As a caregiver, you may notice a pattern of increased agitation or impairment in the late afternoon or evening when natural light begins to fade. Your mom or dad may seem more upset or distressed at this time of day.
This psychological phenomenon is referred to as Sundowning because the behavioural problems occur while the sun is setting. Research shows that as many as 66% of people with dementia will experience some sort of sundowning.
While it can occur at any stage of the disease, sundowning tends to peak in the middle stages and lessens as the disease progresses. Some of the common symptoms are:
- Increased general confusion
- Delusions and hallucinations
- Agitation and mood swings, including becoming demanding or aggressive
- Mental and physical fatigue
- Pacing or wandering, including attempting to leave home
The major causes of sundowning are thought to be fatigue at the end of the day, low lighting and more shadows, a disruption to the person’s sleep/wake pattern or inactivity in the latter part of the day.
Here are eight things you can do to reduce sundowning:
Determine if discomfort is causing the agitated behaviour. Your mom or dad may not be able to communicate that they are feeling pain or discomfort. They may cope during the day but be exhausted by the end of the day and act out. For example, they may have neck or shoulder pain or be irritated by itchy, dry skin. And by the end of the day their tolerance levels have been totally eroded.
Create Rest Times
Your mom or dad will need to re=charge throughout the day. So, allow for rest and naps between activities. This will ensure that they get to the end of the day with less fatigue.
Avoid Stress at End of Day
Avoid stressful activities in the late afternoon or evening. For example, they may find showering stressful so do not try to have them shower before bed. Keep that for a morning activity.
The fast-moving images and sounds from a radio or television are highly stimulating. Prevent over-stimulation from a television or radio by choosing the programs carefully. Sensory overload can increase agitation, so you may encourage them to watch the news in the morning and listen to classical music at night.
Ensure Adequate Lighting
Shadows may increase distress as they are difficult for your mom or dad to process. As night approaches, provide adequate lighting to lessen shadows. Closing the curtains or blinds can also help.
Sufficient Physical Activity
It is important for your mom or dad to have sufficient physical activity. Try and engage in physical activity throughout the day. A short walk in the morning and afternoon is better than one long walk.
Sufficient Mental Activity
As well as physical activity, sufficient mental activity is important. Ensuring that your mom or dad is engaged and mentally stimulated will improve their satisfaction with their day. They will feel happier and more fulfilled and feelings of distress will be reduced.
Provide Activity and Distraction in the Evening
Finally, keep your mom or dad active and distracted when the sun is setting. Providing human interaction at this time of day will reduce feelings of distress and anxiety. This will make it less likely that sundowning will occur.
Sundowning can be a very distressing symptom for you to witness. It is helpful to keep a daily journal so that you can pinpoint the causes or triggers of your mom or dad’s sundowning symptoms.
Do you need help in the area of Dementia Care? Check out this available resource: Fit Minds Family Caregiver Program
Nicole has trained hundreds of professional and family caregivers who have touched the lives of thousands of individuals living with a cognitive impairment. Nicole also holds a law degree from Osgoode Hall Law School, a Master’s in Law from Queen’s University specializing in Negotiations and is a Certified Professional Consultant on Aging.