Sundowning?

  1. I'm sure many of you are familiar with the term "sundowning."

    Has anyone observed this phenomenon in the pediatric home care population? Is that possible? I know it's more commonly associated with Alzheimer's patients.

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  2. 12 Comments

  3. by   eeffoc_emmig
    I have only heard that term and observed the behavior in geriatrics. May I ask what the patient's diagnosis is?
  4. by   chevyv
    Never seen it in peds, but I don't work peds. Now in geriatrics.....lots and lots!
  5. by   CloudySue
    With peds, change in mood to me suggests crankiness r/t nap time or bedtime!
  6. by   caliotter3
    Can't say that I've ever encountered this in ped hh.
  7. by   xoemmylouox
    Not with Peds. Geriatrics all the time.
  8. by   systoly
    Quote from xoemmylouox
    Not with Peds. Geriatrics all the time.
    ditto
  9. by   Adele_Michal7
    Thanks for the replies, all.


    After talking to the PCG and another nurse on the case, I think this behavior is more closely related to one of the following:

    1.) side effects related to Keppra (pt has been on Keppra about 2 years and this behavior started shortly after.)

    2.) Possible DX of depression

    3.) Related to the family stopping all interaction shortly after patient was trached.

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  10. by   caliotter3
    Good sleuthing. All those reasons sound like good possibilities.
  11. by   recognizeD
    I finally realized it today that the recent behavior I saw in a home pediatric patient in the evening in a South Miami community home was sundowning. I'd never seen anything like it in a child before.
    He didn't respond to his mother, at bedtime which he always sought her out, even the sound of her voice. secondly, he wouldn't sleep for long after he normally does, and his agitation was off the charts.
  12. by   recognizeD
    Correction. The behavior is concerning but could not be sundowning at all. Due to no underlying dementia. Sundowning would not be possible. There might be behavioral puzzles, but sundowning would not present in the very young, whose brains are still developing rapidly.
  13. by   ktwlpn
    Quote from recognizeD
    Correction. The behavior is concerning but could not be sundowning at all. Due to no underlying dementia. Sundowning would not be possible. There might be behavioral puzzles, but sundowning would not present in the very young, whose brains are still developing rapidly.
    Unless the brain is not developing normally? Any thoughts on that?
  14. by   recognizeD
    Ouch! The obvious. Many reasons for childhood dementia. Terrible reasons. I'm going to have to say no to sundowning in pediatric cases, though. Final answer.

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