{"id":3578,"date":"2019-02-05T05:14:41","date_gmt":"2019-02-05T05:14:41","guid":{"rendered":"https:\/\/simplyhealth.io\/?p=3578"},"modified":"2021-05-25T16:39:44","modified_gmt":"2021-05-25T16:39:44","slug":"15-symptoms-of-sundowners-syndrome","status":"publish","type":"post","link":"https:\/\/simplyhealth.io\/15-symptoms-of-sundowners-syndrome\/","title":{"rendered":"15 Symptoms of Sundowners Syndrome"},"content":{"rendered":"\n
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If someone you love is currently suffering from Alzheimer\u2019s disease, you\u2019ll likely see some major changes in behavior, especially during the later hours of the afternoon or earlier hours of the evening. Doctors refer to this as sundowning, or sometimes sundowning syndrome. The trigger appears to be fading light, which is where this syndrome got its name. <\/p>\n\n\n\n

As the night progresses, the symptoms could become more severe, but will often subside by the time morning comes along. While it\u2019s rather difficult to eliminate the symptoms altogether, there are some ways to minimize the changes in behavior even for those who are suffering from this syndrome. <\/p>\n\n\n\n

Treating the symptoms can also help you perform better throughout the day since you\u2019ll be getting more sleep and thus won\u2019t be as tired while you work or spend time with family. Here\u2019s a list of eight of the most common symptoms and how you can deal with them.<\/p>\n\n\n\n

1. Distorted Reality
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One of the most common symptoms<\/a>, especially in the later stages, is a distorted sense of reality. Those who are suffering from the syndrome might think that they are at a different point in their life. The patient may think that they are back in kindergarten, heading to their junior prom, or giving birth to their first child. <\/p>\n\n\n\n

The distortion isn\u2019t limited to temporal variations though, they might even live in another world altogether such as one that contains dragons, zombies, or transformers. The best way to deal with this is to go along with whatever reality they\u2019re currently residing in. Not only is it fun for you, but it\u2019s also the best way to keep them calm. <\/p>\n\n\n\n

Forcing them back into reality by refuting their claims of the things they see will do nothing except aggravate them. Letting them do an activity that lines up to the reality they\u2019re in could also help.<\/p>\n\n\n\n\n\n\n\n

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2. Restlessness
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Others who suffer from the syndrome might become restless throughout the night. This becomes an issue as they\u2019ll likely want to move around the house while everyone is asleep. For someone who is sound of mind and not dealing with any mental conditions, this would be totally fine. <\/p>\n\n\n\n

That said, for someone who is in the late stages of Alzheimer\u2019s<\/a>, letting them wander around in the dead of night unsupervised could have some dire consequences. If you find them wanting to walk around, it\u2019s important that you keep a close eye and remove any obstacles that they might bump into during their pacing. <\/p>\n\n\n\n

Colliding with an object could injure them and\/or put them into a state of panic. A great place to have them pace around is in the backyard. Ensure that there are no weeds that they might trip over and keep watch so that they don\u2019t make their way into the yard of your neighbor.<\/p>\n\n\n\n\n\n\n\n

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3. Yelling
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Those who suffer from sundowning syndrome<\/a> might also start yelling late at night. It\u2019s important to remember that this yelling, while often loud, doesn\u2019t necessarily suggest that the patient is aggravated, it may just be their way of communicating with you in their deteriorated state. <\/p>\n\n\n\n

The words in their sentences will often make as much sense as a serial killer on LSD but there is actually a way to figure out what they\u2019re trying to tell you. While their actual words may not make sense, you can pay mind to their tone when they\u2019re yelling. Based on their tone, you\u2019ll be able to tell if they\u2019re sad, worried, angry, afraid, or otherwise. <\/p>\n\n\n\n

Once you figure out how they\u2019re feeling, it\u2019ll be easier to determine what your next course of action should be. If they appear scared, you can comfort them, while you might want to keep your distance if they appear angry.<\/p>\n\n\n\n\n\n\n\n

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4. Irritable
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Those who suffer from sundowning syndrome can be irritable<\/a>. This usually manifests in the earlier hours following the initial trigger point. It\u2019s important that you keep them calm during this irritable phase and save stressful topics for the next day. <\/p>\n\n\n\n

If you let them get further aggravated during this stage of the syndrome, it will only make the symptoms of the later hours more severe. The best way to deal with your patient when they\u2019re irritable due to the syndrome is to steer clear, keep quiet, and give them a warm glass of chamomile tea. <\/p>\n\n\n\n

Remember, no matter how rude they might be, you should never argue with them as this will only make matters worse by increasing their anger. If they bring up a complaint or ten, just agree with them, apologize, and promise to do a better job next time. Remember, when they\u2019re in this stage, they aren\u2019t thinking logically, so keeping them calm is more important than being right.<\/p>\n\n\n\n\n\n\n\n

