Sundowning

 

Sundowning, sometimes called sundowning syndrome, is when people with Alzheimer’s or dementia experience a decline in functioning or condition late in the day, or as the sun goes down. They may become difficult to care for, aggressive, or wander if left alone. It is thought that more than 60% of Alzheimer’s and dementia patients suffer from sundowning.

What are common signs of sundowning?

• Marked change in condition or behaviour in late afternoon
• Agitation or irritation late in the day
• Difficulty winding down or settling into an evening routine
• Wandering in the evening
• Becoming fearful or confused in the evening
• Reduced capability and functioning as the day wanes
• Difficulty managing tasks late in the day
• Aggressive or uncharacteristic behaviour that surfaces late in the day

What causes sundowning?

Each individual’s experience with sundowning is different, and they may be affected by different elements to varying degrees. However, there are patterns observed often enough to create a list of potential causes or aggravations. Dementia and Alzheimer’s disease may negatively affect the body’s sleep-wake cycles, creating difficulty for the individual to regulate normal patterns of sleep and activity. These conditions also cause confusion and mental fatigue, which peak as the day nears an end. Too much activity or stimulation late in the day or evening can simply be too much for those prone to sundowning. It is also thought that the change in light conditions and developing shadows late in the day can aggravate the symptoms of sundowning.

How can sundowning be prevented?

• Develop routines that encourage activity early in the day when energy and functioning are higher. Challenging tasks and new situations should perhaps be introduced in the morning, rather than late in the day.

• Ensure individuals prone to sundowning have the opportunity for movement or exercise during the day, while they are able. This can help ensure they are naturally more tired later on and more ready to settle into a healthy bedtime and sleep routine.

• Keep notes to identify patterns of behaviour and triggers of sundowning behaviour. Every individual’s experiences and tendencies will be different, but there will often be connections noted once records are kept. From these observations, a daily routine can be created that is least likely to trigger an individual who struggles with sundowning. Maintain the habits and routines that work to keep a consistent schedule.

• Create calming evening rituals and routines can help settle a senior and ease symptoms of sundowning. Removing distraction and confusing tasks can help ensure a quieter, more peaceful evening.

• Monitor blood sugar levels, especially in those already diagnosed with diabetes. Ensuring a senior is eating well during the day, with small, easy to digest meals or snacks as the day winds down can help alleviate symptoms.

• Create a physical environment that removes distraction and stress from a senior’s evening. This may mean limiting or removing television, puzzles, or social time in the evenings, and replacing them with quieter, more soothing pastimes. A senior might read or rest, or listen to quiet music after dinner instead. Shadows and partially dim lights may also cause confusion and anxiety, so ensure rooms are well lit until it is time for sleep.

• Ensure surroundings offer comfort and familiarity to the senior to reduce stress and confusion when they begin to struggle. Photos of loved ones and other sentimental items may help soothe and calm a senior who experiences sundowning.

Those who care for individuals with Alzheimer’s and dementia face challenging work every day. These conditions place great demands on caregivers, made more challenging by the development of sundowning. It can put extreme stress on those providing care, and can often create a need for respite care when families attempt to provide care to family members on their own. It is important that caregivers also take good care of themselves and their well being, and seek support or consider Family Respite care when necessary.

We offer a full range of services and can customize a care plan that will have a direct benefit to the care recipient and for families affected by Alzheimer’s and dementia.  Call us today to learn more about how we can help improve your loved ones quality of life for those dealing with dementia.  We have fully qualified caregivers on staff to offer care in these situations.

Have questions or feedback on what you just read? Please don’t hesitate to contact us, we’d love to chat with you.

 

                                                                                                                ~  Senior Homecare by Angels Calgary team