The "Sundowners Syndrome" Story

It was an ordinary day.  Reading another article on sundowning.  The past few years has really opened my eyes to a whole new chapter in my life.  With the death of my day and subsequent illness and death of my mother, I began to understand, no make that REALLY understand, the problems of our senior population.  We all know or have heard about dementia and Alzheimer's disease, but have you ever heard about the psychological phenomenon known as Sundowning or Sundowners Syndrome.  I certainly am not an authority on the subject, but I do know much more that I knew half a dozen years ago.  I now realize that when my dad called in the early evening and we talked or when he called about the same time and would leave messages, he really didn't understand what he was saying that could be so upsetting to me.  He often would call and beg me to come and get him or tell me that his nurses were trying to take things from him or hurt him.  I would get so upset, not with him, but with those that were the least to blame, his caregivers.  Then he entered Moravian Manor and was placed in the nursing facility of the home.  He died shortly after, but not before he did the same things at Moravian Manor.  When I would visit with him during the day he would be in such a festive mood, but as evening arrived and the sun would go down, he became a different person.  When my mother moved to Moravian Manor it eventually became the same with her.  One day mom's doctor talked to me about Sundowners syndrome and all of a sudden that little light bulb came on in my head.  That's why both my mother and father reacted the same.  Seems that sundowning is a type of mood or sleep disorder that is often associated with the early stages of dementia and Alzheimers.  Both mom and dad seemed to have all their faculties, but as the day turned into night, they became different people.  They had lost their awareness of their surroundings and were not as alert as they were earlier in the day.  They both experienced periods of extreme agitation and confusion during the early evening that led to irritability towards their caregivers.  I often said to my wife, Carol, that there is no way I could work the evening or night shift at Moravian Manor.  In all honesty, there is no way I could have worked ANY shift at the place.  It would have driven me insane.  The exact cause of sundowners syndrome remains a mystery.  Some research points to the possibility of organic causes such as drug interactions or stress associated with diminishing cognitive functions while others say there may be a link with the body's natural day and night cycles.  The change in shifts in the nursing home could trigger the condition.  Before my dad went into the home he had 24 hour care, but they also changed shifts.  I started to understand better the symptoms the more I read about it and that helped with understanding what the doctor was doing to treat both my mom and dad.  Since sundowners is closely associated with sleep disorders and fatigue, sedatives and other sleeping aids can be prescribed to help with agitation in the evening.  Naps throughout the day were encouraged to help with fatigue.  Keeping my mom's room well lit as dusk approached did seem to help.  Ensuring a consistent daily routine really helped mom feel more safe and secure in her environment.  As it became necessary to take her from assisted living to a more structured care, she had a few bad weeks until she became accustomed to her surroundings and the daily routine.  Neither one of my parents lost the ability of awareness or alertness as I witnessed in some of the patients at Moravian Manor, but as the sun set every evening I could see confusion and traces of dementia and Alzheimers.  I found that reading about it made me understand what my parents were going through and hopefully will help me as I age and notice the same thing happening in myself.   Or, do we never notice when it happens to us?   Kind of scary, isn't it.  It was another extraordinary day in the life of an ordinary guy.