We all are affected somehow by the setting sun. The coming of the night time may change our disposition and mood, in a way that varies from person to person. However, for dementia patients and their families, the twilight time could bring challenges in what healthcare practitioners call “sundowning” or “Sundowners Syndrome”.
Sundowning usually happens in the time of sunset or early evening and is one of most challenging behaviors in Alzheimer's Care and Dementia Care. It is characterized by confusion, aggression, anxiety, restlessness, and agitation. Many Dementia and Alzheimer’s patients tend to ignore directions given by their caregivers when they are going through the Sundowner Syndrome. Other common symptoms are pacing or wandering behaviors.
For some patients, the behavior changes are only momentary and they are able to sleep through the night. For others it continues, reversing their sleep patterns so they stay awake all night and sleep during the day.
The exact cause of sundown syndrome is not known but it seems to be related to the brain degeneration caused by Alzheimer’s. As the disease progresses, it affects the areas of the brain that regulate the biological clock and the cycles of sleep and awakening. This process could lead to increased napping during the day and sleeplessness and restlessness at night.
The sunset hours and the consequently reduced light will trigger sundowning, particularly in dementia patients who are extra-tired or those who have a stock of energy from a boring, sleepy day.
Dementia Care Tips
Here are some home care tips to deal with the sundowning behavior:
- Change the environment, turning on all lights available and increasing the amount of light around the house. Consider buying new, more powerful lights;
- Try to observe and minimize other triggers that may be causing the change in behavior, like food habits, caffeine consumption, caregiver changes, or TV volume;
- Close the drapes and blinds to reduce confusion, fear, and agitation, helping your dad to adjust to the new period of the day;
- Create a safe environment, without noises and disruption;
- Try to divert your father’s attention by engaging him in a relaxant and enjoyable activity like looking at photographs, going through magazines that have many pictures, or play simple games like jigsaw puzzles;
- Try to use soft music, a gentle touch, and soft talk to calm him down; divert his attention from what is bothering him, engaging in conversation about other subjects;
- Limit the amount of napping during the day filling it up with activities, but not so much that could cause fatigue; pay attention if fatigue is setting in before sunset and, in this case, reduce the amount of activity.
Home Care for Alzheimer’s Patients
Sundowning may pose safety risks for the patient, but the repeated lack of sleep can be dangerous for the family caregivers as well, leading to caregiver stress and burnout.
It can be extremely helpful to count with a professional in-home caregiver who can stay awake with the patient and help him or her to stay calm and engaged while family members get much-needed rest.