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Sundowning – How to Reduce Late-Day Confusion

If a loved one has Alzheimer’s disease or another form of dementia, you may have noticed that their agitation and disorientation seems to worsen as the day goes on. This late-day confusion is referred to as sundowning and is more common in mid-stage or advanced dementia.

The symptoms of sundowning can be managed with a few steps. Here are some things that you can do:

    • Create and stick to a schedule. Stress, anger, and confusion are common reactions to unfamiliar places and activities. They are also reactions that play a role in sundowning. Avoid altering routines and try to adhere to the same schedule every day. If changes need to be made, make them gradually. If you’re considering senior care, having the same caregiver provide their care each day is important in maintaining consistency.
    • Keep them active. Staying active throughout the day can help your loved one avoid daytime dozing. Inactivity and dozing on and off during the day can make it hard to sleep at night. Go for a walk together or hire a professional senior care provider to accompany your loved one on walks or other daily outings if your schedule doesn’t allow you to do it. Not only does staying active improve sleep and help with downing—it’s great for their health all around. Exercise is also a proven way to lower stress and anxiety.
    • Adjust the lighting at home. The Alzheimer’s Association recommends turning up the lights and brightening the room when a person with dementia is agitated or confused. Placing a full-spectrum fluorescent light one meter or so away from your loved one for a couple of hours each morning may also help, based on research on light therapy.
    • Minimize stress. Reducing stress late in the day and in the evening can help with the symptoms of sundowning. Encourage simple activities that are less likely to cause frustration, such as listening to soft music or spending time cuddling a pet.
    • Create comfortable and familiar surroundings. For a loved one with dementia, creating a familiar and comforting environment is important. Fill their space with cherished belongings from their past, especially if they’re in a hospital or assisted living facility. Enlisting in-home care services can allow your loved one to remain in the comfort and familiar surroundings of home while getting the care they need. Familiarity and comfort can help reduce sundowning symptoms.
    • Track your loved one’s behaviour. Tracking your loved one’s triggers can help you better manage sundowning. Use a journal or smartphone app to track his or her daily activities, environments, and behaviours to help identify and avoid triggers.

Along with these tips, ensuring that your loved one eats well and gets a good night’s sleep is important. And don’t forget about yourself! Caring for a loved one and dealing with the symptoms of sundowning can take a toll on you, too. Take care of yourself and ask for help, either from family and friends, or by hiring professional home health care services to provide respite care so that you can get a break.

David Porter, CPCA

Living Assistance Services – Senior Home Care

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