The term ‘sundowning’ is sometimes used to describe the behaviour of people living with dementia who become more confused in the late afternoon and into the night. Sundowning may include confusion, anxiety, agitation, pacing, hallucinations and disorientation. Attention span and the ability to concentrate may be reduced. Sometimes, people who are sundowning can become more impulsive and place themselves at risk. They may also have sleep difficulties. Many families and carers say anxiety about ‘going home’ or ‘finding mother’ late in the day is common. This may indicate a need for security and protection, where they are trying to find an environment familiar to them, particularly one from an earlier time in their life. The behaviours are complex and their causes are often highly individual and interrelated.
The exact cause of restless behaviour in the late afternoon is unknown. People living with dementia are required to exert far more mental effort during the course of a routine day than most of us and so it is not surprising that they may feel cognitively exhausted, run down and perhaps somewhat irritable after a long day.
At Moran Aged Care, we utilise a number of tools to help residents who are living with dementia to feel more comfortable in the late afternoon and into the night:
- Ensure that rooms are well-lit in the late afternoons and evenings when the sun is going down to help them integrate and interpret sensory input
- Encourage a short nap after lunch which may help alleviate cognitive fatigue towards the end of the day. It gives the brain, and along with it a person’s resilience, an opportunity to
“recharge” - Plan activities in the morning and encourage rest and relaxing activities in the afternoon
- Ensure hunger or thirst needs are met, avoiding stimulants such as caffeine or sugar being given too late in the day
- Reintroduce familiar early evening activities previously engaged in eg. closing the curtains, helping prepare a snack or setting the table
- Walk outdoors in the garden
- Offer activities and things that provide a sense of calm and comfort eg. a favourite pastime, familiar music, soft toy animals
- GP assessment of medications may find that symptoms can be relieved by changing the dose or time a medication is given. They can also discuss the possible side effects of
medication and medications that may help with restless behaviour in the late afternoon
Please speak to the Care Manager if you would like more information for your loved one at one of our Moran Homes or visit Dementia Australia