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 cadence that we can feel a little lost in space with no direction. This feeling is even more prominent for those with Alzheimer’s or dementia.
The feeling of needing to do something that was once done regularly, for example leave work at 5 p.m., can manifest into a feeling of restlessness, also known as “sundowning”. Sundowning occurs when a senior loved one becomes increasingly confused and agitated during the later parts of the day as night approaches. This disorientation can be frustrating and exhausting for individuals and their caregivers, especially if it lasts well into or throughout the evening.
It’s important to understand the signs and reasons behind sundowning to properly help alleviate the disorientation loved ones may feel when experiencing symptoms.
Symptoms of Sundowning
Anxiety, restlessness, irritability, and confusion are all possible symptoms of sundowning. These symptoms can be displayed differently in each individual, or even not at all. According to the Alzheimer’s Association, 20% of the individuals diagnosed with Alzheimer’s experience sundowning.
“Your personality, upbringing, and even your culture all contribute to how you exhibit your dementia,” explained the executive director at Villa at Terracina Grand, a memory care community in Naples, Florida. “It’s truly a unique experience for each individual.”
1. Ask Them Why
Throughout our lives, we go through each day on a fairly regular schedule. It is predictable and repeatable and often has little variance year over year. This pattern of living relates to our circadian rhythm, and recognizing this helps us to better understand the behaviors that are shown when a person is sundowning.
For example, “One resident was looking for the subway at 4 p.m. everyday,” shares a team member at The Goodman Group. “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 V., 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 a Goodman Group team member. “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, her sundowning anxiety would be alleviated.
“It’s really helpful to have something for residents 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. Keep the lights on
Fading light may be a trigger for sundowning. “Keep the drapes 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 lamps. Keeping spaces brighter helps the resident’s circadian rhythm from being triggered by the natural light changes throughout the day.
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.”
Ultimately, these practices are meant to help with the disorientation that comes with sundowning. Since every individual is different, some of these tips may or may not have an effect on your loved one. The general goal is to keep your loved one distracted and relaxed when a sundowning episode is occurring.