My 88-year-old husband has started it and at bedtime. He needs to get his paper and money together, pack and get to the airport. Has no idea where he's going or why. After daylight this morning, I think he is,at least, temporarily satisfied that this is his HOME.
In part, it says:
Sundowning: Avoiding Late-Day Confusion
Stick to a schedule.
Arrange a time to go outside or sit by a window to get sunlight each day.
Aim to be physically active each day, but don't plan too many activities.
Avoid alcoholic drinks and beverages with caffeine, such as coffee or cola, late in the day.
What makes sundowning worse?
Tiredness, hunger, pain or other unmet physical needs. not enough exposure to sunlight during the day. overstimulation during the day, such as from a noisy or busy environment. disturbance to the person's 'body clock' caused by damage to the brain.
1. Observe and minimize triggers-Watch for fatigue and other things that seem to bring on this behavior. Afternoon transitions and activities can be anxiety producing, i.e., tv loud/intense, caregiver shift change.
- Nutritional triggers. Cut back on caffeine and sugar; limit liquids later in the day (avoid excessive toilet nds).
2. Maintain routines and structured activities-Maximize activity earlier in the day and minimize napping (especially if your loved one isn’t sleeping well at night). Try to avoid challenging, stressful tasks around dusk and at night. Keep to a regular daily routine — there’s security in the familiar.
3. Simplify surroundings-Environmental chaos can be difficult for a person with dementia to process. Too much sensory stimulation can cause anxiety and confusion, worsened by changing light. Remember: Their brain is being damaged by dementia and it can be very challenging for the brain to view and process visual information. It may feel completely overwhelming to see a lot of “stuff” in a room, and this can cause sundowning behaviors as the person struggles to understand and organize that visual stimulation.
4. Modify the sleep environment-Try to minimize physical, visual and auditory clutter in your loved one’s bedroom.
At night, keep the room calm and comfortable for sleeping (experts often suggest a temperature between 60 and 67 degrees), and dark (try light-blocking curtains or an eye mask, plus dim night-lights for safe navigation). Evaluate your loved one for sleep disturbances such as sleep apnea.
5. Validate and distract-Simply trying to reason with someone in the midst of sundowning probably won’t work. Instead, try to validate your loved one’s feelings (even if they don’t make sense to you) to let them know you are listening. Try to draw them away from troubling thoughts and anxieties by diverting or redirecting attention to favorite activities, foods, animals and people.
For example, maybe they are soothed by watching a favorite TV show, taking a walk, snuggling with a pet or reminiscing. My dad loved The Lawrence Welk Show; we would give him TV earphones to amplify the volume and limit other sounds. It was almost always an effective distraction.
This is a very long article. For the full article, please google: https://www.aarp.org/caregiving/health/info-2017/ways-to-manage-sundown-syndrome.html
Gena / Touch Matters
There are so many options. Work with his doctor to find what type of medication works for him.
For me, with my husband, who gets more agitated from most medications, it was Trazodone that worked like a miracle. He was finally relaxed and sleeping at night, and even stopped the frequent leg tremors.
Continue to be his wife and support his lucid moments, and try and "go along" with his unusual behaviors, anything you can do to help him feel "safe"!
Routine is key! Keep his days simple, and repeat the same activities every day, at the same time. This will help him to feel comfortable. He will start to recognize and associate each "prompt" with what behavior is expected from him.
Especially keeping routines.
My mom had showers on certain days. Home health came in and gave just as many but they were on different days than she previously had. You would've thought the entire earth stopped and started spinning in the other direction. She looped over and over and over about the showering and I am ashamed about raising my voice to her with "What does it matter!?" It apparently very much matters inside this increasingly smaller world they live in.
So yes, routine is so important. Even when you think it shouldn't matter, it really does to them.
Increased lighting in the afternoon
At least 7 hours of sleep every night (9 hours ideally) - get sleep medications if needed
Create consistent routines and consistent environment - no changing the furniture around for holidays
If person is anxious or agitated - and your hubby seems to be - then ask doctor for medications. Make sure to give medications at first signs of anxiety so they kick in before the person can get very upset.
So, I was wondering if this was happening to your husband? Did he use to travel via plane for work? If yes, if you remember those days back then, ask him questions about his work, etc. Yes, the next day my Dad was back in the current world.
It's also possible that he may need to start being medicated. A milligram of lorazepam or diazepam when it starts can work wonders to keep him calm and not wandering all over the house packing his bags and getting his documents together.
Take him to his doctor and tell him what's going on.
That being said, the first time someone sundowns, it will seem "sudden" and can occur regularly for a phase, which differs by person. My Aunt did it almost daily for a few years.
Also: I put the daylight bulbs in the hallway and bathroom for my Aunt and left those lights on until she went to bed.
One strategy is to make sure you use daylight spectrum lights in the rooms where he'll be in the afternoons and evenings, and turn them one earlier than you normally would, to flood the room with light.
You can try to distract him with tasks, like sorting nuts and bolts and pairing them, pairing colorful socks (lots of them that you buy for this purpose), giving him a simple Lego or Duplo project to assemble, etc.
My very elderly Aunt used to sundown and every afternoon would get agitated and want to go home, even though she was in the home she'd been in since 1975. Before that she lived with me and my Mom in NJ for 20+ years, but that's not the address she recited: it was her childhood home in the Bronx. We even put up large signs opposite her chair with her current address telling her was home. It was no use, because that's not the home in her mind.
You may consider hiring a companion aid for a few hours every afternoon to take him out for errands or entertain him to give you a break.
Dementia is hard on everyone. Make sure you take care of yourself first and foremost. May you receive peace in your heart.
I will devise a task to keep my husband busy and involved. He is young and strong, but has limited movement and severe brain damage. He doesn't want to do anything but sit and watch TV all day and night. But he gets extremely agitated at times. I think he's just restless and bored. But is reluctant to do anything. I'll give him a job sorting nuts and bolts for me.
But remember that as your husband's dementia worsens this too shall pass.
And don't forget that if your husband's care gets to be just too much for you, that it is ok to place him in the appropriate facility.