How to Deal with Sundowners Syndrome

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If an elderly parent is having an episode of Sundowners Syndrome experts suggest that a caregiver:

  • Approach the person in a calm manner 
  • Find out if there is something he or she needs 
  • Gently remind him or her of the time 
  • Avoid arguing or asking for explanations 
  • Reassure them that everything is all right and everyone is safe
  • If you are able to get the person to calm down a bit, distract him or her with simple activities she enjoys.

Here is some practical advice that caregivers can use to try and lessen the likelihood that a person with Alzheimer's or dementia will experience sundowning:

Plan More Active Days
A person who rests most of the day is likely to be awake at night. Discourage afternoon napping and plan activities, such as taking a walk, throughout the day.

Have a Routine
Maintain a routine tends to alleviate the severe anxiety experienced by those sundowning. Even simple tasks like "putting on pajamas" can be helpful.

Provide a Peaceful Setting
Guide the person to an area away from family activity and other distractions. Try to prevent excessive noise during sunset.

Use Music
Sometimes soothing music will help to calm and relax a person with Alzheimer's or dementia. Arts and crafts, and even pet therapy also have a calming effect.

Ensure Safety
Install locks and safety devices as necessary. Take precautions to provide a safe space for him or her at night so that you can get a solid night's rest, even if he or she needs to stay awake and wander.

Change Sleeping Arrangements
Allow the person to sleep in a different bedroom, in a favorite chair or wherever it's most comfortable.

Use a Nightlight
Keep the room partially lit to reduce agitation that occurs when surroundings are dark or unfamiliar.

Draw the Curtains
Be sure the person's environment is well-lit. You may find it helpful to draw curtains and turn on inside lights as it grows dark outside.

Monitor Diet
Restrict sweets and caffeine consumption to the morning hours. Serve dinner early.

Seek Medical Advice
Physical ailments, such as bladder or incontinence problems, could be making it difficult to sleep. Your doctor may also be able to prescribe medication to help the person relax at night.

Whether or not you fully understand Sundowners Syndrome, the look of terror and bad behaviors that accompany this time of day are extremely taxing and stressful.

 
 

Comments

 
  •  Comments 1 to 10 of 46 
 
 

Mari

Give a Hug

Oct 16, 2008

My mother has been having "dreams" but she says shes awake, maybe she is, anyway she sees people in her room,animals, people that are ghost like and glide through a closed door or window, kids poking sticks through the floor and into her matress while she sleeps. Are these signs of dementia or could they be caused by a lack of oxygen to her brain from a heart condition?

 
 

Mari

Give a Hug

Nov 6, 2008

Hi All--What I thought might be sundowners doesn't seem to be, my mother now says that she sees people on the roof tops on the houses across the alley, she says they're taking the shingles off, and then they go inside and remove the copper pipes. could this be a problem with her eyes or dementia, she sees these things in broad daylight thats why I question sundowners, any thoughts? thanks!

 
 

clairef

Give a Hug

Dec 4, 2008

Hi Mari,
My Dad did the same thing. He was seeing people in the courtyard of his building installing oil pipes. This same hallucination was sustained for months- with the story getting more and more elaborate over time. With my Dad it is the result of worsening dementia and, related to his dementia, a decreasing ability to process visual signals. He has become legally blind due to the effect of dementia on the visual processing center of his brain. I think that, in the absence of seeing real things, he either completely creates a story, or interprets the very little bit he can see in a spectacular way!
I would guess with your Mom that what is going on are dementia related halllucinations. I would have her evaluated by her family doctor and gerontologist to figure out what is going on-sooner rather than later.
Good luck.
Claire

 
 

tmluna

Give a Hug

Jan 13, 2009

My mother does the same thing, but usually only at night. She has kittens running around in her room, sees people in a truck outside the house in the middle of the street, and said my sister came over at 3am and had been in the ER all night and she needed to take her to the doctor at 8am. My mother hasn't driven in over 4 years. During the day she see ants, holes in the floor where light is coming through (we live in a concrete slab house) and hears phones ringing ALL the time. It is just her demenita and sundowners working. I just agree and attempt to make her believe the problem has been corrected. Good luck and bless you!

