Daylight Saving Time officially ends November 1 this year, but if your loved one has mid-stage dementia, they may already be experiencing negative effects of fall’s shorter days and longer nights.
“A lack of sunshine can dampen anyone’s spirits, but it can have profoundly upsetting effects on an estimated 20 percent of people with memory loss,” says Danielle Buck, Director of Community Relations at YourLife™ of Stuart, a Memory Care community in Stuart, Florida. “And, although it’s known as sundowning or sundowners syndrome, it’s important to note that symptoms can manifest early in the morning and on dreary afternoons just as they can at dusk.”
In this post, we’ll help you recognize the signs of sundowning, pinpoint possible triggers, and manage your loved one’s symptoms so you can keep both of your spirits up when the sun goes down.
SIGNS YOUR LOVED ONE MAY BE EXPERIENCING SUNDOWNING
People without memory loss who experience a similar phenomenon, seasonal affective disorder or SAD, can usually understand what is happening or at least why. This awareness, of course, can help them put their symptoms in perspective and deal with them rationally by seeking treatment and taking steps to keep them at bay.
However, for those with progressing dementias, awareness is replaced by confusion, fear, and a host of other challenging symptoms that can present along with depression and fatigue typical of SAD.
• Anger, Agitation or Anxiety
• Repeating Questions Over and Over
• Inability to Communicate Coherently
• Emotional Outbursts
• Fear, Paranoia, Delusions or Hallucinations
• Depression, Sadness or Crying
• Restlessness, Rocking, Pacing or Wandering
• Violent or Aggressive Behavior
• Insomnia or Sleep-Wake Disturbances
• “Shadowing” – the habit of closely following, observing, or mimicking their caregivers
DETERMINING & AVOIDING YOUR LOVED ONE’S TRIGGERS
A lack of sunlight alone can contribute to depression, lethargy, sleep-cycle disruptions, and other SAD-like symptoms for people with dementia, but sundowning syndrome is often paired with other factors to consider.
Is your loved one in physical pain or discomfort?
Your loved one may not be able to identify or communicate what is bothering them. Look for signs of infection, injury, and other sources of physical distress and take appropriate actions to alleviate it. Are they constipated? Is their chair uncomfortable? Are they hungry or thirsty? Are they overly tired? Are they suffering side effects of medications?
Is your loved one bored?
Give your loved one a simple, soothing activity to keep them engaged and occupied before bedtime. Folding laundry, a puzzle, or time spent with the family pet can have calming effects.
Is ambiance to blame?
Low lighting: Changes in lighting can be very disorienting for people with memory loss, and the inability to function well in the dark can cause anxiety, fear, or embarrassment. Install nightlights to help keep your loved one safe and oriented in their surroundings.
Overstimulation or excessive noise: In the evening, try to reduce background noise and stimulating activities, including TV viewing, which can sometimes be upsetting for people who can’t identify the source of unexpected voices and sounds. Play familiar music in the evening or relaxing sounds of nature, such as the ocean.
Increased shadows or reflections: Draw the curtains so they cannot see the sky change from light to dark. Turn on inside lights to keep the environment well-lit, minimize shadows, and improve visibility.
Is your loved one physically or mentally exhausted?
It takes a lot of energy for people with dementia to process everyday sensory stimulation and information, and the resulting fatigue can exacerbate irritability and other end-of-day sundowning symptoms. Follow your loved one’s lead and don’t push them to do more than they are able.
Dementia and a lack of sunlight can wreak havoc on the body's internal clocks and sleep-wake cycles. Exposure to natural light during the day can help regulate circadian rhythms, provide vital Vitamin D, and reduce agitation and anxiety after dusk. On dark mornings and afternoons, bright light therapy – the use of artificial light machines that mimic natural sunlight – can help alleviate irregular sleep patterns, depression, and lack of energy.
Maintain a consistent routine for waking, meals, activities, and bedtime to help orient your loved one to time of day. In the evening, simple tasks like eating dinner and putting on pajamas can help indicate that the day is winding down.
Limit caffeine and sugar to morning hours, limit daytime napping, and plan activities and exercises that will expose your loved one to sunlight and keep them engaged and awake to encourage nighttime sleepiness.
Allow them to sleep wherever they are most comfortable. This could be in a different bedroom or their favorite chair. Limit noise and activity near their sleeping accommodations.
When to consult a doctor: Physical ailments, such as a urinary tract infection, incontinence, or sleep apnea, could be making it difficult for your loved one to sleep, which can worsen sundowning behaviors.
Is your loved one having delusions or difficulty separating dreams from reality?
If they are experiencing delusions, paranoia, or hallucinations, meet them in their version of reality and reassure them that everything is all right and they are safe. Cover windows and mirrors in the evenings, as reflections can make it look like strangers are looking through the other side.
If pacing soothes your loved one, create a safe space for them to do so whenever they need to, such as in the middle of the night. Prevent wandering by installing locks and alarms.
APPROACHING YOUR LOVED ONE DURING AN EPISODE
• Avoid rationalizing and arguing with your loved one.
• Assure them they are safe and that you will stay with them.
• Offer them a drink, snack, trip to the bathroom, or something to do.
• Stay calm and offer reassurance. Respect your loved one’s space and avoid yelling and angry body language. “Even if you don’t voice your frustrations, your loved one can pick up on them,” says Buck from YourLife™ of Stuart. “And those negative vibes can stoke your loved one’s fears and worsen behaviors.”
YourLife™ of Stuart’s care specialists keep our residents’ spirits up all day – and night – long. Learn how today! 772-212-2448
Designed for You. Defined by You.
YourLife™ of Stuart was created with one purpose – to provide the most exceptional Memory Care and uplifting lifestyle for our residents. As Memory Care specialists, we focus all our energy, attention and resources on creating a community that caters to each resident’s personal needs, respects their choices and honors individuality while providing unmatched peace of mind and support for families.
Because Memory Care is our sole focus, we have the unique ability to design and personally tailor plans around our residents. We see each resident as an individual, understanding that everyone has their own story, specific needs and retained abilities. With that information, we develop personally inspired care plans that value and support each person’s independence.
Our team of attentive, caring YourLife™ Personal Care Specialists is on site 24 hours a day, seven days a week to assist with everyday activities, gentle reminders, and redirection.
Through our signature programming, YourStory, we create an individual experience centered around each resident. From cultural, educational and health and wellness programming, scheduled outings and other special events to personal care, assistance, and multiple therapies, we create days with meaning. At YourLife™ of Stuart, our residents and families know that this is a community designed for you, with a lifestyle defined by you. Contact us to learn more! Call 772-212-2448.