Imagine waking up in an unfamiliar bed and not recognising your surroundings. You pace a dimly lit hallway that isn't yours, filled with framed photos of smiling faces you just can't place. You don't know how to get out or how you are going to get home.
What if someone told you that you are, in fact, at home? Anyone would feel anxious at the thought, but for people with dementia, this is often a reality that begins as soon as the sun starts to set.
For many people with dementia, feelings of distress and intense anxiety can emerge in the late afternoon and continue into the night, which is often known as 'sundowning'. This anxiety can present itself through stress and anger, or the person may begin to feel lost, for example asking to 'go home' when they are in their own home.
Why does sundowning happen?
There are lots of reasons why sundowning occurs. One of the reasons may be due to tiredness, resulting in their symptoms worsening. Contributing factors also include feeling hungry or thirsty. Other factors may include experiencing pain, which may be common in those who experience chronic pain.
How do you support someone through sundowning?
If a loved one, or someone you support, is experiencing sundowning, it can be difficult to know the right thing to say or do and if it runs into the night, can make the person and those supporting them even more tired. Thankfully there are several methods to support sundowning as it happens.
Tips for managing sundowning as it happens
Use distraction techniques:
- You could go into a different room with the person
- Support them to make a drink or a snack
- Listen to some soothing music
Offer comfort:
- Ask the person to talk through their concerns and listen carefully to the response. If possible, see if you can deal with the source of their distress
- Talk in a slow, soothing way
- Hold the person’s hand, or sit close to them and stroke their arm (if they are comfortable with touch)
Tips for preventing sundowning
- Follow a routine during the day that contains activities the person enjoys
- Introduce an evening routine with activities the person enjoys, such as: watching their favourite programme, listening to music, stroking a pet etc.
- Try to keep television or radio stations set to something calming and relatively quiet sudden loud noises or people shouting can be distressing for a person with dementia
- Going outside for a walk, or visit the shops
- Limit the person’s intake of caffeinated drinks and support the person to refrain from drinking alcohol, if possible. Caffeine-free tea, coffee and cola are available, as is alcohol-free beer and wine
- Try and limit the person’s naps during the day to encourage them to sleep well at night instead
- Close the curtains and turn the lights on before dusk begins, to ease the transition into nighttime
- If possible, cover mirrors or glass doors. Reflections can be confusing for someone with dementia
- Once you are in for the evening, speak in short sentences and give simple instructions to the person, to try and limit their confusion
- Avoid large meals in the evening as this can disrupt sleep patterns
For further information and advice on sundowning, visit:
- Sundowning (changes in behaviour at dusk) - Dementia UK
- Sleep and dementia - Dementia UK
- Dealing with restlessness - Dementia UK
- Down’s syndrome and dementia. A resource for carers and support staff - Dr. Karen Dodd, Vicky Turk and Michelle Christmas
- Easyhealth.org
- Resources – bild
- Books Beyond Words about dementia - booksbeyondwords.co.uk
Webinars for staff
Do you work at MacIntyre? Do you support someone with dementia? Join Jane Nickels, our Learning Disability Admiral Nurse for exclusive webinars and drop-in sessions for MacIntyre staff. The next topic will be on 'Dementia and Changes in Behaviour'.
- Topic: Dementia and Changes in Behaviour
- Date: 27 May
- Time: 11 am
To sign up to this webinar log in to the Intranet and refresh this page.