 
 

Mari

Give a Hug

Jan 14, 2009

thanks so much for your input on my mother's problems, it does sound more and more like dementia. When I take her to her cardiologist next month I'll tell him about it, in the meantime we have to get a new pcp. thanks everyone and I'll be praying for you and your ill family members. Mari

 
 

JenJilks

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Jan 22, 2009

My theory is that it is a combination of various issues. The most important is that at the end of the day is the time when families get together, you finish your day, and you can breathe a sigh of relief. Every day is the same for many who are alone or ill.

It is important to rule out delirium, vs. dementia or other organic issues and determine if there are biological, chemical, social or other solutions. It is much like parenting!
"Pediatric or geriatrics - the only difference is body mass!" - to quote a friend of mine, as printed in my book on Death & Dying!

 
 

Mari

Give a Hug

Jan 22, 2009

JenJilks-thanks for your input. My mom's pcp said to have the furnace and the sewer lines checked, he seemed to think that leaking radon or sewer gases might be causing her to "see and hear" things. she always things that she hears water running in the basement, and now people are actually in the house getting in through a second floor window.

I apprciate all of you sharing what problems you have with your parents, so many are just like my mothers, its nice to be able to talk to people who understand. My brother is in denial and my husband gets tired of hearing about it. Thanks and God bless all of you. Mari

 
 

JenJilks

Give a Hug

Jan 22, 2009

OMG, leaking gasses, That is a hoot. I had a bipolar friend who had a break down and the parents tried to blame a bucket of floor cleaner - fumes.

Hallucinations are a good predictor of many issues. My dad used to talk to his dog, that was living with another family as we couldn't care for her!
My husband was the best at calming him. You have to let them know you believe them and are working at resolving the problem!

I recall my kids going down to the play room in the basement with pots and spoons. We would chant, "Go away ghosters!" and all would be well. I figure you just have to play along. If it is dementia you haven't a hope in hell of curing or ameliorating it!

My parents both passed away. I learned so much. I am going to be taking palliative care training and volunteering. I volunteer for our Victim Services response team, too.

Be strong. Be tough. Blessings...deep breath.

 
 

Mari

Give a Hug

Jan 22, 2009

JenJilks-What was the cause of your dads hallucinations? You've been such a big help, I used to keep telling her no one is upstairs, no one is on the roof, water isn't running, etc. and she would just get mad, so maybe if I try to be more understanding and go and check upstairs for her and the basement, it might ease some of her fears. Thanks so much (and excuse my typos in the last message, I was in a hurry).

I commend you for taking palliative care training and volunteering, God bless you in your endeavors and thanks for your input. Mari

 
 

JenJilks

Give a Hug

Jan 23, 2009

I think dad's hallucinations were part of the deterioration of his brain. Or, the polypharmacy he was facing.

While there is an inundation of web sites and guidance regarding how to prevent dementia, at some point a lot of what we are seeing in terms of behaviour is a reaction to drugs, treatments, plaque, cholesterol, lack of exercise...as they attempt to deal with their realities.

I think, too, that for some it is a psychological coping mechanism. Why deal with reality when you have lost your home, spouse, purpose in life, friends, etc.?

With Alzheimer's the chat rooms say to play along. You cannot convince them otherwise. My dad's tumour was in the area of language, and he could not retrieve nouns. He phoned one night, in the wee hours as he had insomnia, to tell us that 'the bandaids in the jar are gone' (the candies I had put in a can) and then the 'fire in the oven has gone out' (the TV wasn't working - we had a hurricane and power outage!).

We promised to take care of it in the morning, used soothing language, and soothing words. That seemed to work. We were beyond diagnoses and just dealt with his reality. It helped.

 
  •  Comments 1 to 10 of 46 

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