Dear Jenny, My aunt has been diagnosed with early stages of Alzheimer's disease by her
doctor. She seems fine to me like she has always, but lately in the afternoon or
evening she gets very agitated. The doctor didn't mention this and this isn't
like her. What's happening?
Your aunt is experiencing a condition known as Sundowner's Syndrome.
Sundowner's is fairly common for someone recently diagnosed in the early stages
of dementia (like Alzheimer's), but not everyone experiences it.
There are many different theories as to what triggers Sundowner's Syndrome,
often called Sundowning. Some theories include hormonal imbalances, fatigue, or
even a response to limited visibility as it gets darker. The symptoms of
Sundowning differ in each person; some have rapid mood swings with anger or
fearfulness, while others experience random crying, excessive pacing or general
restlessness. In many cases the individual tends to become stubborn, or more so
than usual and sometimes will refuse the caregiver's direction, even from their
spouse. In extreme cases, a person with Sundowning may wander away from familiar
surroundings or even become violent. Whatever the cause of Sundowner's Syndrome,
once the sun comes back up these symptoms usually go away.
Sundowner's Syndrome can place a tremendous strain on family members, both
physically and emotionally. Often in the morning, the individual with dementia
will not have any recollection of whatever behaviors they exhibited the previous
evening, so patience is one of the most critical traits for caregivers.
The good news is there are different things that can help reduce the effects
of Sundowning. Routine is crucial to those suffering from dementia, so
establishing a consistent nightly routine while getting ready for bed is
important. Exercise during the day may help reduce some excessive energy that
comes out in the evening. Changes to the environment can also help, such as
ensuring there is sufficient lighting for visibility, reducing unnecessary
clutter, and reducing the volume on the television or radio. If the TV is on,
minimize shows that have scenes of violence, including the news with stories of
kidnapping, murders, bank robberies, war, bleak economic news, or any other
negative messages. Ideally keeping the person engaged in activities that are not
over-stimulating, but still exercise the mind and body help distract from some
of the effects of Sundowning.
Lastly, if one thing doesn't work, try something else to get a better
response or create a calming presence. It may be a trial-and-error approach, but
since everyone is different, this is sometimes necessary. Lastly, consider
attending a local dementia support group since you can share ideas and
techniques that work, and it helps to know that you aren't alone out there.
If you have questions about senior care or helping an elderly loved one,
contact Jenny Wallis, Community Marketing Director at Villa Bonita Senior Living
at (619) 476-9444 or by e-mail at villabonitamkg2@islllc.com.
Friday, October 4, 2013
There are always questions about Assisted Living. Is it good? Is it the right thing to do?
This is a very interesting article that the Union Tribune ran.....
Please read:
Marion is 102 years old. If you meet her, one of the first things you will notice is the brightness in her eyes and her drive to seize the day. Marion wakes up every morning in her apartment at Villa Bonita Assisted Living around 5:00 a.m., does her stretching exercises then walks the entire 3rd floor, followed by the 2nd floor and finally the 1st floor. Next, she attends an organized community exercise program before moving on to cards and whatever else the day brings. At 102, Marion has been able to maintain a level of independence she is proud of and enjoys a lifestyle that would be nearly impossible were it not for Assisted Living.
Submitted photo of Marion.
Marion’s experience is far more typical of what happens in Assisted Living communities across California and the nation than what was recently portrayed on the pages of the Union Tribune. Compassionate and highly qualified senior caregivers were shocked to see how a few unfortunate and disturbing incidents -- from years ago -- were strung together in an attempt to paint a completely erroneous overall picture of Assisted Living. They were equally troubled by sweeping assertions made about the whole of Assisted Living extrapolated from single, isolated allegations which, in one particular case, were dismissed by a state investigation.
The Assisted Living communities I work with have, and will continue to, provide the highest levels of care to improve the quality of life, peace of mind, and independence of thousands of seniors and their families. The story you didn’t see was one of compassionate, competent care regularly and reliably delivered to one of the most valued populations in society. Assisted Living providers work in a profession that is highly challenging but also highly rewarding. That is reflected in what residents and family members have to say about their experience with Assisted Living. Clearly, it is not what the media has portrayed it to be. Rather, residents and their families continue to be highly satisfied with their experience in Assisted Living and they are recommending it to others.
A recent survey confirms this. Across the nation, a whopping 94% of Assisted Living residents indicated they were satisfied with their experience and 99% of residents say they feel safe in their communities. Additionally, 93% of Assisted Living residents say they are satisfied with the level of personal attention they receive from staff working in their communities. Assisted Living has listened to residents and families and responded. Popularity and success of the Assisted Living model has occurred because it is consumer-driven and offers residents what they want- flexibility, a home like setting, and independence.
For those questioning oversight of Assisted Living in the wake of the Union Tribune series, it is important to recognize that Assisted Living communities are licensed as Residential Care Facilities for the Elderly (RCFEs) in California and governed by a robust set of laws and regulations. From the initial licensing process to inspections, the regulatory framework is designed to promote resident independence and self-direction to the greatest extent possible in a residential, non-medical setting. Nearly every aspect of the Assisted Living experience is governed by state regulation. Is it enough? Our answer, as Assisted Living providers, is that more frequent inspections will only add to the integrity of Assisted Living and that is why we have strongly supported more frequent inspections. We remain committed to ensuring that California regulators have the resources they need to do their job. Unfortunately, California’s budget situation has reduced the frequency of inspections against our objections and those of consumer groups.
Providers have also strongly supported enhanced licensing and enforcement mechanisms to ensure compliance with all requirements. Our members have supported a proposed 20% licensing fee increase to support more frequent inspections and will continue to support such an effort in the future. We have worked hand in hand with legislators and regulators to ensure that we are doing everything we can to provide the safest environment possible while also protecting the home like setting and independence our residents and their family pay for and expect.
Even the strongest of operations and oversight cannot prevent all problems. Unfortunately, it is the rare unfortunate outcome that makes news. There is no question that Assisted Living wouldn’t be in high demand or enjoy extremely high resident satisfaction if quality care were such an issue. Thousands of caregivers have devoted their lives to helping seniors and it is truly unfortunate that their work and contributions are being undermined. In the end, it will be seniors and their families – who want what Assisted Living offers – who will lose if a cloud of misinformation is allowed to linger.
The positive, everyday experiences taking place in thousands of senior communities across this country are the reality of Assisted Living. Like Marion, countless seniors and their families breathe a sigh of relief daily knowing they are well taken care of, safe, and living as independently as possible. Their caregivers are dedicated professionals who go the extra mile to make life more comfortable and easier to manage. While the truth about Assisted Living is not likely to be the focus of overblown media hype, it has taken hold. 94% of residents like what they have experienced and 99% feel safe. This is a model that works and preserves dignity and independence for our seniors.
Sally Michael is the president of the California Assisted Living Association, which represents over 460 Assisted Living communities in the state. Members range from providers that cater to an active lifestyle to those that specialize in caring for residents with memory impairment.
Dear Jenny,
