October brings home dusk dilemmas
The term “Sundowning” may conjure thoughts and images of beautiful sunsets, however in dementia care, unfortunately, it doesn’t have the same connotation.
Sundowning presents in different ways, but it is usually reflected in a change in behaviour as daylight begins to disappear. This can be especially challenging, as it also tends to be the time of day when all of us, but especially carers are tired and are wanting to wind down themselves.
What is Sundowning?
Sundowning is often exacerbated in the winter months due to the darker evenings and the lack of natural light. Those affected can experience increased levels of anxiety, confusion, aggression and can become more agitated. Recognising the symptoms of Sundowning is not always easy, as everyone is different, and it may present in different ways. However, it is likely that you may hear someone say things like:
- “Am I in the wrong place?”
- “I need to go home “
- “I need to pick up my children”
-“Where is my Mum or Dad?”
This can be upsetting for everyone involved, but we hope that what follows makes it easier to understand and provides some useful thoughts about what you can do if you find yourself in this position.
Why does Sundowning happen?
Of course, there is no simple answer!
Sundowning is thought to be a part of our natural body clock and we all have a different one! Our body clocks are affected by chemicals being released in the brain at different times – this is why one person maybe an early riser, while another, a night owl.
Not getting enough sleep can trigger the Sundowning effect, as can hunger, thirst and physical pain. What can you do? Natural light is so important for all of us. Try and get plenty of natural light during the day and then shut the curtains and turn on the lights, before dusk, especially on those dark winter days. It’s simple but can be very effective.
Rule out the basics……We all have basic needs, and if for example, we need the toilet and cannot go for whatever reason, it is painful, makes us feel uncomfortable and irritable. If someone living with dementia is unable to communicate that they need to use the bathroom they are likely to become unsettled and possibly show symptoms associated with Sundowning. It is therefore important to rule out these immediate needs. So, ask them if they are in any pain, do they need to use the bathroom, or would they like a drink or something to eat. Be prepared with some healthy afternoon snacks to hand, or perhaps an occasional slice of cake. This, alongside drinking plenty of water is vital.
There are also the same basic environmental needs to consider, so pause for a moment and think about what is going on, is the TV on in the living room, and the radio playing the kitchen, the noise from which could be overwhelming? Maybe the room itself has become quite dark as the evening is drawing in? Eliminating these physical and environmental factors could reduce their anxiety.
Once those things have been addressed remember;
Try not to get angry. Understandably, it may provoke feelings of worry, anger and frustration, especially if it has been a hard and tiring day.
Try distraction techniques, use something that the person finds enjoyable, maybe go for a walk, or sit and share a drink or snack together. Music can often be useful.
Validation techniques are also helpful when people are asking for loved ones, ask about that person; “Tell me more about that them, what did they do? What did you love doing with that person?”
Consider why they may be asking for a certain person, like their mother or father. Often, when a person asks after their mother, they are wanting to feel loved and cared for and when asking for their father, they want to feel safe and secure. Converse in a soothing way and at a slow pace, sit close to them or hold their hand. We all want to feel loved.
Remember, Sundowning does not affect everyone living with dementia and sometimes it comes and goes. However, being aware and well equipped with skills to manage this, should it occur can help make such a positive difference.
Final Thought
Our Wayfinding Team are always here to help but adjusting and educating ourselves is for some the first step on the journey. Offering free advice and guidance for your whole dementia journey, even from before you have a formal diagnosis. The Wayfinders can also sign post to other services we work with to provide holistic, person-centred support.
If you have concerns about your loved one's memory, you can contact our Wayfinders on 01243 888691. They can support you and your loved ones for your whole journey with dementia, from pre-diagnosis to end of life care.