the bones by her neck was showing & she was picking up every germ in the SNF. But since she home, she eats better & bones don’t show anymore. I was at SNF every day when she was there. ....but there is no end in sight now with her being home. So Please don’t take her home...it will be a major mistake.
Hugs 🤗

Helpful Answer (9)

Report

Thanks! We all have our different experiences when taking care of our loved ones. At least my mom is fed healthy meals and is being taken care of very well.

(0)

Report

Teepa Snow on YouTube has been a tremendous help. She has wisdom on how to approach Alzheimer’s and Dementia. Perhaps you could recommend her to staff.

Helpful Answer (5)

Report

We are all learning. This facility has been in existence for 4 years.

(1)

Report

The same thing happened with my father, pleasant in the morning, angry at night...sometimes we would feed him in the bedroom and put medicine in his food or drink as if he came out to the kitchen table he would not go willingly back into the bedroom and would refuse to walk. Also the deal with his hearing aids, brushing his teeth, drinking, or holding drinks in his mouth. My husband used to put on some Italian music for him and it would calm his nerves..he would tap his feet and hold his hand...it kept him more calmer at night, so perhaps her favorite music?

Helpful Answer (4)

Report

When she eats, she is okay. I did hear that one time, she refused to go and eat breakfast. I know that all they want is for them to have 3 healthy meals. They even give them choices of what they would like. Still hard to see my mom at 88 years old and in this situation.

(1)

Report

Honestly, I would try to figure out, if there is anything at night that causes anger. It could be health issues or fear. Did she really hit someone or is it profiling. Take one step at a time. Try to put the puzzle pieces together. Certain health problems can cause anger, have that checked out. Did something, in her life, ever happened to her at night. Is someone abusing her. One never knows. The things I know, you don't want to know what they are doing to older people. The things they have done to me to cover up deliberate mistakes. Attacks, profiling & darn right lies. A police officer did stick up for me & told me the little bit of proof I showed him was more than enough. All proof of anything, did not put on line, because of fraud & theft, but get a good filing system too heavy to pick up or nail it to the floor!!!

Helpful Answer (1)

Report

Thanks! There is only 1 person that I don't feel should be in that location where she is. Different kind of personality. She is nice, but young and she is still learning. At least they are making sure that she gets her showers and that there are no bed sores. I am in contact with the manager there and the director of the facility.

(0)

Report

Consistent routines and calm demeanor of all caring for her are the best for dementia patients. She probably is more confused and tired in the evenings so things seem more threatening to her - Sundowner's Syndrome indeed. They may have to get her ready for bed earlier than usual. If her behavior is threatening staff, tolk to her doctor about mild antianxiety agents to help her relax in the evenings.

Helpful Answer (1)

Report

She wears hearing aids and I don't think that they were putting them on. They told me that she didn't want to put them on. But to me, it depends how they would talk to her. I don't have a problem with her but then I'm her daughter. Her behavior isn't threatening. Just getting used to being taken care of. For years, she took care of herself. I know that they aren't telling me things that I should know. And hopefully, they are telling my brother about it. She was supposed to be taking some melatonin to help her sleep at night but not sure if she is still taking it or not. Sleeps in her recliner during the night. Not the bed. :)

(0)

Report

Oh Boy, having her live with you is the very last thing I would do. The people who are taking care of her are clinically trained, let them handle her. She is just in another stage of her disease, there is no getting better at this point.

Helpful Answer (4)

Report

They are doing the best that they can. At least I don't get anymore texts about her. Only one caregiver did that. But I think that they are having more caregivers there due to the fact that they have more people in the memory care area.

(1)

Report

First of all, please understand that dementia is not just a "forgetting" disease. Many aspects of the person is impacted. Their entire behavior might change in addition to memory loss. Some people become withdrawn and others become violent. There is no predicting nor preventing or controlling the behavior. Sundowning is very common. They frequently become more agitated then, and might be more prone to act out. Striking out physically is more likely to be then than first thing in the AM, although as you have learned, they might try to hit someone at any time. I'm sorry there isn't more I can say to help. If you don't feel her caregivers are up to the task, it might be time to move her to a specialized facility where people are specifically trained to deal with patients in that stage of disease. At this point, moving her into your home is the last thing I would recommend, especially if you have children. You certainly do not want to put them at risk.

Helpful Answer (5)

Report

Thanks! I think that they are just getting used to her and they to them. She usually isn't agitated unless provoked. Been trying to keep her hearing aids in, at least I hope that they are.

(0)

Report

See 1 more reply

This happened to my mom. It was Quite unsettling. Yep urinary infection.

Helpful Answer (1)

Report

They do try to make sure that she cleans herself when she takes a shower. Wish that I was there with her but I have to trust the caregivers there.

