About Sundowners Syndrome
Sundowners syndrome is a condition seen mostly in people in the early stages of Alzheimer's disease or dementia. Someone with Sundowners syndrome will become confused and agitated in the late afternoon and onset of evening, a state which makes them angry and upset with their caregivers. At one time the belief was that Sundowners syndrome was the result of people with Alzheimer's or dementia having their body clocks thrown off by the sun going down. But it is now thought that the drugs used to treat their ailments combine with the stress from having much lower brain function produce this syndrome.
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Theories
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While there is much to be learned about what causes Sundowners syndrome there are plenty of theories as to why it occurs. One is that the daily grind of trying to cope with Alzheimer's or dementia can become too much for elderly people by the end of the day. This theory deduces that this builds up into an overload that brings on the mood swings associated with Sundowners. Once the sun comes back up these symptoms usually go away. Other theories include hormonal imbalances as a possible cause and others attribute Sundowners to either fatigue or being unable to see as well in the dark. The "stress combined with the medications for their condition" theory is beginning to gain more steam with medical experts.
Symptoms
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The symptoms of Sundowners syndrome, which is also called Sundowning, differ from patient to patient. There can be incredibly quick mood swings and the person may become angry or fearful. Pacing and crying is common and they may often become stubborn and refuse to comply with their caregivers. They may rock to and fro in a chair or become restless, with some people even suffering from hallucinations. In extreme cases, a person may become violent or attempt to leave wherever they are being cared for.
Other signs that someone is dealing with Sundowners syndrome include the patient following a caregiver around and mimicking everything they do. They may keep asking the same questions over and over and interrupt people. Their ability to understand or communicate may be compromised and sleeping may become difficult for them. People with Sundowners syndrome have been known to hide things away for no apparent reason and they also undergo frequent bouts of paranoia. -
Treatments
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Medications are often used to attempt to treat Sundowners syndrome. Anti-psychotic drugs such as Haldol can calm down people with this condition. Music has been employed to attempt to soothe agitated behavior, as has aromatherapy. Touching a person with Sundowners can work as long as he is not engaged in violent behavior; holding his hand or massaging can be relaxing for him. Recorded sounds such as birds singing or waves breaking in the ocean have also been known to appease people with Sundowners. Light therapy has also been utilized, with the idea being to imitate sunlight with an artificial device such as a lightbox.
Advice for Family Members
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There are some things that people can try to reduce the effects of Sundowners syndrome, which can put tremendous strain on family members and caregivers. Patience with the individual is first and foremost, since in the morning they often do not have any recollection of whatever they did the evening before. Caffeine should be reduced or ingested by someone with Sundowners only in the morning hours and having people with this problem exercise during the day may take some of the energy out of them at night. Establishing a firm routine at night when they prepare for bed may go a long way in quelling their fears.
Speaking to a Sundowners Patient
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Better results can be achieved with someone suffering from Sundowners syndrome if activities that require energy and thinking are scheduled for the morning hours and they are told in advance what they will be doing. When they become irritated from Sundowners it is prudent to ask questions that can be answered either "yes" or "no" when trying to discover if they are feeling okay. It is also advisable to tell the patient with Sundowners what you wish them to do rather than tell them what you or other caregivers do not want them to be doing. Never show that you are angry or frustrated to someone with this condition as it will only makes things worse for your relationship in the long run.
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