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5. Suspicious
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Another symptom of sundowning syndrome is suspicion. For no apparent reason, the patient may start suspecting you, your statements, and your motives. They might think you\u2019re an imposter who is lying to them to hide some malicious agenda. If a patient with sundowning syndrome starts suspecting you, the important thing is to comply with them. <\/p>\n\n\n\n

If they give you instructions such as the stay back then you should listen to them and keep your distance. Disobeying their orders will only make them doubt you more and escalate the situation further. The only time you should intervene when they are already suspicious of you is if they are about to injure <\/a>themselves or someone else. <\/p>\n\n\n\n

Be sure to answer any questions they have for you, but try to keep your responses short and simple. Overcomplicating your answer will only aggravate them if they are unable to understand it. Be sure to maintain a calm tone of voice as well.<\/p>\n\n\n\n\n\n\n\n

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6. Hallucinations
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One of the more common symptoms of sundowning syndrome is hallucinations<\/a>. Most of the time these hallucinations will be harmless such as a bright light or person standing still. If the hallucinations aren\u2019t aggravating the patient, just go along and pretend you see it too. <\/p>\n\n\n\n

That being said, if they are having hallucinations that make them anxious or scared, it\u2019s important to reassure them that there\u2019s nothing there and that it\u2019s all in their head. If they don\u2019t believe you, just head over to the area that they\u2019re pointing toward and walk around it to show them that it is truly a blank space. <\/p>\n\n\n\n

Turning on the lights in that area may also help as those hallucinating will often see things manifest in areas with insufficient lighting. If they are hallucinating, it\u2019s likely because their mind is understimulated. You could remedy this by letting them watch some TV or read a book until their hallucinations go away.<\/p>\n\n\n\n\n\n\n\n

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7. Confusion
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Confusion is a common symptom of sundowning syndrome. Just imagine how confused you\u2019d be if you only had bits and pieces of your memory<\/a>. Those who suffer from the syndrome might forget where they are, who you are, or even who they are. If this confusion continues, they\u2019ll go into a state of panic and may become violent. <\/p>\n\n\n\n

This is why it\u2019s important to nip their confusion at the bud before it worsens. If they have questions, answer them in a calm tone. They may ask these questions repeatedly, but remember that it isn\u2019t their fault. You\u2019ll need to have a long patience, but staying calm and answering any queries they might have is the best course of action for both your sake and theirs. <\/p>\n\n\n\n

If the questions become so frequent, you could record a tape that answers some of their frequently asked questions. You could also take the modern path and record a video if they have a computer capable of playing it.<\/p>\n\n\n\n\n\n\n\n

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8. Mood swings
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Mood swings<\/a> are another common issue that those with sundowning syndrome suffer from. It\u2019s very difficult to regulate your mood when you have no sense of logic nor memory. Think about it as being drunk while also sedated and suffering from amnesia, that\u2019s what they have to deal with. <\/p>\n\n\n\n

When the mood of the patient swings, don\u2019t shift your own mood, instead, just be their emotional anchor so to speak and maintain a calm demeanor throughout all their swinging. If they get angry, don\u2019t get dragged into it, otherwise, things will only get worse. Just stay calm and talk them down. In the same way, if the patient becomes sad, you can comfort them but you must avoid getting too emotional yourself. <\/p>\n\n\n\n

Putting on their favorite show or letting them read their favorite book could help mitigate these mood swings as it will occupy their mind so that they aren\u2019t thinking of random things that might impact their demeanor.<\/p>\n\n\n\n\n\n\n\n

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9. Fear<\/h3>\n\n\n\n

Seniors who are suffering from the effects of sundowning syndrome experience frustration and disorientation when the light starts to fade at the end of the day. Affected individuals describe the sensation as a growing sense of fear that increases as the evening hours\u2019 advance. <\/p>\n\n\n\n

This fear of the unknown can spark an anxiety attack, which produces a range of symptoms which include tightness in the chest, heart palpitations<\/a>, and fear of the unknown. As a result, the seniors may think they are experiencing the start of a heart attack. <\/p>\n\n\n\n

Controlling this feeling of fear using medication is possible. A doctor may prescribe drugs, such as Valium or Xanax, to help the patient deal with their emotions and remain calm as the sunsets. It\u2019s vital that caregivers understand the potentially addictive nature of these medications, and only administer the drugs when they are needed. Misusing or abusing medications to sedate a senior is illegal.<\/p>\n\n\n\n\n\n\n\n

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10. Anxiety<\/h3>\n\n\n\n

As mentioned, anxiety <\/a>is a prevalent issue when dealing with individuals affected by sundowning syndrome. Many people confuse anxiety with stress, but if you look at the symptoms associated with the condition, they are very different from those produced by a stress response.<\/p>\n\n\n\n

Stress occurs when we encounter an environmental stimulus that takes us out of our comfort zone. An example you may be able to relate with is when your boss asks you to deliver a project on a tight deadline, and you stress about whether or not you\u2019ll be able to get the work done in time.<\/p>\n\n\n\n