(0)

Report

I was caregiver for my Mom in her condo before I needed to place her in a Memory Wing of a care home. Yes, what you are saying is Sundowning. Each person exhibits it some what differently, but yet the same. I can not begin to tell you about all the things my Mother said and did. The Memory section of the home was the very best for Mom. She would have needed 24 constant care/supervision etc by a skilled person if remained at home, of which there was no way humanly possible I could do. Dementia/Alzheimers is a journey of changes, many happen fast. The main thing through it all is let her know you love her with your kind words, hugs and kisses. It is not easy for you, I know, but as the child of a parent that is going through this, we are now the parent giving the comfort and love as they once did to us when we were little children. However they could correct us when we did something wrong or unsafe, where with this disease....we can't correct them, they can't learn and it would make it worse. There were times my Mother would say or do things that would make me laugh about it when I got home and those times I still remember along with all the many good times through the years. I know it is not easy, but try to focus on those times.. My Mom passed away over 10 years ago at age 94. Now my husband is in the mid stage of Alzheimers. I know from my experience with Mom, things can change in an instant, so live in the now. I wish you and your Mom a very sunny day, filled with love. I hope I was able to be of help to you.

Helpful Answer (7)

Report

I had to hug my mom to get her out of her anger and it worked. Also working at them putting her hearing aids put on daily. I always hug my mom and tell her that I love her each time before I leave to go home. Having her hearing aids in are such a big help. Hard to me to remember to clean them but I am doing the best that I can whenever i am there. The caregivers there have a lot that they are responsible for and the little things that I can do for my mom, I will.

My mom/we were told that she has mild unspecified for years. She is 88. And her doctor said that she will have good and bad days. It is expected. Shoot, I have my good and bad days too. :)

(3)

Report

My mom became a little more agitated when her night time medication was stopped, so her doctor put her back on it. See if that is what is needed. I've watched new and old residents move in and out of my mom's assisted living place. Most who had to leave when their care got too difficult were the wanderers and the hitters, then they went to memory care, but your mom is already there, so I would think that is where, between her doctors and staff, her needs should be dealt with. Did you see the posts on sundowners? Lavendar filled cotton balls in a cup calms people.

Helpful Answer (2)

Report

I got her some lavender airwick solid. She also has some sleep lotion from BBW that a good friend of hers bought for her. Her doctor is going to go and see her this week and possibly adjust her meds. She doesn't take that many either. She was originally put in that dept just to get her in there. And where an assisted living apartment because available, she could move in there. But things changed when they found out that she wandered 3 times. That is another long story. Considering she is 88, it won't hurt her to stay where she is. Another time of moving might hurt her even worse. She is getting adjusted to where she is. My brother wants to move her after 6 months due to finances. He doesn't understand the severity that it would cause if he decides to move her again. But all if in God's hands. And the facility where she is.

(0)

Report

Most employees are trained to deal with these issues so stop worrying about that - your mom isn't the first one to be like this & unfortunately she won't be the last either - she probably finds the glasses & hearing aids as intrusions in her personal space [which they are] so when someone else tries to make her wear them then it is extra intrusion ... think about from this perspective as you may see what she is on about [sometimes]

Helpful Answer (3)

Report

Thanks! She does the hearing aids okay just not the glasses.

(0)

Report

See 1 more reply

Have you taken your Mom to a neurologist? The anger & lashing out is very problematic & is VERY possibly there! Sundowners.
my mom was giving Quetiapine (seroquel) for her fits of rage & sleeplessness. My Mom has taken swings at me multiple times.
The staff knows of sundowning but probably can’t do anything about it. You’ll have to make that step to help her in helping them, medication.
A friends Mom used to get violent but because they had never researched, they didn’t know what to do & would instead take her to ER. That’s how bad this mood swing can get...the hospital would end up sedating.
It sounds like you need to take this info, from caregivers, to heart & research! They need your help if you are your Moms POA.

Helpful Answer (2)

Report

She has been seeing a neurologist. He said earlier this year that she had dementia because of some of the things that he could see. There is a long history about my mom that is too long to put on here. She was fine last year before she moved. She has been at her location for almost 3 months with hardly any problems except for this couple of times. I did talk to her doctor about it and she said that she might have to adjust her medication. She also wears hearing aids and just got a new pair a couple of weeks ago. Plus the caregivers are learning how to make sure that they are put on daily. So far, she hasn't hit me at all. She might go to the upset stage but just sit there and close her eyes.
My brother is her POA. I am her healthcare rep. But they go between the both of us for issues. Plus they have been hiring more caregivers because they have a lot more people there than they did when she moved in there.

(0)

Report

You have some great advice here. Wishing you the best.

Helpful Answer (2)

Report

Be involved with her care. Talk to supervisors and/or MD staff.
Perhaps she needs medications changed to manage her brain chemistry.
It is certainly possible that line staff do not know how to deal with your mom in an appropriate manner - with the stress they are under. I would encourage you to not 'just' let the staff deal with her as some here are advising. If I were you, I'd ask to speak to the MD/medical professional in charge.

Helpful Answer (2)

Report

There isn't a medical professional in charge. I have talked to her family doctor and she will take care of monitoring her meds.

