| It's called sundowning because, traditionally it tends to | | | | 3. Give a nutritious snack of, for example, banana |
| begin around sunset. It's the agitation time which | | | | bread and a sliced apple about an hour before normal |
| affects many who have dementia. It typically continues | | | | sundowning time; |
| for a couple of hours and then may pass. It is most | | | | 4. At the same time, give a natural juice drink and |
| likely to start in late afternoon, although some people | | | | plenty of water; |
| begin earlier and others reported as starting in the | | | | 5. Listen attentively to the feelings expressed by your |
| morning. | | | | person during time of agitation to learn what emotional |
| That's untypical. It's also untypical that someone begins | | | | issues are unresolved; |
| agitated behavior in late afternoon and then continues | | | | 6. Remember that, in sundowning, this person |
| all night long, but it happens. Whether that should really | | | | expresses real issues with which we can help; |
| be called sundowning is something for a medical | | | | 7. Plan for diversion at the expected sundowning time |
| expert to decide. If I were a caregiver to someone | | | | and increase emotional support; |
| with dementia whose behavior included agitation all | | | | 8. Use environmental support -- music they love, |
| night long, I'd be getting the help of a good psychiatrist. | | | | lavender oil diffused into into the air (notably effective |
| Families tend to attribute everything to Alzheimer's | | | | in reducing emotional stress responses); |
| dementia, whether it is or not. You have other | | | | 9.Understand that agitation can be contagious and that |
| conditions as well. You could have Post Traumatic | | | | your best contribution is to stay calm. |
| Stress Syndrome and Alzheimer's. You could have | | | | I have been able to recommend this approach to care |
| flashbacks and Alzheimer's. So it's very important not | | | | units which have found very positive responses from |
| to blame everything on the dementia. | | | | the plan. I and many other family members have found |
| Sundowning needs a multi-faceted approach because | | | | it very affective at home. |
| we don't know exactly what causes it. We can make | | | | It is definitely possible to reduce sundowning time and |
| good guesses though. | | | | intensity and even to eliminate it altogether. While |
| Five Possible Causes of Sundowning: | | | | you're working on those results, remember anyway |
| 1. Fatigue; | | | | that sundowning tends to reduce and eventually |
| 2. Hunger; | | | | disappear as dementia progresses. |
| 3. Dehydration; | | | | As a caregiver, not as a doctor, I can assure you that |
| 4. Disorientation; | | | | we can do a great deal to help as caregivers. |
| 5. Loss of purpose, belonging and sense of security. | | | | However, not all caregivers can do this and that's okay |
| In my 20 years of working with people with dementia, | | | | too. Caregivers can only do what they can do. We |
| Alzheimer's and other dementias, I've learned that we | | | | are all human and it is out of our humanity that family |
| can maker affective care plans for sundowning. Each | | | | caregivers undertake the heavy task of caring for a |
| plan is particular to each person, but every plan should | | | | family member with dementia needs. |
| include some or all of the following. | | | | One last suggestion: it is not usual that sundowning |
| The Sundowning Care Plan: | | | | involves violent acting out or extravagant fear |
| 1. Study the typical pattern of your person's | | | | reactions. Such manifestations suggest a deeper |
| sundowning; | | | | psychiatric issue. Please don't hesitate to see mental |
| 2. To decrease fatigue overall, encourasge sleeping | | | | health specialists if you have questions. |
| later and having a nap after lunch, if possible; | | | | |