Relief from Sundown Syndrome
Researchers at the University of Nebraska Medical Center College of
Nursing have found that dogs can provide Alzheimers patients relief from
sundown syndrome. The syndrome, which happens in early evening, causes
restlessness, confusion, aimless wandering, agitation, and aggressive behavior
such as hitting, kicking and biting. Its cause is unknown.
We wanted to provide data to show it is worthwhile to use trained
and certified therapy dogs to improve the quality of life for Alzheimers
patients, said Mara Baun, DNSc., professor and associate dean for research,
UNMC College of Nursing. We think this fits for a non-drug method of treatment
to reduce inappropriate behavior which can lead to social isolation.
Barbara McCabe, Ph.D., associate professor of nursing, UNMC College
of Nursing Lincoln Division, also was investigator of the study which focused
on 28 patients in three Midwestern extended-care facilities with Alzheimers
disease or a related disorder. Results were published this year in the
Journal of Psychosocial Nursing.
Dr. Baun has done about 20 studies on the benefits of companion animals
and makes presentations worldwide on her findings. In the early 1980s,
she and colleagues conducted one of the original studies which found petting
dogs could decrease blood pressure in humans. Pets are used successfully
in health care to reduce stress and provide affection and companionship
with those who have reduced ability to socialize.
Sundown syndrome is well-known to caregivers of Alzheimers patients.
Agitated patients often become uncooperative with evening routines, making
management of their care difficult for health care staff. Aggressive behaviors
may lead to alienation, loneliness and fear, and ultimately may result
in increased aggressiveness.
During this sundown time when a person with Alzheimers can be most
agitated, we have found a dog can be effective in distracting them from
that behavior, Dr. Baun said. We found if the dog is present, some patients
benefit by appropriately focusing their attention and decrease their need
to be agitated. Its sometimes hard to settle patients down. Its a benefit
to them and staff as well.
Sundown syndrome may be caused by changes in lighting, the day coming
to an end and the feeling of going home, Dr. McCabe said. The evening
may trigger old memories or maybe they are reacting to an increase in activity
by staff. People with Alzheimers cannot always sort out the things going
on around them.
Dogs best suited as therapy dogs are friendly, tame and obedient large
dogs such as golden retrievers and must be trained and certified. The dog
used in the study was Sadie, a Golden Labrador mix.
Therapy dogs may produce positive effects by inducing relaxation and
distracting patients from agitation, according to the research findings.
Researchers say the presence of a therapy dog evokes looks, smiles, leans
and touching from patients, indicating interest and pleasure with the dogs
appearance.
It matters little to a pet if the persons body has deteriorated or
if the same stories are repeated over and over, Dr. Baun said. All humans
need to be touched and to touch others. The therapy dog can provide the
missed physical contact through petting, hugging and caring for the dog.
The findings could benefit patients and those who care for them. In
1998, the Alzheimers Association estimates 4 million people have the disease
and by 2050, it will increase to an estimated 14 million. Alzheimers is
a slow, progressive brain disorder that impairs memory, reasoning, and
personality. Its cause is unknown.
Progression of mental deterioration and agitation of Alzheimers disease
is a common reason why families find it necessary to place the patient
in a long-term care facility. There is no known cure or treatment for Alzheimers
disease although research of non-drug interventions is underway to manage
its behavioral symptoms.
Health care staff are aware of this increased time of agitation and
do their best to cope, Dr. Baun said. Alzheimers is a terrible disease.
Social isolation is a concern in Alzheimers patients. Family visits
may not be possible and staff are limited in the time they spend with residents.
Although patients lose their ability to initiate relationships, they still
need social interaction. A therapy dog can help fill some of these needs,
Dr. Baun said.
Dr. McCabe works with Alzheimers patients in a special care unit at
Madonna Rehabilitation Hospital in Lincoln, Neb., one of the three sites
at which the study was conducted. She said a pet in the care unit makes
the atmosphere more like home and makes it easier for families to visit
loved ones.
It helps the family during visits. If a visit isnt going quite how
the family expected, it takes a little of the tension off and keeps people
smiling, including the staff. Pets in Alzheimers units are becoming the
norm but theres still not as many as there should
be, Dr. McCabe said.
She said home caregivers of Alzheimers patients also might want to
consider a therapy dog. Because they are taking care of Alzheimers patients,
caregivers also become isolatedthey cant go anywhereit may be good for
them too, she said.
The UNMC College of Nursing is the largest nursing school in the state
with a total of more than 700 students at its Omaha, Lincoln, Kearney and
Scottsbluff campuses. It is the only nursing school in the state to offer
undergraduate, master’s and doctoral degrees.
UNMC is the only public academic health science center in the state.
Through its commitment to research, education, outreach and patient care,
UNMC has established itself as one of the country’s leading centers for
cancer research and treatment and solid organ transplantation. More than
$32 million in research grants and contracts are awarded to UNMC scientists
annually. In addition, UNMC’s educational programs are responsible for
training more health professionals practicing in Nebraska than any other
institution.
PHOTO AVAILABLE of Alzheimer’s patient petting a therapy dog with a
researcher in the photo.