Sunday, August 12, 2012

Sundown Syndrome

Heidi, the dog we had before Caitlin, used to take my aunt for walks. Aunt's dementia was worsening. She had lost her driver's license a few years before--a terrible blow for her, as she had been a skillful driver, loved to drive, and loved her little VW bug. She never forgave our brother-in-law for having bought it from her when it became clear that she would never drive again. It seemed as though things went rapidly downhill after that.

It soon became clear that she couldn't find her way, even around her own neighborhood, where she had lived since 1965.

The loss of her independence was a huge blow. Another huge blow was her feeling of uselessness as more and more she became unable to do simple tasks. Whenever she tried to help, she would make mistakes--sometimes dangerous mistakes, such as when she set the kitchen on fire by putting a box on on a lighted burner and wandering away.

The best solution we ever found was asking her to take Heidi for walks. Heidi was totally reliable. We could count on her to bring Aunt home, whether Aunt knew the way or not. We didn't have to worry, and Aunt felt that she was performing a useful service.
Heidi at Dog Beach, July 2007

Both of them are gone now, but I will be forever grateful to Heidi for being a wonderful companion to Aunt in her last years.

These days Alzheimer's facilities often depend on dogs to help improve the patients' quality of life. Not only do they give the patients affection and physical contact, they are particularly helpful in mitigating the agitation and restlessness from which the patients suffer, usually in the early evening--hence the name "Sundown Syndrome."

Patients suffering from Sundown Syndrome often become aggressive and uncooperative, making the evening routines very difficult to manage. They are noticeably calmer and less depressed when dogs are there to help.

Toward the end, Aunt was more and more frequently either boiling over with anger or sunk in deep depression.

One evening Mother called, frantic because Aunt had disappeared after an angry outburst. Although Mother had keyed deadbolts on all the doors, she was afraid that Aunt had slipped out and wandered away. We finally found her hiding behind some furniture in the garage.

After that incident, despite Mother's resistance, we finally made the decision to put her into residential care. She was clearly beyond Mother's ability to handle.

She had a fatal stroke the next day.

I now wonder whether, if Heidi had actually been in the same house with her, the last few months of her life might have been a bit happier.