Page 14 - Leisure Living Magazine: Spring 2020

What Is Sundowning Syndrome?
By Theresa Bowen, Ph.D., Email - theesajb@gmail.com
Sundowners’ syndrome is a controversial phenomenon care- givers should know more about
if they care for someone with cognitive decline such as Alzheimer’s disease. According to Ag- ing Clinical and Experimental Research (2016) early evening disruptive behavior, also known as sundowning, has been reported to the medi- cal literature without a consistent diagnosis and criteria to define the phenomenon. It is essential for caregivers to understand what sundowning is and what it is not. Currently there is not a for- mal definition that everyone in the medical field agrees on. Once you know more about how and why this syndrome gets related to certain behav- iors you can take actions that may lead to a better quality of life for your loved one. Technically sun- downing syndrome is not an illness. It is a group of symptoms of observable behavioral problems that occur late day or during the nighttime. This phenomenon is reported to affect up to 20% of people with Alzheimer’s disease.
Have you ever been restless and irritable after a long day that has left you overtired but unable to relax or rest? Many normal adults may expe- rience this sometime in their lives or regularly due to poor sleep, stress, and busy schedules. So becoming moody when the sun goes down may be a common human experience. Thinking about this from your loved one’s point of view may help you understand as a caregiver what they are go- ing through. Picture their frustration when they are asked to do a task they can’t remember how to do late in the day while struggling to tell you their own needs. Observed behavior described by caregivers of sundowners’ include restlessness, agitation, anger, paranoia, confusion, wander- ing, screaming, rocking, pacing, and many other symptoms that may occur from sunset to sunrise. So far no one has been able to find one cause ex- plaining all the possible behaviors. It is evident that there are different causes for different people with Alzheimer’s disease suffering from this syn- drome.
Care and treatment may come down to pin- pointing your loved one’s unmet needs. It may be necessary to think about your own behaviors and caregiving routines as well. This can be ac- complished by keeping a journal of what hap- pens everyday. This can also help you identify
Learn about the symptoms of Sundowning.
potential problems with your loved one. Then if any new behaviors arise a doctor can be consult- ed. You may want to keep your notes descriptive but short or jot them down on a daily calendar for reference. Caregivers report that developing a late day schedule that is familiar to your loved one is very helpful. A few other suggestions are: keep- ing rooms well-lit, providing hand and neck mas- sages, limiting daytime naps, avoiding caffeinated drinks in the late afternoon, keeping familiar ob- jects around, keeping evening meals smaller, and playing soft music. Sundowning symptoms are usually worse during the middle stages of Alzhei- mer’s disease but one caregiver reported that her husband’s sundowning disappeared in late stage about the time his ability to speak declined.
Medications such as a low dose of melatonin along with lots of exposure to bright light during the day is suggested by the Mayo Clinic. Mela- tonin is a hormone that induces sleepiness and can help sundowning syndrome. Health profes- sionals do discourage some medications due to their side-effects.
Consult your doctor for the best medications for your loved one. Sundowning does not just af- fect your loved one it affects the caregivers too. Always be aware of your own well-being by get- ting help from a friend or family member so you can get the rest you need. It is normal to feel over- whelmed, especially trying to manage sundown- ing syndrome, so seek help and support when you need it. The Alzheimer’s Association (alz.org) and the Family Caregiver Alliance (caregiver.org) both provide online support groups for caregivers.
14 |LeisureLiving Spring 2020
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