(0)

Report

Hi Judy
Doubt that your mom with dementia will ever be able to live in a regular assisted living unit. Memory Care Unit within an an AL could work until dementia becomes worse. The drugs Namenda and Aricept, have been used for years to help slow progress of Alzheimer's disease. Having worked with patients who took these meds, I would say results are mixed. Nothing works for everyone! At a point in the progress of the dementia, the above meds are most definitely not going to help! But there are other medications that can help with combative behaviors and also drugs to help sleep patterns.
Also remember that sundowning behaviors can partly be caused by waning of light, increased shadows, and fear. (Many other reasons too)

Helpful Answer (1)

Report

I had pain for osteo arthritis and my doc perscribed CBD oil, just 2 drops at bedtime. Didn't do much for the pain but made me very very relaxed and sleepy. Maybe CBD oil could help your mom against outbursts.

Helpful Answer (1)

Report

My mom, I think, is just getting used to where she is living. A big change from being on her own all of these years. She is 88 and have been widow for 23 years.

(0)

Report

This may indeed be sundowners. A neurological exam may be in order.

Helpful Answer (0)

Report

Focusing on the behavior first:

Having read through most of the comments (focused more on your posting/replies, the previous comment if context needed) I agree with 2 things others have said:

Test for UTI
Sun-downing

These *MIGHT* be related. Our mother, when living alone, didn't have traditional sun-downing symptoms, but rather ever longer OCD behaviors later at night, just before bed (we had camera that caught all this!) She is in MC now (3 years in January.) Around mid-year last year, she developed some serious sun-down symptoms (posted more in response to another/your question if it only happens at night.) It WAS UTI related AND behavior was only later day/early evening. She was always begging to go home regardless (less now) but in general was mild-mannered, well behaved, so this was out of the ordinary for her.

You indicate mom has been there about 3 months - is this a recent behavior change? It could be one or the other or even both UTI/sun-downing. The UTI test is simple, cheap and can rule out that as the cause. She may not need any other medication changed, but in our case mom got Lorazepam (anti-anxiety) to take the "edge" off. It was the smallest dose, only one later in the day if needed for the sun-down behavior, and once UTI was treated, we haven't needed it again. It works quickly (10-15 min, even the first time), doesn't "dope" her up and took care of the behavior.

There is also discussion about moving her to AL - she IS where she needs to be, in our opinion. She has already wandered from her previous place, and there are NO restrictions to coming/going in AL, so there won't be anyone around to prevent her wandering off, which she WILL do. Additionally, every move is hard on those with cognitive decline. She is where she will need to be, I would not move her. She is also only recently moved - it can take a long time to adjust fully. Mom sometimes either doesn't realize this is "home" or forgets where her room is (first one around the corner from the LR/TV area and mere steps away from the hallway bathroom, who she is on intimate terms with!!! :-D

When I joined this forum, I didn't believe the UTI posts, but now having experienced it, I am a believer! Additionally, she recently had night-time bed wetting, which is also not her norm, and sure enough, UTI. Clearly it was, because now that it is treated, the bed wetting has stopped.

Also, no matter how clean they (or she) might think she is, UTIs are so easy for elderly to get. Merely wiping "the wrong way" can introduce bacteria and the older we are, the less able our bodies are to ward off the infections.

Helpful Answer (2)

Report

Thanks!

(0)

Report

Some confusion from your posts:

"I don't want her to leave and I know that my brother doesn't either."
VS
"My brother wants to move her after 6 months due to finances."

Although you are not POA for finances, you two have to work in conjunction. Have you been able to discuss the financial concerns with him? If she truly doesn't have enough funding to stay beyond 6 months, this needs to be dealt with NOW!

Would her income be low enough to qualify for Medicaid?
Does the facility she is in accept Medicaid?
If she is over the income for Medicaid, what are the alternatives?

Moving her might not even be an option - while costs can vary, if she is in dire financial need, there isn't likely to be another place she can afford. AL & MC certainly are not cheap, and are usually in the same dollar bracket per regional area. Hiring in-home care is usually MUCH MORE expensive and finding good aides is difficult at best ($25/hr x 24hrs x 365 = $219,000! Mom's MC is less than half that - we're in a more expensive but not the most exp region.)

Helpful Answer (2)

Report

Thanks, something to think about. I just feel that it would affect her more than my brother knows. The executive director e-mailed my brother but he never got back to them. I don't know why either. He is her POA and until the new healthcare rep form is notarized, he is still her healthcare rep. I don't think that her atty thinks that I will do anything further. She understands what I am telling her. Meaning that her dementia isn't as bad as some would think. She was initially put in memory care to at least get her into the facility and when a room became available in the assisted living side, she would move up to the top of the list because she is already living there. She is 88 and had a stressful time with the move last year. Sold the house in 1 day and 30 days to move out. She is slowly improving in some areas. No, she will never be the same mom but she isn't a spring chicken anymore either.
I would be thinking about having someone stay with my mom during the day then she would be with us during the evenings. But then I know that I would eventually overwhelm myself with the responsibility and work. I am just awed how some people are able to take care of their parents full time. Have to quit their jobs,etc.

(0)

Report

See 1 more reply

1 2

This question has been closed for answers. Ask a New Question.

What do we do about mom and her outbursts/anger at night?

31 Answers

Recent Questions

Popular Questions

Related Questions