Autumn is a favorite season for many, but this time of year can also bring about seasonal sundowning in aging loved ones. If you are a caregiver of a parent with Alzheimer’s disease, you may be interested in learning more about sundowning, which can bring about increased agitation, confusion and memory loss in a senior loved one.
Learn more about seasonal sundowning and read how to manage symptoms.
Sundowning
A common symptom of Alzheimer’s and other forms of dementia, sundowning involves an increase in symptoms of agitation and confusion, which occur during the early evening hours or late afternoon hours.
Some experts feel that sundowning may occur due to a disruption in the circadian rhythms (sleep and wake cycles).
The time span between sunset and twilight can be particularly disturbing for people with Alzheimer’s and sundowning symptoms within this time can include:
- Agitation
- Confusion
- Disorientation
- Hallucinations
- Pacing back and forth
- Paranoia
- Restlessness
- Shadowing
- Wandering
- Yelling
If you notice a worsening of behavioral symptoms starting in the late afternoon hours, it is a clue that sundowning may be starting. Fading light seems to be a trigger for sundowning and symptoms get worse as the night goes on. The symptoms usually begin to improve by morning.
Sundowning can put a lot of stress on caregivers, as well as anyone who spends the evening or nighttime hours with a person who has Alzheimer’s.
The goal is to help a parent or senior loved one who is experiencing sundowning to maintain a sense of calmness and help them stay oriented to place and time.
Ways to Manage Seasonal Sundowning
There are some steps that you can take to help manage seasonal sundowning symptoms.
Some measures that have been known to lessen the symptoms of sundowning include:
1. Adhere to a regular schedule.
A person with Alzheimer’s is prone to react to unfamiliar places, people and things. Sticking to a routine and involving the same time for a daily ritual in the same location will help a person who is reacting negatively to stress with confusion and anger. Avoid making changes if at all possible, but if you must change the daily schedule, try to change things gradually, instead of all at once.
2. Adjust an eating schedule.
Avoiding large meals late in the evening can lessen symptoms of sundowning. Be sure to avoid giving a person with Alzheimer’s alcohol and caffeine particularly late in the day. Plan for the biggest meal as early in the day as possible and offer a light snack in place of a large meal as the day becomes later.
3. Administer medicine.
Administer a parent or senior loved one’s medicine as prescribed by their healthcare provider. Some doctors may recommend trying a natural supplement, such as melatonin for sleep, but never give a person with dementia any type of supplement without first consulting with the prescribing physician.
4. Encourage activity.
Keeping a person with Alzheimer’s active during the daytime hours — by taking walks, working in the garden etc. — will help improve the sleep quality at night, while helping to reduce seasonal sundowning symptoms.
5. Keep track of causative factors.
No two people with Alzheimer’s are exactly alike and what frustrates one person may not bother another. Identify factors that contribute to agitation, confusion and other symptoms of seasonal sundowning, then keep a record of triggers to share with all other caregivers.
6. Minimizing stress levels.
Avoid giving a person with Alzheimer’s complicated things to do that could cause frustration, particularly later in the day. Frustration can add to the symptoms of seasonal sundowning. Keep in mind that even things that are not considered very complicated, such as reading or watching television, may be too difficult for a person with late-stage dementia. Keep the environment as calm and quiet as possible.
7. Using full-spectrum fluorescent lights.
A recent study found that light therapy can lower agitation and confusion in those with dementia. Healthline recommends using full-spectrum fluorescent lighting for a couple of hours each day and the Alzheimer’s Association suggests brightening the lights when a person with Alzheimer’s feels agitated or confused.
As the days gradually become shorter, seasonal sundowning may become an issue with a parent or senior loved one. The overall goal of managing sundowners is to learn about common ways to manage the symptoms. Try each tactic, then note what works and what doesn’t. Try to keep in mind that it’s an ongoing process.
Medical professionals can also help rule out other causes of seasonal sundowning, like pain, urinary tract infections (UTIs) or vitamin deficiencies, which are a common cause of symptoms that mimic sundowning.
How has seasonal sundowning affected you, a parent or senior loved one? We’d like to hear your stories in the comments below.
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