Sundowners - What is That?

When I was younger I loved the croonings of Gordon Lightfoot. One of my favorite songs of his was called "Sundown." I loved the harmony, the haunting melody, and his voice. Today I am fascinated by another title of "Sundown." You see my mom has Sundowners Syndrome, also known as sundowning. It is a condition often associated with the early stages of Alzheimer's, although a definitive connection has not been made. Sundowners syndrome can also be considered a mood disorder or even a sleep disorder. Sufferers experience periods of extreme agitation and confusion during the late afternoon or early evening hours, leading to irritability towards caregivers or hospital staff. It was once believed that sundowners syndrome was a result of missed day/night light cues, hence the sudden onset at sundown. My mom worked for Wal-mart for over 20 years. She worked third shift. I am so curious as to how many third shift workers experience sundowners in their later years. If I were a researcher I would take this up as a challenge. Caregivers and nursing home staff members can often anticipate an elderly patient's bout of sundowners syndrome. A period of irrational thoughts and irritable behavior might begin after the last meal of the day and last until bedtime, for example. One theory concerning sundowners syndrome is that the constant daily mental processes for normal living can become overwhelming for the elderly during evening hours. They simply have too much incoming information and their restricted cognitive abilities become overloaded. The result is a period of irritability and negative thoughts. In my mothers case the Dadeville Healthcare Center is too stimulating. There is too much activity going on and by evening it sets her off royally. She and her roomie both are sundowners and high elopement risks...but they are not good for each other at night because one won't go to sleep until the other one does. So I can see the wheels turning and you are asking yourself...ok...your mom is a sundowner...what can be done about this to help her lead a normal life? Well therein lies the problem.
Treatment for sundowners syndrome is generally limited to the underlying condition which triggers it, such as Alzheimer's or clinical depression. Anti-depressants may lessen the severity of the confusion, while drugs like Aricept may improve cognitive function. Since sundowners syndrome is also closely associated with sleep disorders and fatigue, sedatives and other sleeping aids may also help. Experienced caregivers suggest encouraging the patient to take several naps throughout the day and limit stimulating activities to the morning hours. All this has been tried....my mom has been given enough sleep enhancing drugs to stop a stampeeding herd of cattle...and none of it has worked to date. That is where another problem exists because there are other conditions which closely resemble sundowners syndrome, especially in unfamiliar hospital settings. Some elderly patients may become confused or irritable as a result of the anesthetics used during their surgeries. Others who spend time in the ICU or are connected to noisy medical equipment may experience a condition called hospital psychosis, which may also be especially noticeable during evening hours. But hospital psychosis can affect any age group, while sundowners syndrome is generally limited to the elderly population. Ok...so she is a classic sundowners. As far as dementia goes...it is just one of many stages she will go through...hopefully. This to shall pass they say...worst case scenario...it won't. Understanding the sundowners concept though has explained a lot of things that my mom did before my dad died and while they were living with me. I believe she has been a sundowners for a while. It is good to know....but does it make me feel any better? Nope...Not really...to be honest...it just makes me feel worse for my mom...she has been suffering for so long...and was so good at bluffing...I missed the cues completely. This woman should be playing poker in Vegas....she is good! Happy Hump Day! Hug your momma if you can. If not...hug somebody else's momma. It will make their day!