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"Sundowners" or sundowning, isn't a disease, but a symptom that accompanies many forms of dementia. It is actually a kind of psychosis in which a person can become more confused, irritable, angry, or apathetic in the late afternoon than other times of day. (Hence the term sundown.) Hallucinations can be more common this time of day. Some people have negative reactions to hallucinations--becoming fearful or anxious--and some people don't. Any caregiver or nurse can recognize sundowning when it happens. A physician can diagnose the underlying cause of sundowning behavior. best wishes
Like xray said, sundowners is a set of symptoms related to dementia. You should absolutely expect a caregiver in a Memory Care environment to notice your mother's symptoms and report them to you! Sundowner's is not as much a 'diagnosis' but an observation of behaviors being exhibited at a certain time in the evening. You can also learn certain techniques to use to reduce her symptoms.
"Known as Sundowner's syndrome or sundowning, it involves a pattern of sadness, agitation, fear, delusions and hallucinations that occur in dementia patients just before nightfall. This increased confusion around twilight can be distressing for both patients and caregivers alike."
If you'd like more information, here is a link to a Google page with many more links to articles on the subject:
I am curious why you need to have an “official” determination of sundowners. The diagnosis of dementia is the determination needed for most.
the only way I know is to be there when it happens. For about 3 years if you came to my house after 4pm you would not be left in doubt. But, one thing is...the victims are really good at holding it together until the visitors depart. In my Dads case, even the visiting doctors from the VA didn’t ever see it full blown....but, wow did I get it once they left....he could not deal with any stress. Even a phone call late in the day would make it so much worse.
As I understand it (I could be wrong), sundowners is when your loved one with dementia sufferers a noticeable decline about the same time every day. Not necessarily in the evenings. Any diagnosis should be done by a physician. I imagine that caregivers who are around others with it could recognize the condition, but it would simply be their opinion and not a valid diagnosis. Best wishes!
With my Dad...it seemed to have more to do with sunset and the level of stress he had late in the afternoon. It was never a set time, but did seem to follow the sun. Later after noon in the winter, and later in the evening in the summer.
I agree. But not sure if there is a diagnosis. Sundowners is a symptom of Dementia. So the diagnosis would be Dementia. In the early stages you may not really recognize changes until they have Sundowners. Early on a person suffering from a Dementia knows something is wrong and are able to "showtime". But this is tiring and usually around late afternoon early evening the symptoms get worse. This is "sundowning". Some people find it happens earlier in the day.
If. u think ur LO is "sundowning" its time for a neurologist.
Has this diagnosis by an untrained CNA caused problems for your mom?
Is the new facility treating her in a way that they would not be doing without this "diagnosis"?
Are you able to see her frequently enough to know for sure that she is not having these symptoms?
If you don't see her frequently she could be showtiming for you and you really don't know how she is because of that.
Here's the hard thing to face with dementia, it is hard to tell what the behavior is tied to. Is it a true, rational, appropriate reaction or is it an irrational, inappropriate response to a perceived reality. If it isn't going on all day, it very well could be sundowning that was prompted by her anger and inability to hear because of the batteries. If it was only when her batteries were dead, well that is pretty obvious. So many daily factors to understanding what is going on. And it all sucks in my experience, whether sundowning or just uncontrolled anger.
