Seriously? Sundowning?

Sundowning occurs in over 60% of people with dementia. The experience may be as confusing for the person being cared for as it is for the caregiver. Have you seen the signs?

It isn't uncommon for people to become fatigued following a busy day but it is especially problematic for people with dementia. It is during the late afternoon and evening hours when sundowning usually occurs. That is typically a hectic time, preparing meals while the family gathers.

There are no known causes of sundowning; some suspect sleep deprivation, being mentally and physically over-tired from a busy day, hunger and thirst, or boredom. I have seen situations where people with dementia are confused about where they are in time and place. Often, mothers became anxious their child wasn't home from school and men were worried about what was happening at work.

"It's not a cognitive issue per se, but rather a change in behaviors," says Spencer Liebel, a clinical neuropsychologist and assistant professor in the Department of Neurology at the University of Utah Health. "There's newer research coming out suggesting that this is tied with circadian rhythm. The body wants to sleep, but some of the brain structures regulating sleep might be damaged in the dementing process." For more information on sundowning, the article from the University of Utah provides more details and resources to help you on your dementia journey.

Teepa Snow's "Positive Approach to Care," suggests caregivers, "Connect with the person to hear what they have to say, to see if you can figure out what their need might be. Be sure to approach your conversation with curiosity, not judgment."

Ideas for reducing confusion:

• Routine is comforting

• Avoid tripping hazards.

• Set a peaceful mood

• Establish visiting hours

Ideas for lessening stress and enjoying the evening together:

Your care is equally important. Be aware of the feelings you experience and reach out to someone for support. Seek trusted family and friends when you need to be away. Find a caregiver support group for additional resources and comradery. Contact a counselor to sort through your feelings and provide you with insights into caregiving.

On a bright note, it’s good to know that most sundowning behaviors dissipate at night. When that time comes, do your best to get some sleep. A new day can provide new hope for better times. I wish you well in your care.