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The term "sundowning" refers to a state of confusion occurring in the late afternoon and spanning 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.
Sundowning isn't a disease, but a group of symptoms that occur at a specific time of the day that may affect people with dementia, such as Alzheimer's disease. The exact cause of this behavior is unknown.
Factors that may aggravate late-day confusion include:
Fatigue
Low lighting
Increased shadows
Disruption of the body's "internal clock"
Difficulty separating reality from dreams
Presence of an infection such as urinary tract infection
Tips for reducing sundowning:
Try to maintain a predictable routine for bedtime, waking, meals and activities.
Plan for activities and exposure to light during the day to encourage nighttime sleepiness.
Limit daytime napping.
Limit caffeine and sugar to morning hours.
Keep a night light on to reduce agitation that occurs when surroundings are dark or unfamiliar.
In the evening, try to reduce background noise and stimulating activities, including TV viewing, which can sometimes be upsetting.
In a strange or unfamiliar setting, bring familiar items — such as photographs — to create a more relaxed, familiar setting.
Play familiar gentle music in the evening or relaxing sounds of nature, such as the sound of waves.
Talk with your loved one's doctor if you suspect that an underlying condition, such as a urinary tract infection or sleep apnea, might be worsening sundowning behavior, especially if sundowning develops quickly.
Some research suggests that a low dose of melatonin — a naturally occurring hormone that induces sleepiness — alone or in combination with exposure to bright light during the day may help ease sundowning.
When sundowning occurs in a care facility, it may be related to the flurry of activity during staff shift changes or the lack of structured activities in the late afternoon and evening. Staff arriving and leaving may cue some people with Alzheimer's to want to go home or to check on their children — or other behaviors that were appropriate in the late afternoon in their past. It may help to occupy their time with another activity during that period.
With
Jonathan Graff-Radford, M.D.
Best of luck!!
1 paper dixie cup small
1 cotton ball
lavender oil
we a dip cotton ball in lavender oil (just a little), place cotton ball in paper cup and hand to patient to walk around with. It calms them tremendously. They love to keep smelling it. We distribute these cups about the time we know they will start to sundown.
Try different oils on different folks. Some love certain smells over others but do not overpower their cotton ball or it will be too abrasive for them.
Just a little goes a long way.
Hope this helps...
We have to laugh when we can.
This disease is so horrible and just devastating, but having watched many patients and just recently my dear mom go through it, there are some moments of comfort that are found in the experiences.
The best thing I could do was to eliminate every source of stress after noon. Appointments were morning only...etc.
this way he could have whatever he liked for early dinner and fall asleep in front of the TV or with his coloring books.
any excitement (even a phone call) could set it off.
Your mother’s doc should get her on the med now because it takes time (a month for my husband) to take effect. You will see the night-day difference. There are many meds out there, so ask her doc for advice. Most are cheap with Medicare.
Another option is to try CBD - the non-addictive/good oil in marijuana. You can get them in capsules. It is available online, but not covered by insurance. It is expensive.
Dealing with someone having sundowning is NOT fun. You are not alone. Keep us posted. Good luck.
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