Psychosocial Integrity Q 4

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The client with dementia is experiencing confusion late in the afternoon and before bedtime. The nurse is aware that the client is experiencing what is known as:

  

     A. Chronic fatigue syndrome

     B. Normal aging

     C. Sundowning

     D. Delusions

    

    

Correct Answer: C. Sundowning

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Increased confusion at night is known as “sundowning” syndrome. This increased confusion occurs when the sun begins to set and continues during the night. The term “sundowning” refers to a state of confusion occurring in the late afternoon and spanning into the night. Sundowning can cause a variety of behaviors, such as confusion, anxiety, aggression or ignoring directions. Sundowning can also lead to pacing or wandering.

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Option A: Fatigue is not necessarily present. Sundowning isn’t a disease, but a group of symptoms that occur at a specific time of the day that may affect people with dementia, such as Alzheimer’s disease. The exact cause of this behavior is unknown.

Option B: Increased confusion at night is not part of normal aging. Some research suggests that a low dose of melatonin — a naturally occurring hormone that induces sleepiness — alone or in combination with exposure to bright light during the day may help ease sundowning.

Option D: A delusion is a firm, fixed belief. Delusions are defined as fixed, false beliefs that conflict with reality. Despite contrary evidence, a person in a delusional state can’t let go of their convictions. Delusions are often reinforced by the misinterpretation of events. Many delusions also involve some level of paranoia. For example, someone might contend that the government is controlling our every move via radio waves despite evidence to the contrary.

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