Managing Sundowning in Alzheimer’s: Tips, Tools, and Solutions for Caregivers
Sunsets are my favorite time of day. They are breathtaking moments when the day softly transitions into night, painting the sky with a palette of vibrant colors. They evoke a sense of peace and closure, offering a moment to release the day’s worries and embrace the quiet of the evening. That is until we experienced the phenomenon of “Sundowning.” Sundowning, or late-day confusion, is a phenomenon where those with Alzheimer’s or other forms of dementia experience increased confusion, anxiety, and agitation as the day progresses. Managing sundowning was tough, but we were determined to help our mother-in-love feel more comfortable and at ease during this difficult time.
Understanding Sundowning
Before diving into our strategies, it’s essential to understand why sundowning happens. Although the exact cause isn’t fully understood, it’s believed to be related to changes in the brain’s internal clock, making it harder for individuals to regulate their sleep-wake cycle. Fatigue, low lighting, and the end of daily routines can all contribute to increased confusion and restlessness in the late afternoon and evening. For us, sundowning looked like frantic pacing, verbal outbursts, increased rummaging, and just a general unease in our mother-in-love. It was hard to watch but we were determined to find ways to help our mother-in-love be more comfortable.
Nine Strategies To Manage Sundowning
Just like most things in our journey, we researched a lot of solutions, tried a lot of different things and through tracking narrowed down our journey with sundowners to the following nine strategies.
Establish a Consistent Routine
Establishing consistent routines was one of the best things we did for your mother-in-love, even outside of sundowning. This strategy proved to be key in managing sundowning symptoms. A regular daily schedule helps someone with Alzheimer’s feel more secure and reduces anxiety. Try to keep meal times, activities, and bedtimes consistent every day. By doing this, creates a sense of predictability, which can be incredibly comforting for someone with Alzheimer’s.
Tip: Plan more strenuous activities, like walks or outings, in the morning or early afternoon when your loved one is likely to have more energy. Reserve calmer activities, such as listening to music or reading, for the late afternoon and evening.
Maximize Exposure to Natural Light
Exposure to natural light during the day can help regulate your loved one’s internal clock. Take advantage of morning sunlight by opening curtains or taking a walk outside. If natural light is limited, consider using light therapy boxes, which can simulate the effects of sunlight and help in stabilizing sleep patterns.
Tip: For those days that natural light is not possible, check out the Circadian Optics Light Therapy Lamp. It is a convenient replacement that is compact and easy to use. It added a nice touch to our morning coffee routines on those cloudy or cold days when we could not get outside.
Create a Calm Environment
As evening approaches, create a soothing environment to help reduce agitation. Lower the lights to avoid harsh shadows that can be disorienting, and play soft, calming music. The goal is to create a peaceful atmosphere that encourages relaxation.
Tip: Aromatherapy can also be beneficial. Scents like lavender and chamomile are known for their calming effects. Consider using a diffuser with essential oils to help your loved one unwind. The InnoGear Essential Oil Diffuser is a highly rated product that’s easy to use. For us, the remote control was handy so we could set the diffuser out of reach.
Limit Caffeine and Sugar Intake
Diet can play a significant role in sundowning symptoms. Caffeine and sugar can increase agitation and interfere with sleep, so it’s best to limit these in the afternoon and evening. Instead, offer snacks that promote relaxation, such as herbal teas, whole grains, and foods rich in magnesium like almonds or spinach. This may have been one of the hardest strategy for us because our loved one absolutely loved her cookies in the afternoons. Luckily, there are some sugar free options that we could incorporate and not completely remove everything she loved.
Tip: If your loved one enjoys warm beverages in the evening, try offering caffeine-free herbal teas like chamomile or peppermint. These not only help with hydration but can also have a soothing effect.
Engage in Soothing Activities
Finding the right activities for the evening can help distract and calm your loved one. Gentle activities like listening to familiar music, looking through photo albums, or doing simple puzzles can be comforting and reduce anxiety.
Product Idea: The Simple Music Player designed for Alzheimer’s patients is an excellent tool. It’s easy to use, with large buttons and familiar songs that can bring comfort and joy, helping to soothe nerves during the sundowning period.
Monitor and Manage Triggers
Identifying what triggers sundowning in your loved one can be a game-changer. Common triggers include too much stimulation, fatigue, hunger, or even certain medications. Keep a journal of your loved one’s behavior to help pinpoint patterns or specific triggers.
Tip: If you notice certain activities or environments tend to increase agitation, try to avoid them in the late afternoon and evening. For example, if loud noises seem to be a trigger, consider investing in noise-canceling headphones or creating a quiet space in the home where your loved one can retreat.
Consider the Use of Medication
In some cases, medication may be necessary to manage severe sundowning symptoms. However, this should always be discussed with a healthcare professional. Sometimes, adjusting the timing or dosage of existing medications can make a difference. Your loved one’s doctor can guide you through this process.
Tip: Keep a list of your loved one’s medications and discuss any concerns with their doctor. Sometimes, even over-the-counter medications can have side effects that contribute to sundowning, so it’s important to review everything with a healthcare provider.
Encourage Physical Activity
Regular physical activity is beneficial for overall health and can also help reduce sundowning symptoms. Exercise can help regulate sleep patterns, improve mood, and reduce anxiety. Even a short walk or simple stretching exercises can make a difference.
Tip: Try to incorporate physical activity into your loved one’s morning routine to help them burn off excess energy and reduce restlessness later in the day.
Ensure Comfort and Safety at Night
As bedtime approaches, make sure your loved one is comfortable and safe. A comfortable mattress, soft bedding, and familiar surroundings can all contribute to a better night’s sleep. If wandering is a concern, consider using motion sensors or door alarms to alert you if your loved one gets up during the night.
Product Idea: The Smart Caregiver Motion Sensor and Pager is a useful tool that can alert you when your loved one is on the move, allowing you to ensure their safety without hovering over them.
Practice Self-Care
Caring for someone with Alzheimer’s, especially when dealing with sundowning, can be exhausting. It’s crucial to take care of yourself as well. Make sure you’re getting enough rest, eating well, and taking breaks when you need them. Consider joining a support group where you can share experiences and get advice from others who understand what you’re going through.
Tip: Don’t be afraid to ask for help. Whether it’s from family members, friends, or professional caregivers, accepting assistance can provide much-needed relief and ensure that you’re able to continue caring for your loved one.
Final Thoughts On Managing Sundowning
Managing sundowning symptoms in Alzheimer’s patients can be challenging, but with patience, understanding, and the right strategies, you can help your loved one feel more at ease during these difficult times. Remember, every person is different, so it may take some trial and error to find what works best. Stay flexible, keep a sense of humor, and most importantly, remember that you’re not alone on this journey. There are resources, tools, and communities out there to support you every step of the way.
