Sundowner’s syndrome can be worrisome and perplexing to the family of an elderly person. Symptoms generally grow worse as evening approaches, or may not even be present until the sun goes down. Knowing how to deal with symptoms such as restlessness and agitation are challenging because the patient typically cannot be reasoned with. It is important to know how to deal with sundowners so that the elder and the people around him or her do not suffer injury.
People who suffer from various forms of dementia, such as Alzheimer’s disease, may develop sundowner’s syndrome. Experts are unsure of what causes sundowners syndrome, but some speculate that it could be caused by an accumulation of all the stimulation from the day causing the person to feel overwhelmed and stressed. Others think that it may caused by an imbalance of hormones at night. Still others think that it is caused by darkness and not seeing well, or simply fatigue. Even seasonal affective disorder (SAD) has been thought to contribute to its cause.
Combinations of symptoms that can be seen are: anger, agitation, fear, rapid mood changes, restlessness, rocking, crying, pacing, stubbornness, and depression. More severe symptoms include paranoia, hallucinations, wandering, hiding things, and violence. These symptoms can pose safety concerns and treatment may need to be adjusted for safety. Other times they will follow someone around and copy their actions. A loss of language abilities and the ability to process abstract thoughts may also be seen.
Sundowner’s syndrome treatment varies by the symptoms exhibited and their triggers. One treatment is to regulate the sleep cycle. Some things that can be tried at home are discouraging naps during the day and opening curtains to allow bright light exposure in the morning, as well as throughout the day. To help with excess energy, encourage exercise during the day, limit caffeine intake, and allow for relaxation in a quite environment at nighttime. Triggers can include pain, hunger, thirst, and noise. About an hour before the symptoms usually begin, ask if they are in pain and are in need of pain medicine, or if they are hungry or thirsty. Turning off noise, like the television, can help.
Other home treatments that have been helpful are aromatherapy and light therapy. Having your loved one sit next to a light box for a specified amount of time in the morning has also been shown to work, especially if the patient suffers from depression.
Some people have had success with medicine to treat the symptoms. These can include antidepressants such as Zoloft, Paxil, and Prozac. Mood stabilizers like valproic acid or lithium as well as benzodiazepines such as Xanax, Valium, and Ativan have been successful. Medications like Aricept, Razadyne, and Exelon help to improve cognitive function and improve memory. Agitation can be treated with Haldol.
Sometimes people become too difficult to deal with at home. For safety reasons and to ease stress on the family, elder care help is needed. Assisted living facilities have trained staff to deal with dementia symptoms, but your loved one needs to have mild symptoms and be able be alone and independent. Nursing facilities also have staff trained and are able to handle the difficult symptoms such as hallucinations and agitation. Many even have special units that keep the elder safe if they happen to wander or become violent. The decor and planned activities are designed specifically for the dementia patient.
It is stressful managing a loved one with Sundowner’s syndrome. Try these tips and hopefully improvement in the symptoms will be seen. Improving the quality of life for someone with dementia takes listening, caring, and patience.
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