“Dad and I were about to take Mom home from the hospital. It was in the afternoon, I remember,” Lori Wark, a caretaker daughter, told me. “Then we realized she was too weak to take a cab so we sent for an ambulance. While we were waiting, Mom and I had a great time talking and laughing. Everything seemed so normal. Then Mom got tired and decided to take a short nap.
“When she woke up she was a completely different person. She accused Dad of keeping some important information from her; she thought we were taking her away from a former home she had loved. She was very upset.” Gone was the playful woman she’d been just a few minutes ago.
The above story is an example of a typical sundowners syndrome incident. Although there is very little agreement on the defining characteristics of the syndrome (also known as sundowning) some studies suggest that it is a phenomenon in which an elderly person shows an increase in confusion and agitation in the late afternoon or evening.
Most professionals believe sundowning occurs only in elderly who exhibit symptoms of dementia such as Alzheimer’s Disease, but this may not always be the case. Dr. Maria Sullivan, associate professor of clinical psychiatry, at Columbia University and the New York State Psychiatric Institute, explained that all elderly people exhibit some age-related cognitive decline, even if it cannot be termed dementia. Therefore, even a minimal mental degeneration may predispose someone to sundowning. It is also important to note that not all those with dementia exhibit symptoms of sundowners syndrome and as definitive sundowning characteristics have not been defined, as a caregiver, all unusual behaviors should be checked out with your doctor.
Symptoms
Visual Hallucinations
According to Dr. Sullivan the primary symptom that she has observed besides confusion and agitation is benign visual hallucinations. These hallucinations are considered benign because they tend not to be threatening or frightening as is frequently the case with psychotic hallucinations. A common hallucination is seeing a stranger (that no one else can see) who has come to the hospital room to visit the elderly person. In the story at the beginning of this article “Mom” saw the place where she once had lived, even the furniture seemed the same. This qualifies as a benign visual hallucination.
