By Dr. Maria Simbra

PITTSBURGH (KDKA) – More than 5 million Americans are currently living with Alzheimer’s disease and other forms of dementia.

For some of them, their confusion seems to be worse at night.

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This is true for Jan Klein’s mother, Fran, who has Alzheimer’s disease. Sometimes, Fran gets more confused when the sun goes down, which is something called Sundowning.

It’s thought to be related to light cues, daily body rhythms and perhaps end-of-the-day fatigue, but no one really knows why it happens.

“Sometimes she feels she has a baby, she’s looking for a baby, or she’s looking for her husband that passed, she’s looking for her way home, she wants the bus,” Klein said. “Sometimes it could happen in the early afternoon, and it just gets worse and worse.”

Sundowning is more common than you might realize and often only comes up when doctors specifically ask about it.

“Especially later in dementia…up to 25 percent, and I think it varies in severity,” Allegheny Health Network Neuropsychologist Dr. Carol Schramke said. “They will not recognize family members, may start hallucinating, may get very agitated.”

In some instances, they may become so agitated that they are given sedatives.

“Some of the medications can actually make behavior worse,” Dr. Schramke said.

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This happened to Fran in another facility.

“She was so overmedicated. She couldn’t function. She couldn’t walk. They said she was on her last stages of dementia, and she would not walk again,” Klein said. “I kept saying, it’s the medicine, it’s the medicine. And they thought I was in denial. That I didn’t believe my mom has dementia. And I know she has dementia, she was just being over drugged.”

However, there are non-drug strategies.

“Instead of medicating her, they give her an iPod, and she starts listening to music, and she loves that,” Klein said.

“Rather than argue with them about whether today is Tuesday or Wednesday, or whether someone was just here or not, to just…you certainly don’t want to encourage somebody to think something that’s not correct. You don’t always have to challenge it,” Dr. Schramke said.

“I look into her eyes, hold her hands, and just tell her it’s going to be okay,” Klein said. “Just have patience. And treat your loved one just with love and respect because that’s what they need.”

If you notice an increase in sundowning, or any sudden behavioral changes, mention it to your loved one’s doctor.

Sometimes, it can be the sign of another health problem, like a urinary tract infection, which can be treated.

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