Anxiety is a mental health disorder. This condition develops when the affected individual is triggered by a physical or psychological event that creates feelings of panic and dread that something terrible is about to happen to them. If left unmanaged and untreated, people with anxiety may experience a wide variety of physical symptoms, such as the cardiovascular issues mentioned above.
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11. Depression<\/h3>\n\n\n\n

This mental health disorder affects more than 3-million Americans, that\u2019s almost 1.5-percent of the population. Depression <\/a>is a toxic state of mind where the affected individual loses their drive and lust for life. The condition occurs due to many factors. Some common causes of depression include a chemical imbalance in the brain, as well as hormonal issues related to autoimmune disorders.<\/p>\n\n\n\n

Depression is the leading cause of suicide worldwide, and it\u2019s easy for an affected individual to spiral down into a deep depression where they decide to take their life. This tears family\u2019s apart in the wake of the suicide, and many people that commit suicide don\u2019t want to die, they just what a way to stop the mental anguish they experience every day.<\/p>\n\n\n\n

Doctors treat depression with SSRI medication, (Selective Serotonin Reuptake Inhibitors.) These drugs block the reuptake of this neurotransmitter in the brain, preventing feelings of depression and low self-esteem.
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12. Pacing and Wandering<\/h3>\n\n\n\n

It\u2019s vital that seniors who experience sundowning syndrome reside in a managed care facility. Many seniors with the condition, notice bouts of confusion as the sun starts to set and the light fades. As a result, the lack of understanding of their current situation may lead them to wander. <\/p>\n\n\n\n

These symptoms of confusion and wandering may escalate in patients who are suffering from a mental health disorder, such as Alzheimer\u2019s disease<\/a>. In unmanaged care, the patient may wander out into the street and roam, ending up in a neighborhood they do not recognize, with further exacerbates feelings of panic and anxiety.<\/p>\n\n\n\n

The person may not remember their full name or confuse it with someone else\u2019s name. They may not remember where they live \u2013 or how they got to their current location. Another symptom of Sundowning syndrome \u2013 is pacing. This symptom has close ties to anxiety, and the patient may pace up and down the length of their room as they try to cope with the increasing levels of anxiety and fear.
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13. Fatigue<\/h3>\n\n\n\n

Patients with sundowning syndrome may experience symptoms of fatigue <\/a>during the late afternoon, especially if they are active. These feelings of fatigue can exacerbate the condition, with the individual experiencing heightened sensations of fear, anxiety, confusion, and frustration that they are unable to control.<\/p>\n\n\n\n

Doctors recommend that patients who feel tired in the mid-afternoon should take a nap under supervision. If the patient wakes up and experiences a reduction in their symptoms during sunset \u2013 it may be advisable to let them have an afternoon nap every day. Should the napping increase symptoms, then it’s best to keep them awake during the afternoon and let them sleep at night.<\/p>\n\n\n\n

Dementia affects changes in circadian rhythm, and some may find it harder to get to sleep at night, resulting in feelings of fatigue the following day. These patients may require medication, such as Ambien, to help them drift off to sleep at night.
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14. Let it Play Out<\/h3>\n\n\n\n

Patients with dementia <\/a>and sundowning syndrome require managed care to ensure they do not harm themselves or others due to their incompetence. Unfortunately, many caregivers, especially family members, may try to alter the behavior of the affected senior. The caregiver may try to make them complete a task to make the patient feel better.<\/p>\n\n\n\n

However, this strategy may have unintended results, producing the exact opposite effect they had hoped would occur. The patient may feel like they are being instructed and refuse to listen. They may resist any attempt to calm them down \u2013 resulting in the patient spinning out of control. In some cases, the reaction to authority can be so severe that the patient goes on a rampage, breaking furniture and fixtures in the room.<\/p>\n\n\n\n

Experts suggest that you do not interrupt their behavior. Instead, provide them with a safe space to carry out their repetitive behavior, and wait for the patient to calm down. It\u2019s vital that the patient receives monitored care during this time to avoid self-harm or harm to others.<\/p>\n\n\n\n\n\n\n\n

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15. Validate, Reassure, Distract<\/h3>\n\n\n\n

Caregivers should adhere to the \u201cvalidate, reassure, distract\u201d strategy when dealing with patients suffering from sundowning syndrome. The process starts with the caregiver acknowledging the patient\u2019s onset of symptoms. They may say something like, \u201cI notice you look like you\u2019re feeling afraid or anxious right now \u2013 and it\u2019s okay to feel this way.\u201d <\/p>\n\n\n\n

By making this statement, the caregiver acknowledges the patients growing fear, providing them with the reassurance that helps them understand that it\u2019s all part of the process, and the feelings will pass. Caregivers should do everything they can to identify the source of anxiety <\/a>and offer reassurance. <\/p>\n\n\n\n

After reassuring the patient, its best to give them something to do that distracts them from the mounting emotions of fear and anxiety. Remove all triggers from the immediate environment, such as television noise and the radio \u2013 sharp sounds may exacerbate symptoms. Introduce positive reinforcement to their environment and play some classical music, or turn on the TV with the volume down and let them watch a nature documentary.
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