Sundowning & Sleeping [Checklist]
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For many people with dementias such as Alzheimer's, the approach of nighttime may be a difficult time.
For the exhausted caregiver, sleep can't come too soon. For many people with dementias such as Alzheimer's, however, the approach of nighttime may be a difficult time. Many people with Alzheimer's become restless, agitated, and irritable around dinnertime, often referred to as "sundowning" syndrome. Getting the person to go to bed and stay there may require some advance planning.
- Encourage exercise during the day and limit daytime napping, but make sure that the person gets adequate rest during the day because fatigue can increase the likelihood of late afternoon restlessness.
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Try to schedule more physically demanding activities earlier in the day. For example:
- bathing could be earlier in the morning
- large family meals could be at midday
- Limit outings to the morning hours.
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Decrease the length and amount of stimulus:
- Even during the earlier part of the day, the individual with Alzheimer's can only tolerate so much stimulation and commotion.
- Take steps to eliminate over-stimulation such as T.V., children, any noise making item, quick movements and many things going on at one time.
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Set a quiet, peaceful tone in the evening to encourage sleep.
- Keep the lights dim
- Eliminate loud noises
- Even play soothing music if the person seems to enjoy it.
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Identify and minimize physical discomfort.
- Physical discomfort may play a part in sundowning.
- Hunger, being wet or soiled, feeling cold/hot and other sources of discomfort can increase agitation, especially in the late afternoon and early evening.
- Provide light snacks during the day to prevent hunger. Apples and other fruits can help replace lost energy from pacing or other activities.
- Try to keep bedtime at a similar time each evening. Developing a bedtime routine may help.
- Restrict access to caffeine late in the day.
- Use night-lights in the bedroom, hall, and bathroom if the darkness is frightening or disorienting.
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Make sure that all medical conditions are dealt with.
- Conditions such as urinary tract infections, flus/colds, asthma, allergies and other conditions can contribute to sundowning.
- When you notice the first signs of sundowning, go see the doctor to make sure that there are no conditions that need medical attention.
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Source:
National Institute on Aging
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