by Lois G. Tager, M. Ed., CSA
Director of Geriatric Care Management, Litherland, Kennedy & Associates, APC, Attorneys at Law
Sundown Syndrome, sometimes referred to as sundowning or sunsetting, describes the onset of behaviors such as agitation, confusion and irritability. These behaviors are often found in people who have cognitive losses or Alzheimer’s disease; although some research suggests that they can also be found in seniors simply because of age-related changes. Symptoms are often seen when the sun starts to set in late afternoon or early evening.
Although experts do not know the exact cause of sundown syndrome, many believe that there are numerous contributing factors. Behaviors such as confusion, anxiety, and agitation or disorientation are most frequently reported; there are some steps that can be taken to help those who exhibit these behaviors.
Although there is no single known cause of sundown syndrome, we do know some simple ways to mitigate its effects and to make the experience less traumatic for the person who has it, as well as his or her caretakers:
– Try to plan structured activities, such as bathing (often a difficult task) early in the day, when a loved one is most alert.
– Try taking a walk, or find a gentle exercise in which both the senior and caregiver can participate.
– Redirect the affected person’s attention to a familiar activity.
– Turn off the television, which many experts believe can cause confusion.
– Soft classical music often has a calming effect.
– Establish a familiar routine, and encourage the senior to help with simple tasks such as setting the table for dinner or folding clothes.
Most importantly, speak in gentle, loving tones, and avoid confrontation. If the sundowning behavior becomes aggressive, dangerous, or self-destructive, be sure to contact a medical professional. In such instances, medication might help to minimize the behavior. Senior care centers can be extremely valuable in assisting with exercise and the diversion of day-to-day activities.
Because long-term memory usually outlasts other types of memory, talking about family members or savoring a special event in the senior’s life often has a calming effect on a person experiencing sundowning. If the senior loved to sing, start a familiar song. Focus your attention and speak slowly, quietly and directly to calm and soothe.
The cause of this difficult problem is largely unknown; how to solve the problem is a mystery. What we do know is that extrinsic factors can make it worse and behavior modification techniques will often help to mitigate the intensity of the behaviors. Sundown syndrome is very real to those who experience it, and continued research should be directed to discover both its cause and treatment.
ABOUT THE Litherland, Kennedy & Associates, APC, Attorneys at Law
Roy W. Litherland is an attorney whose practice emphasizes elder law and estate planning. Roy has practiced law in the greater Bay Area for the last 34 years and is certified as a legal specialist in Estate Planning, Trust and Probate Law by the California State Bar Board of Legal Specialization. In addition to his extensive legal background, Roy was also previously licensed as a Certified Public Accountant. Although Roy has an extensive background in accounting, he retired his license to practice as a CPA to devote his time and energy entirely to the practice of law, specializing in estate planning, trusts, Medi-Cal planning, and probate. Roy is a noted speaker on living trusts, Medi-Cal Planning, and estate planning. He is a member and designated Fellow of theAmerican Academy of Estate Planning Attorneys, an organization that fosters excellence in estate planning.
Lois Tager, Director of Geriatric Care Management, holds a Masters in Education, specializing in counseling and psychotherapy from Providence College, a Bachelor of Science in Education from Boston University and is a Certified Senior Advisor and Geriatric Care Manager. Lois worked in the Bay Area as an instructor in healthcare at West Valley College and maintained a private practice in counseling for many years. Lois has worked with the Alzheimer’s Association for the past 13 years as a facilitator for caregiver groups. She published “Sundown Syndrome: A Primer” in the CSA Journal of the Society of Certified Senior Advisors, CSA Journal 46, 2010. She authored a column “Ask Lois” for the Alzheimer’s Association Monterey County Newsletter and wrote numerous articles. She is a former columnist for AOL’s Campbell Patch, Senior Corner, an on-line news column.
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