Post by norbert1 on Jul 9, 2006 9:11:39 GMT -5
There is no universal agreement of what sundowning is or what causes it.
Generally, sundowning is an increasing level of confusion in late day, resulting in increased agitation, and personality change. This person is less able to function or tolerate difficulties.
Possible explanations include-
- After coping all day, the person becomes tired and runs out of ability to cope by the time late afternoon/evening arrives.
- The person is physically tired.
- The person is hard wired by life experience to be active at this time periods. Late afternoon is the time when we finish up our tasks at work, rush home, get dinner ready, deal with household commotion (kids home from school) etc. The person with dementia is not doing these things and feels that something they are supposed to be doing is missing.
- The person is reacting to increased levels of activity that occurs this time of day.
Recommendations for minimizing sundowning behavior -
- Opportunities for moderate exercise earlier in the day
- have periods of activity and mixed with opportunities for rest throughout the day. Activities should be short and not over tax the person.
- Do personal care in the morning when better tolerated
- Effective treatment of any pain
- Reduce late day triggers - environmental triggers - too much activity, noise, people rushing around at this time.
- Follow a predictable routine during the day
- Eliminate stimuli during the day - TV, talk show, Jerry Springer
- No caffine
- A calm environment during the later part of the day
- Calming activities - eating dessert, listening to music
If absolutely necessary, a dementia doctor can prescribe a low dose of antipsychotic (typically a vert low doesage of seroquel..6.5MG) to be given before the sundowning time begins.
Norbert
Generally, sundowning is an increasing level of confusion in late day, resulting in increased agitation, and personality change. This person is less able to function or tolerate difficulties.
Possible explanations include-
- After coping all day, the person becomes tired and runs out of ability to cope by the time late afternoon/evening arrives.
- The person is physically tired.
- The person is hard wired by life experience to be active at this time periods. Late afternoon is the time when we finish up our tasks at work, rush home, get dinner ready, deal with household commotion (kids home from school) etc. The person with dementia is not doing these things and feels that something they are supposed to be doing is missing.
- The person is reacting to increased levels of activity that occurs this time of day.
Recommendations for minimizing sundowning behavior -
- Opportunities for moderate exercise earlier in the day
- have periods of activity and mixed with opportunities for rest throughout the day. Activities should be short and not over tax the person.
- Do personal care in the morning when better tolerated
- Effective treatment of any pain
- Reduce late day triggers - environmental triggers - too much activity, noise, people rushing around at this time.
- Follow a predictable routine during the day
- Eliminate stimuli during the day - TV, talk show, Jerry Springer
- No caffine
- A calm environment during the later part of the day
- Calming activities - eating dessert, listening to music
If absolutely necessary, a dementia doctor can prescribe a low dose of antipsychotic (typically a vert low doesage of seroquel..6.5MG) to be given before the sundowning time begins.
Norbert