For some people who have Alzheimer’s disease and other associated dementia ailments, the list of symptoms can very often be confusing and worrying to the family, carers and of course the sufferers themselves. There will very frequently be dramatic changes in behavior and also mood swings to add to the confusion.
There is one extra twist to the symptoms, and this is called Sundowners Syndrome. The reason for its name comes from the fact that the onset of the symptoms tends to occur in the evening around the time that the sun sets and nighttime starts to set in. The changes in behavior often show the sufferer in a state of increased agitation, and they appear to become fearful. For the family witnessing this change, it can be very overwhelming as the Alzheimer’s sufferer may have seemed relatively calm for the first part of the day.
15 Confusing Symptoms of Sundowners Syndrome
While there are possibly many more subtle symptoms of Sundowners Syndrome, I have collected together the central fifteen in the following list:
In this state, the patient can show signs of anger for apparently no reason. This state may be demonstrated by outbursts of bad language or can also resort to physical signs of violence.
The sufferer may have been in a relatively calm state all day, and then as the evening falls, the sufferer can begin to show signs of being mildly or profoundly anxious. This mental state can be recognized similarly to anyone else appearing to be anxious, so it includes an appearance of stress when there is no apparent reason for that stress.
#3 Outbursts of Emotion
This feature can be demonstrated in many different ways, but often it can be in the form of tantrums or may even be in the form of appearing to be upset and ending in tears. This symptom can overlap another trait which is depression.
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#4 Being In an Agitated State
This can be demonstrated by having a lack of patience in anyone and everything. It can be similar to someone who is very nervous about an upcoming event and their nerves are on edge.
No real explanation of this one is required. But seeing a member of your family crying is undoubtedly as upsetting for you as it is for them.
#6 Delusional Thinking and Actions
The manifestation of this symptom is that the sufferer will get strong contradictory beliefs about what is true and what isn’t true. These beliefs can often be the total opposite of what is true to the people around them. An argument over something simple such as a spoon being on the table or not being on the table can blow out of proportion very quickly and easily because of this symptom.
#7 Fearful Thoughts and Behaviors
We all suffer from fear occasionally, but luckily for most of us, it’s not a common emotion. For someone suffering from Sundowners Syndrome, however, it can be a commonplace occurrence, unfortunately. Being afraid when there is nothing to be fearful of is a very frightening experience.
— Wiser Home Care (@WiserHomeCare) February 4, 2016
It may have become apparent that many of the symptoms related to Sundowners Syndrome are a little like the feelings we all get when we are having bad dreams. The way the mind works for Sundowners Syndrome sufferers does seem very comparable to how we suffer from nightmares; only there’s takes place during their waking hours. Hallucinations are very frightening for anyone at any time, so be aware that hallucinations are indeed one possible symptom.
#9 Hiding Things
The ‘things’ being referenced here can be almost any ‘thing.’ It can be the food off their plate or other items around the property. Try to be vigilant to anything going missing and be aware that you may not have misplaced things yourself, but the individual suffering from Sundowners Syndrome may have hidden the article.
#10 Trouble Sleeping – Insomnia
Because Sundowners Syndrome takes places in the evening, this can disrupt the regular sleeping pattern of the sufferer (and the carers.) It is very common that the nighttime schedule becomes a very tense part of the day. This can be further compounded by the fact that the previous night was very similar, and so nobody is getting enough sleep generally at any time at all. The general lack of sleep for everyone concerned can increase the effects of insomnia for the nights following.
#11 Becoming Restless
Many of us can become restless for many reasons. Perhaps waiting for a significant job interview would be a good example. For people with Sundowners Syndrome, the anxious moments can come out of the blue.
Mid afternoon delight, it’s happy hour looking forward to sunset. But if you have Alzheimer’s Sundowners syndrome it’s confusion & anxiety! pic.twitter.com/J03hC1oKQw
— 67Tiger3 (@67tiger3) May 19, 2017
#12 Rocking Movements
Rocking back and forth is another possible symptom of a person with Sundowners Syndrome. While the movement is far from being a good thing, it’s not a symptom that causes enormous distress as such. Other items in this list certainly can cause more significant stress and discomfort. Be aware however that the rocking movements are all part and parcel of this condition.
#13 Being Extra Stubborn
If the person suffering from Sundowners Syndrome is elderly, then you may already have experienced some stubbornness, as some older people exhibit stubbornness at times in any case (not generalizing as such, but it can be the case.) For seniors not prone to being stubborn, then Sundowners Syndrome can undoubtedly develop this trait. Be aware that their new form of stubbornness can indeed be the effects of the syndrome.
#14 Wandering or Pacing
Again, this could be described as a form of restlessness as described in symptom number eleven. With wandering and pacing, there is apparently an active element but its distinct from constant shuffling in a chair or continuously getting up and then sitting down again. With pacing, the sufferer can be pacing up and down the room space. Wandering can be wandering off and perhaps heading outside to wander farther afield. Try if possible to keep the person indoors as wandering off too far can undoubtedly be dangerous for someone already confused.
#15 Violent Behavior
I have left this one to the very end as it’s undoubtedly one of the most distressing possible symptoms. I say possible, because not every person suffering from Sundowners Syndrome will show signs of violent behavior. Similarly, not all symptoms in this list will be typical of all sufferers. Some symptoms will be experienced, and some will not. When violent behavior does become noticeable, then take precautions to defend yourself while at the same time avoiding harming the person suffering from the syndrome. Ideally, speak to a professional in this field if violence becomes an issue, as they’ll be able to advise best how to handle these situations safely.
Sundowners Syndrome Is Not A Guaranteed Outcome
It is not an established 100% fact that all sufferers of Alzheimer’s disease or other forms of dementia will become affected with Sundowners Syndrome. Some sufferers may exhibit some of the items in the above list during their period of illness without actually having the syndrome.
If you are a family member caring for someone with Alzheimer’s disease, dementia or Sundowners Syndrome, then ask for help from professionals in that profession. It is possible to keep your loved ones at home with you if you have the support and guidance from professional carers.
Sundowners Syndrome Does Not Only Affect The Elderly & Not Only Humans
While my article has leaned towards elderly sufferers of this syndrome, it can equally apply to younger people who have dementia. Dogs can also suffer from Sundowners Syndrome, but that area of discussion would need to be an entirely separate article.