Causing Harm with Intent–Bless Them

My father needs constant care 24 hours around the clock that my mother and a few other caregivers offer him. He has dementia, COPD and a sever anxiety disorder. Along with this, he has something that many people with dementia and Alzheimer’s have and yet so few people know about and it is called Sundowners Syndrome, which is also considered a mood disorder as well as a sleep disorder.

People with Sundowners experience periods of extreme agitation, confusion, mood swings, disorientation to time and place, hallucinations, abnormally demanding behavior during the late afternoon or early evening hours, anger, fear, crying bouts, depression, rocking, restlessness, paranoia and violence.

The exact cause of Sundowners appears to be a mystery. It was originally believed to be a result of missed day/night light cues — a malfunctioning internal biological clock — hence the sudden onset at sundown. More recent research has raised the possibility of more organic causes such as drug interactions or stress associated with lower cognitive function.

Some of the things that increase the risk of this condition is pain, fecal impaction, malnutrition, polypharmacy (taking a lot of drugs), infections, REM sleep disorders, and environmental disruptions.

A nonpharmacologic approach could be helpful since antidepressants and tranquilizers have severe side effects such as anxiety and suicidal thoughts. What has been found to be the most helpful is light therapy. Keeping lights on into the hours of darkness may help. It is suggested that people get light boxes, shut the curtains by sundown and us light therapy.

Structured activities is very important. If an activity has been planned and structured in advance and is something that would definitely interest the person with Sundowners, chances are they will experience less agitation.

Very important it monitoring diet. Watch for patterns in behavior linked to certain foods. Avoid giving foods or drinks containing caffeine or large amounts of sugar, especially late in the day. Drink plenty of water!

Controlling noise. It may be helpful to reduce the noise from televisions, radios, and other household entertainment devices beginning in the late afternoon and early evening. You might want to think about music therapy, which has been shown to help individuals with sundowners syndrome feel calmer.

The herbs ginkgo biloba and St. John’s Wort have assisted people with Alzheimer’s and dementia in the past. Vitamin E has also been found to minimize sundowning in some cases. Melatonin is a hormone in supplement form that helps regulate sleep.

It is important for caregivers to use a natural approach to help them deal with the stress and anxiety of those who have Sundowners and we will talk more about that is the next blof. For now, this is Dr. tyler Woods saying….walk in peace….

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