For many of us working in the senior care industry, the term sundowning is very familiar to us. Sundowning ” refers to a state of confusion at the end of the day and into the night. Sundowning can cause a variety of behaviors, such as confusion, anxiety, aggression or ignoring directions. Sundowning can also lead to pacing or wandering”.
I sometimes believe my children experience sundowning: They are always confused when I tell them it’s time for bed. They seem to become anxious when they are told to turn the TV off and oftentimes will ignore my directions. I hear them pacing in their rooms..hoping I will fall asleep so they can continue watching TV. Out of respect for people with dementia, I refuse to refer to their behaviors as sundowning…more like full on teenage angst.
On a more serious note sundowning is no laughing matter for families caring for individuals with dementia. Many have reported sleepless nights, exhaustion, and eventual burn out. I have talked with wives and husbands who cannot sleep as their spouses wander throughout the home, confused and agitated. Sundowning disrupts sleeping patterns and creates an unhealthy cycle- including sleep deprivation for caregivers.
Ways to make sundown syndrome less severe include:
Activity- Being more active during the day may help Alzheimer’s patients sleep better at night.
- Discourage daytime naps.
- Encourage exercise, like walking.
- Encourage hobbies that get dementia patients up and moving.
Healthy diet. Caregivers should make sure Alzheimer’s patients eat properly:
- Limit caffeine and sugar to the morning hours.
- Plan an early dinner.
- Keep snacks light before bedtime.
My advice for family caregivers is to first, ask for help.
- Make time for respite
- Go on a vacation while your loved one either stays with family or in a healthcare environment
- Find a hobby or an outlet during the day
- Hire a caregiver for night time while you rest
- Join a support group for-support
One theory which points to the cause of sundowning has to do with changes in the brain’s circadian pacemaker-our internal clock. This is not surprising since certain changes in the brain will invariably lead to behavioral changes. My heart goes out to not only the patient but to the caregivers. Sundowning affects everyone. The caregiver has an internal clock too and over time, the disruptions take a toll. I have witnessed caregivers who begin to exhibit abusive behaviors due to their state of constant stress and anxiety. Many families are unable to make sense of the situation and they become very overwhelmed.
I consciously try to put myself in their shoes so I am able to portray empathy and create a plan that considers all aspects of the situation. Home care creates one option for families to keep loved ones at home, as long as they are able to.
Oftentimes the caregiver is forgotten in the process, they lack tools and resources to address the challenges. Sundowning is just one of many symptoms of dementia, but it’s worth talking about.
Have you ever wondered how all those behaviors could be summed up in one peculiar word-sundowning..hmm