My mother sometimes address people in her room and has conversations with them. We told her doctor and she started that this is called "sun downing" and that it typical for older to seniors to experience them. Anyone else encountering this with a parent? If so, how do you handle it?
My mother had vascular dementia, but did not experience sundowning. She did, however, invent an imaginary husband and would carry on both sides of her conversations with him, including adopting a deeper voice when he was "talking."
The way you handle it is to go along with it and don't argue about whether the people are there or not. Those "visitors" bring your mother comfort and companionship. My mother's imaginary husband became part of the family, and we'd ask what he was up to, how his work was going, etc. At the end of her life, my mother's caregivers told me she weathered the pandemic lockdown better than most residents because "Dan" never left her.
If it has been awhile since your Mom had her last UTI test, this can be done at her primary doctor office or even at urgent care. If the test comes back positive, the infection can be treated with antibiotics.
My Dad had sundowning, but for him it was liked he climbed into a time machine and went back to the 1940's. He would call me at home and tell me the office meeting ran overtime and he had missed his bus back home, so he will stay at the hotel [the hotel was his room at the senior facilities]. What I did was just go along with whatever he said, and not correct him.
My mother had advanced dementia *thought to be vascular* by the time SHE was Sundowning in the late afternoons, insisting her dead relatives and mom & dad were alive and being 'hidden away from her' in the Memory Care AL she lived in. THAT is why she was experiencing Sundowning: it was dementia related and that level of agitation & anxiety was treated with Ativan to calm her down some. Sundowning is common to ALL dementias, not just Alzheimer's Disease.
You handle this by demanding your mother get tested for dementia immediately, either with a SLUMS test or a MoCA test which is 11 questions that evaluate memory, attention, visual-spatial function, and executive functioning. It's scored on a 1-30 point system as follows:
SLUMS scores are interpreted as follows:
27 to 30: Normal in a person with a high school education
21 to 26: Suggest a mild neurocognitive disorder.
0 to 20: Indicate dementia.
My mother first scored an 18 on the SLUMS test and was diagnosed with progressive dementia, which was spot on. She progressively worsened over a 6 year period and then passed away when her dementia was quite advanced and her heart gave out. The Sundowning she experienced from year 5 and on, but it got VERY bad in the final year of her life.
Your mother can also be tested for organic health issues such as a UTI which can cause confusion in elders, but once that's eliminated, you're left with dementia testing as your next course of action.
My 'uncle' George just passed at almost 102 and had no 'Sundowning' whatsoever. The things doctors chalk off to 'old age' is disgusting these days.
Wishing you the best of luck getting mom properly diagnosed.