Understanding Dementia Sundowning: How to Prevent and Manage It

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Written by Larea Mcqueen

Hi, I'm Larea, a Certified Dementia Specialist and Registered Nurse with 30 years of hands-on experience helping dementia patients in various settings, from hospitals to nursing homes and hospice. Drawing on personal experiences with my family members and patients over the years, I'm here to help guide you on your caregiving journey.

June 21, 2023

Have you ever heard of something called “dementia sundowning”?

It’s a term used to describe a phenomenon that affects some people living with dementia. Dementia Sundowning refers to a set of behavioral changes that usually occur in the late afternoon or evening. In this article, we will explore what dementia sundowning is, how to prevent it, and what to do if it happens. Let’s dive in!

What is Dementia Sundowning?

Dementia sundowning is also known as sundown syndrome. It shows up as increased confusion, restlessness, and agitation. It tends to happen during the late afternoon or evening and can last into the night. Not everyone with dementia experiences sundowning. But for those who do, it can be very distressing for both the person with dementia and their caregivers.

Understanding the Causes:

The exact cause of sundowning is still not fully understood. However, there are several factors that can contribute to its occurrence. These factors may include changes in the person’s internal body clock, exhaustion from daytime activities, sensory overload, hunger, thirst, or an underlying medical condition. It’s important to remember that each person’s experience with sundowning can be unique.

Preventing Dementia Sundowning:

While it may not be possible to completely prevent sundowning, there are strategies that can help reduce its frequency and severity. The following tips can significantly improve the overall well-being of individuals with dementia

a) Establish a Routine:

Maintaining a consistent daily routine can help regulate a person’s internal clock. Try to keep regular meal times, bedtime, and wake-up times. Having a predictable schedule can provide a sense of security and stability. Maintaining a routine is vital when you are caring for someone with dementia.
Straying from the routine can send your day spiraling into chaos! Learn more about the importance of maintaining a routine HERE.

b) Create a Calm Environment:

Keep the living environment quiet and soothing in the late afternoon and evening. Dim the lights, close curtains or blinds, and reduce noise to create a relaxing atmosphere. Consider using soft, calming music or aromatherapy to promote relaxation.
 

c) Watch Food and Drink Intake:

Ensure that the person with dementia is well-hydrated. Provide plenty of nourishment throughout the day. Offer light, nutritious snacks in the afternoon to prevent hunger and dehydration. Avoid serving stimulating foods and beverages like caffeine or sugary snacks. Learn more about the importance of nutrition HERE.

d) Promote Physical Activity:

Encourage regular physical exercise during the day. This will help promote better sleep patterns at night. A walk in the morning or gentle stretching exercises can be beneficial. However, it’s important to avoid vigorous exercise close to bedtime, as it may increase restlessness.

e) Manage Medications:

Some medications can contribute to sundowning symptoms. Speak with their healthcare provider to ensure that the medication regimen is optimized. Help prevent potential side effects, including those associated with sleep disturbances.

Let the Sun In: Harnessing the Power of Sunlight to Manage Sundowning in Dementia

Sunlight can play a big role in managing sundowning in individuals with dementia. Here’s a bit more info:

1. Natural Light Exposure: Ensure that the person gets plenty of natural light during the day. This can help regulate their circadian rhythm, making it easier for them to distinguish between day and night.

2. Morning Sun: If possible, try to expose them to sunlight in the morning. It helps set their internal clock and promotes wakefulness during the day.

3. Outdoor Activities: Encourage outdoor activities like short walks or sitting in a garden. Being in nature and soaking up sunlight can have positive effects on mood and sleep patterns.

4. Light Therapy: In case natural sunlight is limited, consider using light therapy lamps. These lamps mimic natural sunlight and can be used indoors to help regulate the sleep-wake cycle.

5. Be Mindful of Evening Light: As evening approaches, try to reduce exposure to bright lights. Dim the lights gradually to signal that bedtime is approaching.

Remember, a good dose of sunlight can do wonders for overall well-being, not just in managing sundowning. Give it a try and see the positive impact it can have! 🌞

Coping with Dementia Sundowning:

If a person with dementia experiences sundowning, it’s important to respond with compassion and patience. Here are a few strategies to help:

a) Maintain a Calm Demeanor:

Stay calm and composed when faced with sundowning episodes. Your demeanor can influence the person’s behavior. Try to remain patient and understanding. Use a gentle and reassuring tone when communicating. You can learn more about developing more patience HERE.

b) Engage in Soothing Activities:

Provide activities that help the person relax. Listening to soft music, reading a favorite book, or engaging in a quiet hobby can help. These activities can distract and calm the person during episodes of agitation. Avoid stimulating activities. Watching action-packed movies or engaging in intense discussions, before bedtime can lead to sundowning.

c) Ensure Safety:

Keep the environment safe. Remove tripping hazards. Install nightlights in the hallways or bedroom to reduce disorientation during the night. Consider using safety devices. Bed alarms or motion sensors, can alert caregivers if the person with dementia get up at night.

d) Establish a Bedtime Routine:

Create a soothing bedtime routine. This signals to the person that it’s time to wind down and prepare for sleep. The routine can include activities like a warm bath, listening to calming music, or reading a book together. Consistency is key in reinforcing the routine. It helps prepare the mind and body for restful sleep.

e) Provide Comfort and Reassurance:

Individuals experiencing sundowning may feel disoriented, anxious, or frightened. Offer reassurance and comfort by staying close to them. Use gentle touch, and offer words of support. Sometimes, a simple gesture like holding their hand or sitting beside them can provide a sense of security.

f) Avoid Arguments and Confrontation:

Sundowning episodes can lead to challenging behaviors, such as aggression or resistance. It’s important to avoid arguing or trying to reason with the person during these moments. Instead, redirect their attention to a calming activity or topic, or simply offer understanding and empathy. Sometimes, a change of scenery or a distraction can help diffuse the situation.

g) Seek Professional Support:

If sundowning becomes a persistent issue or affects the person’s well-being, don’t hesitate to consult a healthcare professional. They can provide guidance. They can evaluate the person’s overall health. They can recommend interventions tailored to the individual’s needs. In some cases, medication or adjustments to the treatment plan may be necessary.

Conclusion:

Dementia sundowning can be a challenging aspect of caring for someone with dementia. However, by understanding the condition and implementing preventive measures, such as maintaining routines, creating a calm environment, and addressing the person’s physical and emotional needs, we can help reduce its impact.

When sundowning episodes occur, responding with patience, engaging in soothing activities, and ensuring safety is vital. Remember, each person with dementia is unique, so finding the right approach may require some trial and error. With support and compassion, we can navigate the challenges of sundowning and provide comfort and care to our loved ones.

 

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