Sundowning
About six months after my mother-in-law’s diagnosis, we were preparing dinner for the evening. We called her down after she had been napping for a couple of hours.
She followed me into the kitchen and watched with rapt attention as I helped her plate her food. She appeared quite worried so I asked her why.
“Everything looks good, but I don’t normally eat this kind of food for breakfast” She replied. “ We have to hurry, I don’t want to be late for morning service.”
It was clearly dark outside, the news was on, and it was a Thursday evening, but I tried not to seem too alarmed.
“It’s ok. It is the perfect time for this meal” I replied.
She would not be moved. She insisted that tomorrow had come and that it was time for her to go to church. Finally we decided to take her outside on the porch , it wasn’t until she gazed at the moon for a full ten minutes that realization dawned on her and we were finally able to calm her down.
Sundowning is a term used to describe a phenomenon often observed in people with dementia, particularly Alzheimer's disease, though it can occur in other conditions as well. It refers to an increase in confusion, agitation, and behavioral problems that typically occur later in the day or in the early evening, as the sun sets or as darkness falls.
Symptoms Of Sundowning
Agitation: Restlessness, pacing, or increased irritability.
Confusion: Disorientation, difficulty recognizing familiar people or places.
Anxiety: Heightened feelings of worry or fear.
Aggression: Verbal or physical outbursts, sometimes directed at caregivers or others.
Hallucinations: Seeing or hearing things that aren't there.
Mood swings: Rapid shifts in emotions, such as from calm to angry or anxious.
Sleep disturbances: Difficulty falling asleep or staying asleep, frequent waking during the night.
If your loved one has exhibited any of these symptoms know that sundowning usually occurs in the middle to late stages of dementia. We have found that repetition helps. Create and maintain a regimented schedule for their daily activities which includes the time of day they get up out of bed, bathing, naps, and meals. If they insist that they are correct in their assessment about the time of day, try demonstrating where they are wrong instead of insisting on telling them that they are wrong. Also one of the best tools that helped us through this period is a specialty, digital clock, sometimes referred to as a dementia clock. These clocks display the time, day, date, and specifies morning, noon, and evening. Some of them are equipped with large colorful displays. Encourage your loved one to write down when they wake, eat lunch, or go to bed to enforce that they use the clock on a daily basis. Or simply ask them “what day is it? what time is it? what month are we in? This ensures that they are more engaged and will give them the confidence to respond.
