Sundowners – Part 1

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Have you heard the term sundowners? Let’s dive into learning what it is, and what we can do to help someone experiencing it.

Welcome to the Senior Circle, where we hope to inspire and help others by providing valuable, relevant information related to caring for an elderly loved one. Hi, my name is Dawn Neely, and I’ll be your host. Thank you for joining us.

If you have a loved one suffering from dementia, you may have heard of the term sundowners. It is a term that is used to describe a change in behavior that usually occurs later in the afternoon, and into the evening. All of a sudden, things just get a bit little bit wonky. Many call it sundown syndrome or sundowning. According to the Alzheimer’s Association as many as 20% of people with Alzheimer’s experience sundown syndrome.

This symptom of dementia along with other conditions as well, are commonly seen upon the approach of the sun setting which appears to trigger sudden emotional, behavioral or cognitive changes. There might be some mood swings, or they may become very anxious and restless. They may exhibit an anxiety that causes surges of energy, and increased confusion. In very challenging cases you might even see hallucinations and delusions. Unfortunately some of the symptoms can include very challenging behaviors like pacing, rocking, crying, becoming very disoriented, becoming angry and sometimes even violent. A lot of people that experience sundown syndrome feel urgently that they need to go somewhere, or do something but they can’t really explain what it is they are supposed to do. In some cases, we find that the behavior doesn’t last a long time and with some redirection the behavior subsides. For others however this anxiety and behavior can last all night. It can unfortunately cause a switching of sleep schedules, creating a situation where your senior is awake all night, and extremely tired during the day. There are multiple theories about why this happens. Some say it has to do with the dimming of lights, be them natural or lighting in the home. This, some say, gives a senior with sundowners the sensation of needing to change activities or go home. There is a thought process that suggests that evening and darkness can cause fear, making someone feel unsafe and insecure.

Sundowners is very challenging not only for the senior who’s struggling but also for family members charged with their care. One can feel very helpless as to what can be done to help someone who is struggling with sundowners, but fortunately there are a few techniques that can be tried and just may show results. We always want to be aware of triggers that can exist that cause a senior to experience challenging behaviors and symptoms. Fatigue is one of the things that we should be very aware of as we know that it can spur on difficult behaviors. During the afternoon and early evening the activities that we consider normal can produce anxiety for a loved one. For example, as people get home from work and school, a household can get pretty chaotic and noisy. Many times it is during the evening that the TV is turned on, and it may be loud or intense such as a game show or the news. Meal times are great times for families to get together, and share about their day but this can also create a lot of cross talk, something that is very difficult for someone with dementia to follow, and that may cause anxiety.

Another trigger to watch in addition to fatigue is nutritional. Cutting back on stimulating foods that contain caffeine and sugar can help reduce anxiety. Another thing that is important is to maintain a routine, and have structured activities, activities earlier in the day are to be maximized in order to reduce the amount of napping that our senior does during the day. There are challenging activities such as bathing that should be avoided around dusk and at night as this can be stressful. Plan a routine and structure that will bring as much peace into your seniors transition as possible.

Try to simplify your seniors surroundings, and adjust the sleep environment to accommodate more likelihood that they’ll actually get some rest. If there is too much stimulation anxiety and confusion can be worsened. In a nutshell what we want to try to do is reduce the amount of physical, visual and auditory clutter in our senior loved ones sleep environment.

Trying to reason with someone in the middle of a sundowning experience probably isn’t gonna go very far. What tends to work more effectively is trying to validate their feelings to let them know that you are listening. It may not make much sense to you at all but knowing that you are there for them can be very comforting. Try to redirect them from thoughts and anxieties by diverting their attention to favorite activities. You could consider talking about their favorite foods, animals and loved ones. We had a person that Seniors Helping Seniors cared for that was very gratified by finishing the laundry. So every day at the end of the day we had a load of bath towels fresh out of the dryer that needed to be folded and put away. Because they were the last load, it gave a sense of comfort and closure to our client for the day.

Unfortunately there isn’t a textbook that shows two people with dementia being exactly alike so we have to be prepared to take different approaches until we find the technique, structure and routine that works. Success may be obtained but might be temporary, but even a little bit of success can greatly ease a loved one’s anxieties as well as the stress experienced by those caring for individuals with sundowners. Look for our next video that will include a few more ideas as to how to support your loved one. If you are caring for someone with sundowners symptoms, and have any questions, please feel free to reach out. Contact us at 248-969-4000, and a representative from Seniors Helping Seniors would be happy to discuss with you your situation, and what might be helpful.

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