Sundowners causes are numerous. The term "sundowners" refers to how an elderly person who has cognitive impairment or dementia, may start to act confused, angry, or have other disturbing behaviors in the afternoon or early evening - thus "sundowners" syndrome. It may be comforting to know that sundowners syndrome is a well-known phenomenon but the sundowners causes are not as well known.
Some sundowners causes include common triggers, such as changes brought about by food and light. These may be things a caregiver wants to be on the watch for to predict sundowners syndrome as the sun sets in order to give their loved one the best care during this often trying time of day.
A variety of contributing influences may affect the frequency and severity of the episodes from which an elderly person may suffer. Keep in mind that there are a wide range of causes that can contribute to sundowners syndrome; if you notice something that seems to trigger an episode, it would be well worth your time to experiment with changing that particular factor in order to determine whether it has an ameliorative effect on your elderly loved one.
Additionally, an elderly person's diet can be a significant contributor to sundown syndrome. If your elderly loved one is not eating well enough, hunger pangs can actually contribute to the severity of the episodes. Someone who is already confused and somewhat anxious about their surroundings will be more prone to outbursts if the situation is complicated by hunger.
Further, after a meal--especially a large one--blood pressure will drop while the body focuses on beginning the digestion process. A side effect of this reduced blood pressure is that there will be a smaller amount of oxygen reaching the brain. In sufferers of sundown syndrome, this reduced oxygen level can contribute to an episode, especially if the situation is already complicated by other potential triggers.
In addition, in cases where the elderly person is a diabetic or a borderline diabetic, he or she may react adversely to the change in the glucose level in his or her bloodstream. While a normal, healthy person might experience an unexpected feeling of tiredness or sudden elevated energy levels depending on the situation, a person with dementia or other cognitive impairment will not know how to interpret these feelings, and this may contribute to an elevated sense of anxiety, fear, or hostility.
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Other sundowners causes that can trigger an episode of sundown syndrome are physiological issues that affect your elderly loved one's ability to see or hear well. An elderly dementia sufferer is likely already experiencing some level of confusion and anxiety. Add to that the lowered ability to see or hear may cause the senior to perceive the surroundings in a different way causing behavioral reactions.
Changes in the living environment may contribute to sundown syndrome. The reduced light in a home as the sun begins to set has been cited as one of the causes of sundowning. The senior may begin to experience confusion as the light changes in the room and shadows begin to form. Confusion leads to anxiety and anxiety leads to acting out. Set up a routine of having a lot of light prior to the time when the room starts to darken.
If you begin to notice sundowning in your loved one where it has not occurred before, examine changes in the environment or routine. Is it possible that something has changed that is contributing to this new behavior? Is a light bulb that used to remain on now off? Is something now blocking a light source that did not used to be blocked? There could be any number of factors that would negatively affect an elderly person's ability to see, and--since he or she is in a state of cognitive impairment and cannot easily ascertain the source of the change--this can contribute to sundown syndrome episodes. Has the volume in the environment suddenly been turned up? Are there new noises that weren't there in the past (drilling in the street or construction going on, for example)?
If environmental factors are stable, yet you notice that an elderly loved one is developing a trend of suffering more frequent or more severe episodes of sundown syndrome, you may want to have his or her hearing and vision checked. There may be preventive or remedial measures available to restore his or her hearing and vision to optimal levels, thereby reducing confusion and anxiety.
While there is no one source of sundown syndrome, by keeping a close eye on the diet and environment of an elderly loved one--as well as his or her ability to see and hear--you may be able to identify some triggers. Removing the triggers--or treating declining sight and hearing when possible--should help ensure a peaceful, quiet evening for your loved one.