93

“Sundowners” and How to Decrease their Troubling Effects on the Elderly

If you have a loved one in your life with dementia of any type, Sundowners may be familiar to you!

It is estimated that 60% of seniors in long-term care communities have behavioral issues associated with dementia or Alzheimer’s disease.

Some of the typical symptoms of Sundowners are:

  • agitation
  • confusion
  • increased suspicion
  • irritability
  • disorientation
  • restlessness
  • hearing/seeing things that are not there
  • yelling
  • pacing
  • mood swings that are unpredictable

Unfortunately, the medications used to treat Alzheimer’s and Dementia, depression, and anxiety, can cause side effects too, making it difficult to treat. Oftentimes a person with dementia has trouble communicating when they have a need or a pain, leading to frustration and anxiety issues.

If you are a caregiver for a person with Sundowners, you probably are desiring some ideas for how to help minimize this difficult situation. Recent studies show that melatonin production may be decreased in these individuals due to the degeneration of the Suprachiasmatic nucleus of the hypothalamus. This causes a person’s internal clock to be thrown off and they have difficulty with sleep at normal hours. Dementia patients benefit most from a consistent, calm, and familiar routine.

Disruptions in routine can cause increased Sundown behavior.

  • Keeping your Senior busy throughout the day, getting some exercise, and limiting daytime naps will benefit their wake and sleep rhythm.
  • Sugar and caffeinated beverages should be consumed only in the mornings. Bright lighting in the home also helps with their internal clock.
  • In the evening it is best to keep background noise at a minimum.
  • Maintain a consistent bedtime routine starting well before you turn the lights out.
  • Fighting, confrontation, and arguing will cause more issues with Sundowning.
  • Patients also do not react well to you getting in their personal space, restraining them or using exaggerated hand gesturing.
  • Violent or emotional TV programs can increase behaviors as well. Using a gentle voice, clear but firm instructions, and not trying to reach towards the patient will aid in their trust.
  • If TV is part of the routine, simple and non-violent programming is best. The Home & Garden Channel or nostalgic shows that are familiar to them will help to keep them calm.
  • Most importantly, making sure their basic needs are met and that they are not in pain will decrease episodes of Sundowning.

When these behaviors are minimized there will be less stress on the caregivers and allow for more quality time spent with your loved one.