Sundowning

Sundowning is when a person who has Dementia gets predominantly restless, insecure, upset, disorientated or confused in the late afternoons and evenings. It can become worse after a move or changes in the persons routine. No one is sure what the cause of sundowning is, although it seems to result from injuries or disease to the brain.

People who have dementia tire more easily, and they can become more restless and difficult to manage when this occurs. Sundowning can also relate to a lack of sensory stimulation at night, due to the fact that there are fewer signals in the environment especially as this is usually accompanied by dim lights and the absence of the usual daytime noises.

As the Dementia progresses, the person starts to understand less about what is happening and they try to restore their sense of familiarity and security. They may be trying to find an environment that is familiar to them, particularly a place that was familiar to them in an earlier time in their life. This of course leads to wandering which is covered in it's own section here.

Tips to Help Combat Sundowning

Keep the Person Active

Try to keep the person active in the morning and encourage them to have a rest after lunch. This will help if fatigue is making the sundowning worse.

Schedule Activities

Most activities should be scheduled for morning time. Create a calm and quiet atmosphere for the time when symptoms normally appear.

Don't Restrain the Person

Let the person go about their business and monitor them to ensure they do not injure themselves or others. Let them roam about if they are in a safe environment. Often a walk outdoors outdoors can reduce the restlessness.

Consider Effects from Stimulants

Bright lights and noise from TVs and radios may have an effect on the person and could add to the confusion or restlessness they experience.

Avoid Stress

Avoid anything that causes stress to the person in the afternoon. If baths and showers are upsetting activities, don't arrange them in the afternoon or evening. Alternatively, if a bath calms the person down, then try to incorporate this into the evening routine.

Create a Calm Atmosphere

Warm milk, back rubs, music and night lights may be calming and help the person to sleep.

Get Rest Yourself

As a carer, you too will need to make sure that you get plenty of rest. If you are tired and stressed then the person you are caring for may pick up on this and it could make the situation worse.

Monitor Caffeine

Monitor the amount of caffeine in food and drinks that the person has. Too much could make them more restless and unable to sleep.

Summary

By understanding the cause of sundowning, carers can decide which strategies may be helpful to managing the situation. Arrange a medical examination and discuss the persons medication with the doctor. Sometimes something as simple as adjusting the dosage or the timing of medication can help to relieve the symptoms.