Sundowning, which the Alzheimer’s Association defines as “increases in behavioral problems that begin at dusk and last into the night,” can present major challenges for caregivers.
The syndrome, which affects up to 20 percent of people with Alzheimer’s, manifests itself in behaviors, including agitation, pacing, paranoia, and wandering.
Fortunately, there are effective methods of managing sundowning symptoms. Below are 13 suggestions:
1. Keep your home well-lit. Shadows and darkness could contribute to fear and confusion experienced by your loved one.
2. Try to maintain a quiet environment. Turn off the TV and radio, and save the use of machines (lawn mowers, blenders, etc.) for other times. Noise can increase agitation and distraction.
3. Encourage better-quality rest. Limit your loved one’s caffeine intake to the morning and create an inviting sleep environment.
4. Schedule more demanding activities, such as medical appointments and visits from guests, in the morning. Seniors with Alzheimer’s tend to be more lucid and energetic in the morning.
5. Simplify your language. For example, break down complicated directions into brief, concise steps that are easier for your loved one to follow.
6. Allow pacing. If there’s not much room, clear some space, and make sure the environment is secure. Consider focusing your loved one’s energy on something purposeful like setting the table or sweeping. You may also want to consider accompanying your loved one on a walk.
7. Avoid serving heavy meals late in the day. It’s best for your loved one to eat a large lunch and a light dinner. Also ensure that your loved one does not consume too much sugar or alcohol.
8. Respond to aggressive behavior in a methodical and calm fashion. Do not try to restrain your loved one or argue with him or her.
9. Try to reduce your own stress so that your loved one does not sense your stress and react accordingly.
10. Stick to a routine. Seniors with dementia take comfort in patterns and regularity.
11. Encourage exercise, especially in the mornings, to reduce agitation and improve sleep.
12. Pay attention to the behaviors that your loved one demonstrates. Note their frequency and timing, and advise your loved one’s doctors accordingly. The doctors may be able to suggest additional steps you can take to manage sundowning symptoms, as well as adjust medication dosages that might affect the symptoms.
13. Take some safety measures. Equip your loved one with an identification bracelet and lock doors and gates to prevent wandering. Alternatively, you can put up large “Stop” and “Do Not Enter” signs on doors and gates.
If your loved one’s sundowning symptoms become unmanageable, speak to a medical professional to discuss additional options. You may also wish to consider assisted living or day care.