While Alzheimer’s is just one of the many types of dementia, the phenomenon of ‘sundowning’ may occur with any form of dementia. Sundowning adds a layer of anxiety, dread, fear and sleeplessness to the caregiver.
What exactly is ‘sundowning’? In layman’s terms, this phrase is used when the person with dementia typically becomes confused, agitated, and restless or exhibits other atypical behaviors in the late afternoons or evenings.
Sudden change in behavior such as experienced with sundowning often takes caregivers by surprise. Your loved one may suddenly have delusions, hallucinations or start wandering about aimlessly. The typical sleep-wake cycle becomes severely disturbed and the person with dementia eventually may even have their days and nights mixed up, sleeping all day and up all night.
Some sundowning activities may be transient, while others may last for hours. Redirection, talking about familiar topics and having a routine schedule are all important interventions for those that suffer from Alzheimer’s disease. Research suggests turning on lights when dusk arrives, ensure limited napping in the daytime and encouraging plenty of exercise to ensure that your loved one is tired and ready for bed.
But what happens when none of these interventions aren’t successful? You may experience increased anxiety and dread evenings. You fear you won’t get any sleep tonight either, and after a few days of that, you’re near tears! All these emotions grow stronger even though you’re doing your best to maintain a calm and patient attitude with your loved one.
But you need sleep! It’s vital to your own physical and mental health and well-being.
These challenges are real. Sleep deprivation affects both the individual with dementia and the caregiver, making for a tenuous combination of anxiety.
Tracking is important
While discovering this new behavior, it can be helpful and therapeutic to journal these changes. Jot down the time, what occurs, what delusions are repetitive and what your loved one is seeking while wandering. This might provide insight into potential solutions.
For example, your loved one may be looking for someone or think I’s time to go ‘home’ (meaning somewhere else). Be proactive and talk with your loved on slightly ahead of the time when the behavior usually occurs. This may help.
Reorientation to the fact that they are home and it will be getting dark soon may help to prepare and ‘set the scene’. If you notice that certain items are looked for during these periods, try to gather some of these items close to hand to have ready to prevent the seeking behavior.
Journaling or logging events will gradually divulge information about who, what, when, where and how. The caregiver may feel a variety of emotions when dealing with sundowning: impatience, despair, fatigue and even anger.
While knowing what is going to occur and attempting to deal with these issues ahead of time may not alleviate all the activity and stress, it will better prepare you with knowledge, thus encouraging you to find ways to better control the situation, and therefore, the outcome.
Care for a loved one with Alzheimer’s is challenging enough without the additional stress of sundowning, but observance, preparation and knowing what to expect in advance may help change the tone somewhat and make things go a little more smoothly.