“Dementia is not merely an individual disease. It affects the entire family.” (Dora Leigh)
Sunset is often seen as an occasion to
celebrate, reflect on your day, spend time with family, and relax. Sundowning is
a symptom of mid-stage to advanced dementia of Alzheimer’s disease. Sundowning
is thought to be triggered by fading light. It usually happens during the hours
of 4:30pm to 11pm. The symptoms can get worse as the night goes on and usually
gets better by morning. Sundowner’s Syndrome causes a variety of negative behaviors
like:
· Aggressiveness
· Agitation
· Anxiety
· Confusion
· Increased motor activity (like pacing or wandering)
· Increased verbal activity (like yelling)
· Panic
· Resistance to redirection
· Restlessness
Sundowner’s Syndrome was first described in
the literature of modern medicine in 1941 by a British physician named Ewen
Cameron. He called the condition “nocturnal delirium.” Cameron described
patients who experienced disorientation, agitation, and panic around bedtime.
What differentiates sundowning from delirium is the associated behaviors worsen
in the evening.
You won’t find sundowning in the Diagnostic
and Statistical Manual of Mental Disorders. It’s not considered a diagnosis. Talk
to someone who works with elderly patients. They will be familiar with the
concept of sundowning, and its associated behaviors.
For family members who care for their loved
one with dementia, watching this evening disorientation can be frightening,
painful, and exhausting. This behavior is disruptive to family routines. The
person with dementia needs to be carefully watched and protected. Doors need to
be securely locked, constant monitoring, and sleepless nights are a few
examples of life with a person experiencing Sundowner’s Syndrome.
Simple tips for helping to reduce sundowning symptoms:
· Create a predictable routine: Maintain a
predictable schedule for waking, meals, activities, and bedtime.
· Discourage daytime naps: Naps should be
kept at a minimum especially if your loved one has trouble sleeping through the
night.
· Encourage daily physical
activities: Plan
activities that use more energy at the beginning of the day and encourage your
loved one to take part in exercise each day.
· Get medical advice: Certain
medications can help your loved one get a good night’s sleep. Just make sure
you talk to a doctor first as some medications can actually disrupt sleep and
energy patterns, which can make sundowning symptoms worse.
· Monitor diet: Make sure your
loved one is eating a healthy diet, and limiting caffeine and sugar to the
morning hours. The biggest meal should be eaten during the middle of the day,
and keep snacks light after dinner.
· Practice light therapy: There is
lighting available that provides full spectrum light, which can help minimize
some of the sundowning symptoms. Keep rooms well lit and free of shadows, and
use night lights to help reduce stress if your loved one needs to get up in the
middle of the night.
· Provide a good sleeping
environment: Keep
the sleeping area quiet and comfortable. Play soft music and keep the noise
level low to help your loved one relax and settle in for the night. 7 to 9
hours of sleep is needed for an older adult.
“Too often we
underestimate the power of a touch, a smile, a kind word, a listening ear, an
honest compliment, or the smallest act of caring, all of which have the
potential to turn a life around.” (Leo F. Buscaglia) [i]
[i] Adapted from:
· “Sundowning: A Guide to Difficult Behavior at the End
of the Day” by mmLearn.org
· “THE MOST EFFECTIVE SUNDOWNER’S SYNDROME TREATMENT
STRATEGY” by AssistedLiving.org
· “What is Sundowner's Syndrome?” by
Coleman Adult Day Services
· ” Tips to Help Ease Sundowner’s
Syndrome” by American Senior Communities
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