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Sundowning and the elderly

Caregivers of persons with dementia may notice behavioral changes in their loved ones around sunset. Some persons with dementia become more agitated and restless, becoming confused and even hallucinating as the day progresses. This is known as "Sundown Syndrome," and there are a number of theories as to the cause.

Some medical professionals attribute it to hormones, others blame over-stimulation combined with fatigue, and some believe it is caused by the anxiety of trying to see in diminishing light. The early signs of sundowning are usually subtle and may be overlooked by busy caregivers. The care receiver may exhibit signs of paranoia, feeling like they are being watched. As the condition progresses, the care receiver may become more confused and more agitated by day's end, experiencing very real hallucinations. They may also confuse daytime with nighttime, waking in the night to begin their day's activities. This usually results in wandering and more sleepless nights for caregivers.

Caregivers can take steps to alleviate sundowning. Some caregivers have found installing a full spectrum light bulb about a foot or so away from the care receiver's chair and keeping in on for an hour or two each morning helps "reset" their internal clock. Keep the care receiver well-hydrated, as dehydration can affect the brain and aggravate sundowning behaviors. Remain calm and reassuring if they experience hallucinations. Explain these hallucinations are not real and cannot harm them. Minimize exposure to stressful situations, including television programs Limit stimulating activities to the morning or early afternoon hours. Schedule regular nap times. Darken the home at sunset - close drapes and shut off most lights. This will help get the care receiver in a "nighttime" frame of mind and they will begin to settle in to sleep mode.

For more information contact the BHSN Caregiver Resource Center.

The Senior Connection is a column provided by the Clinton County Office for the Aging. For more information about services for senior citizens, contact their office at 135 Margaret St., Suite 105, Plattsburgh or call them at 565-4620. Information is also periodically provided by the Behavioral Health Services North Caregiver Resource Center. They may be reached at 565-4543 or 565-4625.

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