Effective Strategies for Handling Dementia Sundowning

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Dementia can cause many different types of challenges for people who have it and for their carers. There are practical difficulties involved, like how adults looking after their parents or older relatives can find enough spare time in their day to care for them.

Even knowledgeable, experienced carers struggle with “sundowning,” a word that describes how a person’s condition can swing depending on the time of day. As the afternoon or evening advance, people with dementia can become more agitated, distressed, or even have more severe experiences like delusions or hallucinations.

At Sagecare, we have experienced dementia caregivers on hand to provide wrap-around care in a supportive, understanding environment that plays to the resident’s strengths. Please read on to learn about some of the effective strategies we use for handling dementia sundowning.

General Understanding is Vital

When it comes to dementia, it’s important to understand the basic nature of the condition, which requires understanding how variable it can be. No two people experience dementia in the exact same way because there isn’t merely one condition or illness called “dementia.”

A person’s condition is always changing and in constant flux. Sometimes, it gets better. Sometimes, it gets worse. It can change in the short, medium, and long term. Caring for somebody who may be changing before your eyes can be exhausting and even spiritually draining in different ways.

But we believe that understanding what they’re going through can only help make caring effectively easier.

Facts About Sundowning

Everybody needs a good night’s sleep for their physical and mental health. However, dementia can upset the body’s normal cycles, which affects the body clock in turn. According to research from the Mayo Clinic, roughly 25% of people with dementia experience mild to moderate sleep disturbance, which ramps up to 50% among those with severe dementia.

A senior with dementia and sleep problems may become more difficult to handle towards the late afternoon and early evening as they feel agitated, restless, or confused as daylight dwindles.

According to the National Institute on Aging, some of these symptoms can be attributed to being overly hungry, thirsty, bored, or in pain. In other words, the difficult behaviour could have multiple underlying causes, and it is never clear exactly which ones are at play. It helps to know all the different things that could potentially activate a negative response so carers have a checklist of things they can ask themselves.

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Is the resident getting enough sleep? Do they have enough to eat and drink? Sagecare specialists understand the potential medical causes, but they also know the residents and draw on their knowledge of both to provide the most holistic way forward.

Managing Dementia Behaviours

The negative behaviours associated with sundowning can potentially occur at other times, too. However, managing dementia behaviours requires vigilant observing, especially towards the end of the day. Increased irritability or a change of mood is one thing, but sometimes, sundowning can lead to behaviours that can be dangerous to the individual, like wandering alone.

Sagecare’s specialists understand the urge can arise from restlessness, inability to sleep, or searching for something to do. As the progression of dementia hits the middle stages, wandering alone tends to increase.

We help keep seniors safe by observing what triggers any negative behaviours associated with sundowning and dementia, in general, to recognize the signs sooner and act accordingly.

Sometimes, seniors with dementia wander because they’re nervous in a crowd. Indeed, isolation is not an uncommon thing in seniors who aren’t feeling like themselves and struggle to describe their feelings. Comprehensive, compassionate dementia care requires addressing the underlying causes so they feel good day-to-day, rather than merely ensuring they are safe and sound and don’t go wandering alone.

The upcoming darkness after the sun sets may make seniors feel confused, agitated, or restless. Sometimes, this can make residents feel paranoid or suspicious. They may accuse people of working against them or even trying to take their belongings — it’s crucial to remember not to take it personally and not to argue with them.

We observe residents closely to look for any patterns and understand their experience. We note any changes in their behaviour during the day or evening and make a plan for how to improve it to keep them happy and safe.

Strategies for Improvement

There is no universal approach to sundowning, as no two people are alike, nor are there conditions. However, there are a few things we try, and one or more of them often work.

Regular routines for meals, waking, and bedtime help keep residents feeling the support of constancy. Ensuring they get enough time outdoors while the sun is out helps them feel readier for bedtime in the evening.

Limiting daytime napping and caffeine in the afternoon and beyond is another helpful strategy, as residents feel restful towards the day’s end. Limiting stimulating activities and background noises later in the day also helps encourage restfulness at night.

When residents are in a new and unusual place or setting, it’s important to bring things like photographs which connect them to home and help encourage a feeling of familiarity. Similarly, playing familiar, soothing sounds or music at night can also help calm down residents and make them feel good.

Sundowning may have different causes, from a side effect of their medicine to pain, depression, or something else entirely. Understanding how broad the causes may be should help you remember that there could be many ways of addressing the issue. The main thing is for our trained specialists to draw on their understanding of the condition and the residents themselves to arrive at the best solution at any given time.

Sagecare believes in giving every resident a nurturing, supportive environment based on professional knowledge and a personalized approach. Like everybody, our residents’ moods are in flux and may change throughout the day for external or congenital reasons. Whatever they experience, whether it’s morning or night, Sagecare will be there with concern and support.