What You Should Know About Caring for Someone Who is Experiencing Sundowners

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Most experienced caregivers have delivered care to people who are facing a condition called sundowning. Sundowning affects people who are going through mid to late stage alzheimer’s or dementia. While sundowning isn’t really a specific ailment, the word is used to refer to a number of symptoms that tend to happen from late evening into the night. In order to help sundowners, caregivers need to understand a few things so they can act accordingly.

What Sundowning Looks Like

People who suffer from sundowning syndrome may become aggressive, forgetful, and confused. They may also seem scared for no apparent reason. The fear comes when they become overwhelmed by the symptoms and cannot seem to explain or figure out what is happening to them. The symptoms can vary, but generally, any uncharacteristic or strange behavior seen in Alzheimer’s that seem to be triggered by the later part of the day can be called sundowning.

Someone who is experiencing what is known as sundowning may transition from a calm and gentle personality in the day to an aggressive, angry person by afternoon. They may also make unintelligible utterances or speak as though they have turned back the hands of time and are in a different world or earlier time period. Someone who used to be a dancer, for instance might insist on leaving to attend a dance recital or audition, and someone who was a teacher may become determined to head back to the classroom to teach a class.

If you notice sundowning symptoms in patients who have not been diagnosed with Alzheimer’s, it may be time to get them evaluated by a medical professional.  Although caregivers may not expect  dementia and Alzheimer’s to go undiagnosed, the patient might have slipped through the cracks. According to Web MD, millions of people around the world have dementia or Alzheimer’s but have not been officially diagnosed. 

Sundowners Have Sleep Issues

Because sundowners become confused, they sometimes do not sleep at night or do not sleep through the night. They may not be able to recognize when night comes or that the nighttime is for resting. This leads to drowsiness and irritability in the morning. Caregivers who live with sundowners should be prepared to awaken in the night to the sight of the person standing still and staring blankly or confused. It can be disconcerting, but caregivers should remember that this is just a symptom of confusion brought on by sundowning.

To help sundowners sleep at night, caregivers can use calming music, massage, or aromatherapy or give them melatonin. Antihistamine medications such as Benadryl and Nyquil should be avoided as they are associated with cognitive decline, and you don’t want to exacerbate the condition.  

Sundowners Need Close Attention

Because sundowning makes the behaviour of patients unpredictable and typically means that dementia or Alzheimer’s has entered a late stage of development, more constant attention will be required. During sundowning, patients are likely to wander away, break things or injure themselves. Caregivers, therefore, need to keep a close eye on sundowners to ensure that they remain safe. Caregivers need to ensure that all other duties are complete in time for them to give their full attention to sundowners. If full attention isn’t possible, then frequent checks (at predictable intervals) need to be done.

The Symptoms Will Recur Daily

Caregivers who tend to sundowners should understand that these symptoms will happen repeatedly. Each day, as the evening approaches, the symptoms typically return. This means that caregivers will need to exercise a lot of tolerance for patients who demonstrate these symptoms daily. They also need to prepare and adhere to routines that help to alleviate or prevent the symptoms.

Ways to Help Sundowning Patients

Since the symptoms tend to appear during the late evening and continue into the night, a good way to alleviate them is to keep the space occupied by sundowners well lit. This creates the illusion of ongoing daylight and can delay the triggering of symptoms.  Additionally, caregivers should try to keep sundowners calm by introducing familiar sights and sounds.

Sundowners require reassurance and distraction. Caregivers should find ways to ensure that sundowners do not dwell too much on the confusion that accompanies their symptoms. These distractions may include music, games, snacks, and movies that they like. Activities that would have fit into their routines (such as folding clothes) may also serve as helpful distractions.

Caring for someone with sundowning can be frustrating and tiring. Caregivers should be prepared to face the frustrations that come with the situation, develop routines that work, and plan ahead for unexpected incidents.

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