Sundowning: severe dementia and bringing on the night

KP-PC k.p.collins at worldnet.att.net%remove%
Fri Mar 28 00:08:08 EST 2003


"John H." <johnh at faraway.xxx> wrote in message
news:T1Ega.323$B34.12497 at nnrp1.ozemail.com.au...
| Recently a friend of mine starting working in a dementia ward for
severely
| demented individuals. She was advised by other staff that to be
careful
| after sundown because many of the patients become violent and
extremely
| difficult to control. I'm mystified by this, just wondering if
anyone else
| has noticed this in severe dementia and\or if they have any ideas
re the
| same. I did note a few months ago a report stating that bright
light therapy
| proved beneficial for some dementia patients but this doesn't
account for
| the above observations.

If it's so, then it's probably a result of 'sleep' stuff 'crossing
over' into 'waking' consciousness.

If I were to explore such, the first thing I'd do is work to
rigorously standardize the cycling of natural 'states' of
'consciousness' - in an effort to maximize their
'normally'-synchronized 'states'.

To approach such, the first thing I'd do is, to the degree possible,
tell the subject why it's necessary to optimize such synchronization,
then, if they agreed to it - agreed to endure such - I'd rigorously
synchronize their daily schedules, which would require segregating
them within am environment which would eliminate other desychronizing
factors.

The premise is that the subjects are so TD E/I(up) 'stressed' that
they're 'afraid' to fully give themselves over to sleep.

Course, you specified "profound dementia", and I don't really know
what such entails from your perspective.

For myself, I've never encountered anyone who doesn't respond,
positively, to the 'gentling' that is, of course, inherent in the
approach I've outlined above.

Basically, it's just interanl cycling of "supersystem configurations"
that's become dis-integrated because prolonged TD E/I(up) has been
endured. Such feeds-back into itself because the TD E/I-minimization
mechanisms' functioning becomes increasingly 'abstract' as they
'hunt' for any means to achieve TD E/I(down) with respect to the
prolonged TD E/I(up).

Sadly, in their circumstance, it's most often the case that the
'ignorance' of the folks 'treating' them, with respect to the way
nervous systems work, works against the welfare of the subjects,
instead of with it. That is, the well-meaning, but ignorant, efforts
of the 'helpers', and the 'helpers' presumption that the subjects are
'irrecoverably ill', constitute a major portion of what
'desynchronizes' the subjects' neural dynamics.

[All of this has been in AoK all along, too.]

Cheers, John, ken





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