The experience known as “sundowning” is one which is experienced by 20 percent of those individuals suffering from Alzheimer’s disease. What characterizes this symptom are a number of behaviors that stem from the patient feeling anxious, tense, agitated, fearful or frustrated. Usually, as the sun is going down around dusk, these behaviors become apparent. Very often through the entire evening a lot of patients will experience this which for the individuals taking care of them can create great challenges to be dealt with. It is usually about the time that Alzheimer’s has progressed to its middle stages when this symptom is it’s most severe and as the disease continues to advance, it starts to taper off somewhat.
Why patients experience sundowning is not known by medical professionals and Alzheimer’s experts. One thought is that the patient may be mentally and physically exhausted after going through a full day. Sleep patterns are affected as the body’s “internal clock” goes through a re-wiring. More shadows which bring about nighttime fears and confusion come about as there is less daylight. In the past, it was considered by some experts that sundowning may have been caused by shorter days and the reduction in daylight. However, continuing research has gone on to show that it is actually the patient’s exhaustion and not the amount of light they are receiving which is the cause.
Sundowning And Minimizing It’s Effects
The Alzheimer’s Association along with individuals expert in Alzheimer’s patients treatment offer advice on how best the undesirable effects of sundowning can be lessened and dealt with by you:
Schedule activities to fill the day: A person has more of a tendency to remain awake at night when they are inactive in the day. It can be very beneficial to fill the day with various physical activities like doing light exercises, walking or doing different household chores. Another great idea is paying a visit to an adult day center where a lot of interesting and fun activities take place.
Take care though not to let the individual involved become overly exhausted. You are doing good to raise the activity level but you do not want to go overboard on doing so. Also, in the morning, bathing should take place. And because the individual involved will have greater energy in the morning to deal with things, doctor appointments, outings and visits with friends and family should be scheduled in those times since they are mentally and physically better equipped to deal with them.
You want to maintain a watch for any things that may cause over-stimulation. A calm environment should be maintained as best you can with no surprises. Always be alert to the fact that an episode of sundowning can be caused by different factors such as people running around the house, a blasting TV, loud kitchen appliances running or a noisy vacuum cleaner.
You want to carefully monitor what the aging senior is eating. Only in the morning should they consume foods with sugar and caffeine. In your roll of home care. aide, you may want to keep a food journal and record those foods that cause any feelings of agitation or anxiety within an hour or so after they have been consumed. In addition, any snacks at bedtime should be very light, perhaps things such as warm milk or chamomile tea which may notify the body that it is in fact time to get some rest.
Should you start to realize a pattern around which the sundowning is occurring near the same time daily, you can try to create a calming effect or atmosphere perhaps a half hour or so before that time arrives. Play some soft music, keep things peaceful and calm and have the individual positioned in one of their favorite spots.
Solicit advice from the doctor. Why the individual involved is struggling with falling asleep and resting may be the result of underlying medical issues. Perhaps the doctor can offer some medicine that will assist them in getting good rest at night without causing any sluggishness in the morning. You want to do whatever you can to help offset sundowning whenever possible.
Try keeping the home environment as simple as possible. Anything that adds to confusion and clutter should be removed. You also want to make certain that the living space is illuminated well enough so that the individual involved is not looking at any dark or unfamiliar sights.
Helping to develop a sense of time for the person is truly a big asset. It helps to reduce their confusion and to maintain a mental sense of order. You can do this in little ways like reminding them just what time it is when they complete a small routine they are doing and perhaps repeat it the next day at the same time.
Do not simply assume it is sundowning when you see the individual involved getting upset or frustrated. Try to speak with them calmly and see if they can relate exactly what happened to cause their anger or frustration. Perhaps they are just too hot, too cold or just hungry. Calmly continue to find out the most that you can and then make the effort to calm and reassure them that all is well and they can truly relax and be safe.