Sundowners is a real trip . My 89 year old grandmother goes to her house every other day ( it upsets her too much not to and so far she can still go without issues , she's steady on her little feet ) , my two uncles live across the street so they care for her then until the late afternoon when she comes back to my house to spend the night and the next day with me . It is understood through trial and error that mama must get here to me before 5 pm . Anytime after that she becomes utterly and completely confused : people who have been dead for decades are suddenly alive and well, it's 1954 and mama needs to pick my mum up from school , my deceased grandfather is out , what's keeping him so long , worry worry etc etc . I am not a medical practitioner but I diagnosed sundowners by reading excessively about dementia and now there is no way I let her get here late as it's just too much for her. I also make sure I'm around if she takes a nap. We have found that if she naps and wakes up to find no one to speak to immediately she gets very irritable and super confused about her location . It means that I am checking on her very often but I'm fine with that as I'm youngish and strong enough. We have an established routine that works so far and we ( especially me ) have to dig deep for the utmost patience when mama loses her way in her head . At mamas home , we have removed the gas for the stove and the electric kettle , also matches and lighters. She started a small fire last year ( in the evening before we realizied she needed to be here before night fell ) it could have been catastrophic but for the intervention of uncle Dennis. She had placed the electric kettle on the stove and it had melted into the stove top and ignited a bit of card that she had mysteriously placed near the stove . I mean...... wow . We use several flasks now for her tea and her food is warmed in a microwave so far without incident. We blocked the back door that leads to a treacherous stairwell and installed handrails at the small 3 step side step that leads to the garden. She no longer owns an iron or anything that can start a fire if forgotten. I tell you this just to show you how much planning and changes need to happen sometimes to accommodate a person with dementia who still feel they need to be independent. It's rough , and we are all exhausted but we all know that mamas life is finite and someday she will not be here to ask question after question with her chirpy little voice .We know we will miss her so we are as kind as we can be and patient . Doctors can't or don't always tell you what you need to know so read up , observe and try any and everything you can to keep your loved one comfortable . Every dementia patient is different but there are enough similarities for you to glean sense about your situation from the stories of others . For me , when it comes to sundowners , I turn lights on early or when it gets dim ( 5:30) so the transition from day to night isn't startling . I have a chalk board with the day of the week and the month written on it in caps . I hang out with her , reading or watching a film . I give her laundry to fold or books to look at . Just distractions really . I just spend as much time as I can with her and my life is rough and I've gained 15 pounds as I can't go running anymore but hey , that's how it is . You know , I wish you luck . It's a hard road but it isn't permanent and it's not their fault . Remember that .
By proceeding, I agree that I understand the following disclosures:
I. How We Work in Washington.
Based on your preferences, we provide you with information about one or more of our contracted senior living providers ("Participating Communities") and provide your Senior Living Care Information to Participating Communities. The Participating Communities may contact you directly regarding their services.
APFM does not endorse or recommend any provider. It is your sole responsibility to select the appropriate care for yourself or your loved one. We work with both you and the Participating Communities in your search. We do not permit our Advisors to have an ownership interest in Participating Communities.
II. How We Are Paid.
We do not charge you any fee – we are paid by the Participating Communities. Some Participating Communities pay us a percentage of the first month's standard rate for the rent and care services you select. We invoice these fees after the senior moves in.
III. When We Tour.
APFM tours certain Participating Communities in Washington (typically more in metropolitan areas than in rural areas.) During the 12 month period prior to December 31, 2017, we toured 86.2% of Participating Communities with capacity for 20 or more residents.
IV. No Obligation or Commitment.
You have no obligation to use or to continue to use our services. Because you pay no fee to us, you will never need to ask for a refund.
V. Complaints.
Please contact our Family Feedback Line at (866) 584-7340 or ConsumerFeedback@aplaceformom.com to report any complaint. Consumers have many avenues to address a dispute with any referral service company, including the right to file a complaint with the Attorney General's office at: Consumer Protection Division, 800 5th Avenue, Ste. 2000, Seattle, 98104 or 800-551-4636.
VI. No Waiver of Your Rights.
APFM does not (and may not) require or even ask consumers seeking senior housing or care services in Washington State to sign waivers of liability for losses of personal property or injury or to sign waivers of any rights established under law.
I agree that:
A.
I authorize A Place For Mom ("APFM") to collect certain personal and contact detail information, as well as relevant health care information about me or from me about the senior family member or relative I am assisting ("Senior Living Care Information").
B.
APFM may provide information to me electronically. My electronic signature on agreements and documents has the same effect as if I signed them in ink.
C.
APFM may send all communications to me electronically via e-mail or by access to an APFM web site.
D.
If I want a paper copy, I can print a copy of the Disclosures or download the Disclosures for my records.
E.
This E-Sign Acknowledgement and Authorization applies to these Disclosures and all future Disclosures related to APFM's services, unless I revoke my authorization. You may revoke this authorization in writing at any time (except where we have already disclosed information before receiving your revocation.) This authorization will expire after one year.
F.
You consent to APFM's reaching out to you using a phone system than can auto-dial numbers (we miss rotary phones, too!), but this consent is not required to use our service.
"Known as Sundowner's syndrome or sundowning, it involves a pattern of sadness, agitation, fear, delusions and hallucinations that occur in dementia patients just before nightfall. This increased confusion around twilight can be distressing for both patients and caregivers alike."
