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An unsteady pensioner
Published in Tim French, Terry Wardle, The Problem-Based Learning Workbook, 2022
Nurses often inform junior doctors that a patient was confused and agitated overnight. However, when the patient is assessed during the working day there can be little to suggest that this was the case, i.e. no obvious signs of delirium. This is what is known as ‘sundowning’, where there is increased agitation and activity late in the day, and through the evening and night.
Delirium
Published in Stephen M. Cohn, Peter Rhee, 50 Landmark Papers, 2019
Anchit Mehrotra, Natasha Keric
“Sundowning” used to be a common description for a patient suffering from what we now describe medically as delirium. The definition of sundowning is that it is a symptom of “late-day confusion” associated with dementia. Sundowning is quite different from the definition of delirium, which is a DSM-5 criterion. Delirium is described as “a disturbance in attention and awareness, which develops acutely and tends to fluctuate in severity, causes a disturbance in cognition that cannot be better explained by preexisting dementia or does not occur in the context of severely reduced level of arousal or coma, with evidence of an underlying organic cause or causes.”
Summary and Development of a New Approach to Senescence
Published in Nate F. Cardarelli, The Thymus in Health and Senescence, 2019
Alzheimer’s patients display an attenuation of normal sleep-wake cycles with increased insomnia.236 Some show a day-night pattern reversal. Many have an endocrine disturbance, especially seen as a thyroid dysfunction, as well. Symptoms worsen right after sundown, thus the term “sundowning syndrome”.
Applying Person-Centered Activities for Dementia Caregivers and Activity Professionals: A Review of Creative Engagement from a Social Work Perspective
Published in Journal of Gerontological Social Work, 2021
Recommendations related to communication with people with dementia and managing group dynamics may be useful for social workers and students whether or not one’s focus is on gerontology. The authors’ emphasis is once again on embracing the reality of people with dementia rather than focusing on what is “true,” which may be quite helpful for family caregivers who often struggle with whether telling the truth will cause more distress for their loved one. There is an emphasis throughout this book on the benefits of professionals and caregivers being willing to ask for help, and this humility and vulnerability seems to fit well with social work values. For example, the authors describe how an effective strategy for engaging people with dementia is to ask for their help, which in turn helps them feel useful and valued in their contributions. Additionally, the authors recommend asking for help from other care staff, whose workloads may be lightened by offering simple activity boxes in the late afternoon or evening when sundowning most commonly occurs.
Variation of the occurrence of agitated delirium during the day in palliative care
Published in Progress in Palliative Care, 2018
Ferraz Gonçalves, Ana Almeida, Luís Antunes, Sara Teixeira, Sara Pereira, Natércia Edra
Delirium is often associated with alterations of the sleep–wake cycle, with diurnal somnolence and nocturnal sleeplessness.4 It is stated that agitation is also more common at evening and night that on other periods during the day.5 However, as far as we know, in the medical literature, there are any research data supporting that statement. On the other hand, in the research on dementia, there are several studies showing a higher number of episodes of agitation at evening and night, a phenomenon often called ‘sundowning’ or ‘sundown syndrome’.6,7