For the majority of our lives, we are bound by routines. We go to work, we make dinner, we wrangle the kids, etc. It’s no wonder that when we retire and stop this daily grind that we feel we should be doing certain things at specific times of the day. For those with Alzheimer’s or dementia, this can often lead to a feeling of restlessness that manifests itself in the late stages of the afternoon and evening. It is referred to as sundowning.
Symptoms of Sundowning
Agitation, restlessness, irritability, and confusion are all possible symptoms of sundowning. It manifests differently in each individual, or even not at all. According to the Alzheimer’s Association, 20% of the individuals diagnosed with Alzheimer’s are affected.
“Your personality, upbringing, and even your culture all contribute to how you exhibit your dementia,” says Marthe Lawrence, Executive Director at Villa at Terracina, a memory care community in Naples, Florida. “It’s truly a unique experience for each individual.”
1. Ask Them Why
Throughout our lives, our routines become ingrained. “One resident was looking for the subway at 4 p.m. everyday,” Marthe explained. “He used to live in New York City and at that time he would usually be taking the subway home from work.”
“The best thing you can do is ask them why,” said Tina Vauthier, Regional Director of Life Enrichment for The Goodman Group. “What did they used to do at this time? It makes you aware of what’s going on so you can redirect them before the sundowning hits.”
2. Anticipate and Redirect the Behavior
“We try to anticipate which residents are going to exhibit sundowning and redirect that energy,” says Marthe. “We currently have a resident who is always looking to go home at 3 p.m. She really just wanted to leave the building, so at that time everyday, we would take a walk.” Once the resident was outside, she would forget why she wanted to go home.
“It’s really helpful to have something for them to do in that period,” says Tina. “Do an activity that is meaningful to them, like painting, play some of the music they enjoy, or even have them participate in an exercise class.” She adds that the symptoms of sundowning may be greatly reduced by having the resident participate in an activity they enjoy.
3. Control Light Sources
Fading light may be a trigger for sundowning. “Keep the drapes more modified closed so they don’t experience the light and darkness as much,” says Tina.
You can also adjust the actual lights in the room by putting a higher wattage of bulbs in the lamps.
4. Apply Aromatherapy Techniques
Applying aromatherapy techniques may also help alleviate symptoms of sundowning. Tina remembers a memory care resident who benefited greatly from lavender essential oil massages. “She had been sundowning quite a bit in the afternoons,” says Tina. “We noticed that the symptoms decreased to almost no signs of confusion or anxiety when receiving the lavender massages.”