My latest hang-up is with Sundown Syndrome. Sundowning is the term or condition used to describe late day confusion, agitation, and restlessness typically associated with seniors with some form of dementia.
As nightfall approaches the mood in the house changes. It’s my least favorite time of day, where the energy seems to creep with a menacing edge. My mom gets restless and antsy. She routinely packs her things and gets temperamental about going “home.” My dad’s version is different. He gets frustrated by everything, curses frequently, and is generally ornery. All it takes is one false move and the whole house topples into arguing about things that don’t make any sense because, well, dementia and Alzheimer’s don’t make sense.
If you look hard enough, you can find an explanation for everything. The idea that a concept doesn’t make sense is not something culturally we know how to embrace. Instead we often pick it apart so that we can digest “why.” But why is that? Why can’t unexplainable phenomenons exist to defy the comforts of closure and instead lend themselves to the lesson that we don’t have to know everything. We don’t need to define our existence with scientific explanations, standardized testing, and the evaluation of quantified data merely to plot a point somewhere on a spectrum. As much as the identifying knowledge can provide a basis for moving forward, it seems to equally result in a platform to unfairly categorize, label, and make projections on just about any dichotomy. Specifically, normal verse not.
Is the classic example of Sundowning that much different from what a tired baby experiences around bedtime? Or the toddler who wants to stay up later and fights you on it even though you yourself know exhaustion is near? Fast forward a few years and think about the frustration, exhaustion, or maybe even the depression you might feel when a day escapes you and you have nothing to show for it.
I often experience this pensive energy within myself. It’s a general dissatisfaction for things as the day comes to a close where for whatever reason I am moody. Nothing seems right, no person can fix it, and the upside is the sole fact that sleep will come soon and I can wash myself of this feeling and start fresh again tomorrow. But then tomorrow comes… It’s all rosy and promising till about noon and suddenly the race is on to accomplish something, anything, so that I might release the burden of my own feelings of life being so lack luster. This is an absolute case of the blahs. A shrink would likely label this as depression perhaps with an expensive RX to go with it but what the shrinks don’t know is the definition of “cinched.” How do I explain what cinched is when the word itself is not text book material and just some street slang colloquialized by my old roommate? I am not depressed. I am just cinched, and the recipe for curing cinching is productivity, accomplishment or exercise as a last-ditch effort to feel different. Now, I am not saying that depression isn’t a thing. It most certainly is and “cinched” falls somewhere on the depression spectrum regardless of the word’s actual formality.
My point is we probably all suffer from “sundowning” as the hard wiring of our neurology adjust to the earthly biorhythms that can disrupt circadian rhythm. A day turns to night, summer gives way to winter, and the ocean ebbs and flows. Our internal clocks must adjust to effectively adapt and at times it’s not so easy. What’s to say that sundowning is nothing short of normal considering a senior’s loss in mobility and capacity to act on intention. Seriously, where would we be and what would we talk about without the concept of goals? As caregivers maybe our job is to provide more stimulus, more activity and help create a sense of accomplishment for the “given” so that they might sink into a rewarding night’s sleep and remember that there is no place else they would rather be.
*This piece originally appeared on www.howtofeedasenior.com on February 10, 2016
One of the reasons I’d rather work days than nights.
Pam! We brought Don’s father here after his spouse passed. He began sundowning ( severely) shortly after. Message me if you would like to talk. There are resources to help you! Glenna
This is new to me, and it’s scary! My husband wanders around after we go to bed and he falls and hurts himself. I wake up when he crashes in the bathroom, or falls down the stairs. Sometimes I find blood on the sheets in the morning snd have no idea how it got there.
with my mom, there’s no such thing as sundowning, she’s just restless and agitated the whole day. she walks around the house, opens/closes cabinets and drawers, talks to the cat, and changes her clothes at least 5 times a day. And If we tell her to lie down and rest, she gets angry. she just wants to keep moving around.
Oh my husband had this he thought he was 17 and had to be home take the car back home ,but we were married for 34 years and was in his 50s he had 3 strokes now in a nursing home can’t walk it sad but I love him I see him 3xs a week I had my dad who almost 90 a grown daughter with fibro really bad I’m tired.
Sundown in my favorite time of the day, it means that its getting closer to my semi quite time. Mom goes to bed about 11it takes a while to get her equipment hooked and get her settled, the kids are in bed and my husband who I hardly get to see is in bed. I wait in silence to hear the wireless doorbell we installed for her to ring of she needs me, she usually don’t until morning. I use that time to unwind and reflect on where my life has been, and fear the uncertain future, it’s both a relieving time yet a sad time but it is also the quiet time I crave so badly to get myself together and be ready to face the next day.
Can be rough
Try diffusing some lavender oil from Young Living. It really helps.
She’s starting it now….(sigh) 🙁
97 y.o. Mom goes through this, but she doesn’t have dimentia. In WW2 she was a nurse on a hospital ship that was intentionally struck by a kamikaze. It happened just after the flood lights were turned on, illuminating the 4 red crosses on the Comfort’s smokestack. All breathed a sigh of relief that they were finally safe when the double explosion of the impact and the plane exploding in the ship’s surgery occurred. Six of her nurse friends died as well as the four surgeons and dozens of others. 77 years later, Mom suffers with PTSD more than ever. To her, once the sun sets, someone is always about to come in the door.
My husband struggles more during the day. restless nights as a rsult of advanced pd but he is at least resting.
My grandmother (age 90, mild dementia) has confusion about the actual going down of the sun. She wakes up during the night and does not understand why it’s dark. When I’ve been up with her in the night she often says something like “it looks like the world is coming to an end” and she wants to know why it’s so dark. When I explain that it’s night time and the sun is down like every night she gives me a confused stare. I don’t think of this as sundowning exactly. She doesn’t get grumpy or agitated when the sun goes down. She’s just really confused by the fact that it goes down and the sky gets dark. Nothing I say seems to help.
They can also get violent if thwarted…I was stabbed in the stomach with scissors one night on the oncology unit I worked on by a patient with sundowners…we recognized it…but could not accommodate it…had very sick cancer patients…she was violent…bothering everyone…we had to get an order for haldol…restraints…but in the process…she got my scissors out of my pocket…the next day when I came on…she was right as rain…but it was daytime
It’s not even sweet when it happens at home…night after night…my granny would race up and down the hall at at three am…pounding on doors…waking my kids who had school..ruining my hardworking husbands sleep…who had to get up at five…emptying drawers…cupboards..so the next morning would involve moving back in to your own house…it’s horrible and miserable and it’s what gets people put into facilities…medication must be looked into and tried…this article glamorizes it…minimizes it…it is neither…it is horrible and devastating…and I will go to great lengths to prevent it from happening with my mom…..:(
I just learned this recently while staying with Momma at the rehab. This sweet little resident did move up and down the halls desperately searching for the office, her room or something. One of the therapist explained this process and as I would visit with the resident to try to make her feel comfortable and not afraid it helped me understand how she was different during the daytime. Bless her sweet heart and all that have to go through this.