If you'd like more information, here is a link to a Google page with many more links to articles on the subject:
https://www.google.com/search?q=sundowners+syndrome&rlz=1C1JRYI_enUS478US487&oq=sundowner&aqs=chrome.1.69i57j35i39j0l4j69i60l2.2746j1j7&sourceid=chrome&ie=UTF-8
The more you learn about your mother's disease, the better you will understand and expect her patterns of behavior.
Good luck!
https://www.agingcare.com/articles/sundowners-syndrome-133187.htm
https://www.agingcare.com/articles/autumn-and-sundowning-210080.htm
the only way I know is to be there when it happens. For about 3 years if you came to my house after 4pm you would not be left in doubt. But, one thing is...the victims are really good at holding it together until the visitors depart. In my Dads case, even the visiting doctors from the VA didn’t ever see it full blown....but, wow did I get it once they left....he could not deal with any stress. Even a phone call late in the day would make it so much worse.
Any diagnosis should be done by a physician. I imagine that caregivers who are around others with it could recognize the condition, but it would simply be their opinion and not a valid diagnosis.
Best wishes!
If. u think ur LO is "sundowning" its time for a neurologist.
Is the new facility treating her in a way that they would not be doing without this "diagnosis"?
Are you able to see her frequently enough to know for sure that she is not having these symptoms?
If you don't see her frequently she could be showtiming for you and you really don't know how she is because of that.
Here's the hard thing to face with dementia, it is hard to tell what the behavior is tied to. Is it a true, rational, appropriate reaction or is it an irrational, inappropriate response to a perceived reality. If it isn't going on all day, it very well could be sundowning that was prompted by her anger and inability to hear because of the batteries. If it was only when her batteries were dead, well that is pretty obvious. So many daily factors to understanding what is going on. And it all sucks in my experience, whether sundowning or just uncontrolled anger.
It is understood through trial and error that mama must get here to me before 5 pm . Anytime after that she becomes utterly and completely confused : people who have been dead for decades are suddenly alive and well, it's 1954 and mama needs to pick my mum up from school , my deceased grandfather is out , what's keeping him so long , worry worry etc etc .
I am not a medical practitioner but I diagnosed sundowners by reading excessively about dementia and now there is no way I let her get here late as it's just too much for her.
I also make sure I'm around if she takes a nap. We have found that if she naps and wakes up to find no one to speak to immediately she gets very irritable and super confused about her location .
It means that I am checking on her very often but I'm fine with that as I'm youngish and strong enough.
We have an established routine that works so far and we ( especially me ) have to dig deep for the utmost patience when mama loses her way in her head .
At mamas home , we have removed the gas for the stove and the electric kettle , also matches and lighters. She started a small fire last year ( in the evening before we realizied she needed to be here before night fell ) it could have been catastrophic but for the intervention of uncle Dennis.
She had placed the electric kettle on the stove and it had melted into the stove top and ignited a bit of card that she had mysteriously placed near the stove . I mean...... wow .
We use several flasks now for her tea and her food is warmed in a microwave so far without incident.
We blocked the back door that leads to a treacherous stairwell and installed handrails at the small 3 step side step that leads to the garden.
She no longer owns an iron or anything that can start a fire if forgotten.
I tell you this just to show you how much planning and changes need to happen sometimes to accommodate a person with dementia who still feel they need to be independent.
It's rough , and we are all exhausted but we all know that mamas life is finite and someday she will not be here to ask question after question with her chirpy little voice .We know we will miss her so we are as kind as we can be and patient .
Doctors can't or don't always tell you what you need to know so read up , observe and try any and everything you can to keep your loved one comfortable . Every dementia patient is different but there are enough similarities for you to glean sense about your situation from the stories of others .
For me , when it comes to sundowners , I turn lights on early or when it gets dim ( 5:30) so the transition from day to night isn't startling . I have a chalk board with the day of the week and the month written on it in caps .
I hang out with her , reading or watching a film . I give her laundry to fold or books to look at . Just distractions really .
I just spend as much time as I can with her and my life is rough and I've gained 15 pounds as I can't go running anymore but hey , that's how it is .
You know , I wish you luck . It's a hard road but it isn't permanent and it's not their fault . Remember that .