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Sundowning in the Elderly

Sundowning in the Elderly

Sundowning in the elderly is basically a dementia-related medical condition in which symptoms like confusion, disorientation, and restlessness worsen in evening time. The symptoms of sundowning can be managed effectively with supportive strategies and treatment medications. This HealthHearty article gives information about the same.
HealthHearty Staff
As the name signifies, sundowning symptoms are manifested around sunset time of the day. Medically referred to as nocturnal delirium, it is associated with increased disorientation, confusion, and agitation in late afternoon. The worst part about this syndrome is that it is asymptomatic in the initial stages. Even if symptoms are present, they mimic dementia and other mental health problems. Thus, early diagnosis of sundowning syndrome is difficult in most patients.
Sundowning Syndrome in the Elderly
Although it is agreed that sundowning and dementia are related to each other, there is no relevant medical data concerning this syndrome. Caregivers are of the opinion that symptoms of dementedness amongst elderly patients exacerbate during late afternoon or evening time. And the manifested medical indications are collectively referred to as sundowning or sundown syndrome. Consider the following points to understand more about this syndrome.
Causes of Sundowning
As of date, the exact causes of sundowning in the elderly are not identified. While some medical experts claim that it is related to tiredness and stress, others believe that this could be due to sensory stimulation in the daytime. Another probable cause is hormonal fluctuations in the elderly and critically sick patients. It is observed that patients of dementia get stressed out very easily, which leads to increased confusion. Some other causes include poor nourishment and being on too much medication.
Risk Factors
Elderly patients who have a medical history of dementia or Alzheimer's disease are at a higher risk of manifesting sundowning syndrome than others. According to statistics, approximately 45 percent patients with Alzheimer's disease manifest sundowning symptoms. Also, people with severe cognitive complications may experience similar indications during sunset and sunrise time.
Symptoms
The onset of sundowning syndrome is marked by delusions of being watched or criticized. As the condition progresses, the patient exhibits signs of suspicion, mood swings, anxiety, disorientation, and insecurity. Abnormal demands and increased arguments are other symptoms of sundowning in the elderly. At times, hallucination is observed, which may be because of disturbances in the chemical signaling of the brain.
Managing Sundowning
Signs and symptoms of sundowning can be managed effectively with well-planned treatment strategies. The patient should be allowed to take frequent naps at regular intervals. Convincing a hallucinated patient that what he/she sees is not real and will not harm is a great way to calm them. Other effective tips for caring for sundowning patients include calming the patient, avoiding tiredness, reducing stress, ensuring security, and maintaining a healthy diet. Diverting the aged patient from watches and shades will also help in preventing the onset of sundowning.
Treatment Offered
The severity of disruptive behavior may vary from one patient to another. Accordingly, therapeutic approach for treating sundowning syndrome differs. Based on the behavioral condition, the doctor may recommend antipsychotic drugs (e.g. olanzapine and haloperidol) in a specific dosage. It is to be borne in mind that such medicines are associated with certain side effects. Thus, administration of these medications should be done only under the strict guidance of a physician.
Support from caregivers and family members is crucial for effective management of sundowning in the elderly. They should have a clear idea about the existing condition of the patient. Careful observation of the triggering factors is a sure way to help patients. Any worsening in the manifested symptoms should be informed to the concerned physician as soon as possible. If required, the doctor may change the prescribed medications or their dosage intake. Last but not the least, keeping oneself hydrated through healthy drinks helps in reducing tiredness and restlessness.
Disclaimer: This HealthHearty article is for informative purposes only, and should not be used as a replacement for expert medical advice.