Tips for dealing with

Sundowning

By Carole Larkin

Many people with Alzheimer’s go through a period of heightened agitation, aggression, delusions, paranoia or wandering during the late afternoon or early evening. The phenomenon is commonly called Sundowning. No one knows for sure, but many believe that it is related to our circadian rhythms working in relation to the loss of the bright light of daylight. Others believe that other factors such as tiredness or boredom on the part of the Alzheimer’s care receiver play into the behaviors as well. Caregivers who experience the behaviors know that it is especially troublesome if the caregiver themselves has had a busy and stressful day at work or with their loved ones at home. This is the time of day when the caregiver’s patience is most liable to snap and the caregiver will say or do something they will regret or feel guilty about later.

Here are some things that can be tried to lessen your loved one’s anxiety (and yours) during this time of day. These tips may not always work, but they may be worth trying:

• Put lights on in the house during this time to mimic the bright light of daylight.
• Select one portion of a room, or of the house to become the “quiet place” where there is a bright light and some soothing music or repetitive activity can take place during this time of day. Repetitive activities could be stacking mail or papers, folding laundry or even winding a ball of yarn. You can test different activities like that out and see which one or ones your loved one will do or enjoy.
• If your loved one is experiencing a certain period of time in their lives, such as when they were waiting for you to come home from school, or waiting for your dad to come home from work, try to engage them in activities that would mimic what they might have done in that time, such as prepare a snack for you or straighten the newspaper up for dad to read when he gets home, or set the table or tear lettuce for a salad to be eaten at supper. You know what your loved one’s routine was when you were growing up. Work with that in mind.
• Encourage some exercise during the day, but not enough to exhaust them.
• Allow cat naps (20 minutes or less) during the day, but not hours and hours of sleeping at a time.
• If your loved one walks or paces during those hours, allow them to do so if it is not dangerous to them. They should have a clear path through the house to do so. Accompanying them thorough some of their pacing is beneficial to let them know that they are not alone.
• If they are looking for “dad” to come home, redirect them into an activity to prepare for dad coming home, and then later let them know that Dad called and he was going to have to work late tonight, and that he said that you should all go on with supper.
• After supper, ask them to dry some dishes, cups or silverware, use plastic if needed.
• After supper listen to music with them (music they like) or sit and look at a book, magazine or family album, or even put on a movie they enjoy.  Anything that evokes positive memories or feelings will do.
• Telephone calls to other siblings or friends of your loved ones may work at this point as well.

The point is engaging them in any way that you can to try to take them out of their self focus is beneficial. The more that they can focus on things outside their own thought process, the better chance you have of reducing their time of being upset. That will make that time of day easier on them, and on you.

Carole Larkin  MA, CMC, CAEd, DCP, QDCS, EICS is an expert in Alzheimer’s and related Dementias care. She has a Master’s of Applied Gerontology from the University of North Texas, is a Certified Alzheimer’s Educator, is a Dementia Care Practitioner, is a Qualified Dementia Care Specialist, and an Excellence in Care Specialist at the Alzheimer’s Foundation of America, as well as a Certified Trainer/Facilitator of the groundbreaking dementia care training tool, the Virtual Dementia Tour Experience She is a Certified Geriatric Care Manager who specializes in helping families with Alzheimer’s and related dementias issues. She consults with families telephonically nationwide on problems related to the Dementias. Her company, ThirdAge Services LLC, is located in Dallas, TX, and her website is www.thirdageservices.com.