Mom’s Restlessness or Bizarre Behavior Could Be Sundowners

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When you’re responsible for caring for your mother, you often find that there are a lot of things to consider that you hadn’t really thought of before.  For instance, many people don’t know anything about sundowning syndrome unless they’ve worked with seniors who suffer from dementia or Alzheimer’s. Even then, only about 20% of seniors with some form of dementia will experience signs of sundowning.

What Is Sundowning?

Sundowning is a term used for a whole group of behaviors; it’s not actually a disease, it’s just a list of symptoms that’s often attributed to stages of dementia. What you need to know in order to care for Mom is that sundowning is also a possible side effect of lengthy hospital stays or serious surgery in patients who don’t have dementia. In those cases, the behaviors are usually temporary and related to the surgery or anesthesia.

It’s called “sundowning” because these behaviors manifest as the day ends, usually around dinner time or just after. Common symptoms include:

  • Anxiety. If your mom suddenly appears anxious for no reason, every evening, it may be a sign of sundowning. This can manifest as pacing, an overall sense of worry, or simply the inability to sit still and be comfortable.
  • Anger. Often seniors experiencing sundowning will get angry for no reason, lashing out verbally and physically against people trying to help them. These episodes might be completely out of character with your mom’s normal personality, which is what makes sundowning so traumatic for family members.
  • Sudden mood changes. Mood changes in sundowning might run the gamut, but the common feature is that they seem to be brought on for no reason.
  • Hallucinations or disorientation. If you’re caring for Mom, and she’s telling you about things that aren’t there, that can be scary and troubling. Often these symptoms of sundowning can mimic the disorientation caused by severe fever or sickness.
  • Wandering. If your mom is sundowning, she may be disoriented or think she needs to complete a task or errand and wander off.

These are only some of the many behaviors that are classified as sundowners. Some can be more or less severe lasting for just a few hours or extending throughout the night.

How Do You Treat Sundowners?

As sundowning isn’t an actual specific illness— it’s a whole series of behaviors labeled under the one term, though your mom might only experience one or a few symptoms—there’s no quick fix like there would be for a chronic condition like diabetes.

There are a few theories as to what actually causes sundowning but, so far, there’s no medication that can eliminate the symptoms. In severe cases, however, a doctor might prescribe medication to help calm your mother down, so that she can rest and you can get some uninterrupted sleep. Because sundowning can last the entire night, the lack of sleep caregivers experience can be extremely detrimental and cause burnout and other health problems.

We know that there’s no medication to eliminate the symptoms, but we also know that there are a few ways to change your mom’s lifestyle and routine which can help and alleviate the symptoms. The key is in working with your mom’s individual needs and preferences and noting things that may trigger episodes. For instance, if you notice Mom has an episode every time she has a cup of coffee past noon, eliminating caffeine might be a good first step.

Some people find that favorite pets alleviate anxiety. And there may be favorite old movies or books that take Mom’s mind off of what’s troubling her. Often the key is in the routine. We’ve found that many seniors in the hospital are sometimes prone to episodes due to shift changes at night, so keeping a daily routine that doesn’t vary can help in removing the triggers.

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