Just wonder question>Sundown Syndrome

[Guest guest]

Because of Barb , I took the time to look up Sundown Syndrome. Most that is out there on it, you find in AD, but I did come across some in Dementia and PD. I'm pretty sure this is what Fred has been showing signs of. Maybe there are other's here on the list that also have this , so I've posted what I've came across. There are a few things that may help with Sundown Syndrome, so I've posted all that I could find that seems to be of help.

Take Care Vera

http://www.nursing.uiowa.edu/sites/users/lmarshal/webphyspath/119pdf/nrodegen.pdf

SUNDOWN SYNDROME: People with dementing illnesses seem to have more behavior problems in the evening. This worsening of behavior is often called "sundown syndrome". The cause is not yet understood but if you find that your patient has this problem, some careful planning of the daily schedule can help. For example, do not schedule bathing or going out for an outing in the evening. Also, establish an evening routine so that the patient will not become more confused.

The International Classification of Sleep Disorders

Dementia

ICSD: 331

ICD-10: G47.0 + F01/G30/G31/G91 (Disorders of Initiating and Maintaining Sleep (Insomnias) + ?)

G47.1 + F01/G30/G31/G91 (Disorders of Excessive Somnolence (Hypersomnias) + ?)

DSM-IV: 780.52 (Sleep Disorder Due to a General Medical Condition: Insomnia Type)

780.54 (Sleep Disorder Due to a General Medical Condition: Hypersomnia Type)

780.59 (Sleep Disorder Due to a General Medical Condition: Mixed Type)

Dementia

refers to a loss of memory and other intellectualfunctions due to a chronic, progressive degenerative disease of the brain. Sleep disturbance in demented patients is characterized by delirium, agitatio, combativeness, wandering, and vocalization without ostentible purpose occuring during the early evening or nighttime hours.

Prevalence:

Unknown, but commonly occurs in dementia. Sundown syndrome has been estimated to occur in 12% of a mixed group of demented and nondemented institutionalized patients.

The prevalence of undifferentiated severe dementia has been estimated at appoximately 5% of patients over 65 years and 15% in those over 85 years of age.

Keywords:

Alzheimer's disease, Pick's disease, senile degeneration of the brain, communicating hydrocephalus, obstructive hydrocephalus, non-reversible dementia, sundown syndrome, nocturnal delirium, nocturnal confusion, nocturnal wandering, acute brain syndrome, acute confusional state, nocturnal hyperactivity.

Sundown syndrome Evening confusion followed by agitation - seen in late stages of Parkinsonism - the fluctuating stage

What is "sundown syndrome?"

Sundown syndrome -- also called sundowning or sunsetting -- is a behavior common in people with Alzheimer's disease. It describes the confusion, anxiety, agitation, or disorientation that often occur at dusk and into the evening hours. The episodes may last a few hours or throughout the night.

While the exact cause of sundown syndrome is not known, experts believe there are several contributing factors. These include physical and mental exhaustion (after a long day), and a shift in the "internal body clock" caused by the change from daylight to dark. Some people with Alzheimer's disease have trouble sleeping at night, which may contribute to their disorientation. Medication that can cause agitation or confusion also may contribute to this syndrome.

Sundown syndrome can be draining for the person with Alzheimer's disease and his or her caregivers. Here are some suggestions for helping a loved one with sundown syndrome cope:

Schedule the day so that the more difficult tasks are done early in the day, when the person is less likely to become agitated.

Watch the person's diet and eating habits. Restrict sweets and drinks with caffeine to the morning hours. Try serving the person a late afternoon snack or early dinner.

To help the person relax, try decaffeinated herbal tea or warm milk.

Keep the house or room well lit. Close the drapes before the sun goes down so that the person doesn't watch it become dark outside.

If the person falls asleep on the sofa or in a chair, let him or her stay there. Don't wake the person to go to bed.

Try distracting the person with activities he or she enjoys. Soothing music or a favorite video may help, as well.

Encourage the person to engage in some physical activity -- such as walking, if able -- during the day. This may help him or her to sleep better at night.

[Guest guest]

Vera:

The thing we found most helpful with Sundowning isn't on your list. We

started putting Ken to bed almost immediately after dinner and letting him

watch TV in bed. That seemed to cut down on the late day confusion more than

anything. Also, we NEVER planned to go anywhere or have people over in the

evening. if family members were here, Ken's caregiver would put him to bed on

schedule. The secret seemed to be not changing the evening routine ever if we

could help it.

give Fred my love. I am so sorry to hear that things are progressing

again.

Love, Barbara