Shadows in the Night

Imagine living your night time dreams and nightmares when awake, This is the experience of people with Alzheimer’s disease and suffering from a condition called sundowners or sundowning. Fantastical images, past memories, and present activities jumble together for a disturbing reality.

As the sun rises later in the day, and sets earlier in the evening, we have less daylight. The darkness increases the chances of this disturbing state of mind. Sundowning syndrome is a mood and behavior change that occurs as nightfall approaches and when the barometer falls. It can result in confusion, anxiety, aggression, paranoia, pacing, and/or wandering. Approximately 20% of people with Alzheimer’s develop this condition occasionally to regularly. But it can also happen to older people who don’t have dementia.

Some of the triggers include overstimulation, fatigue, hunger, pain, boredom, the onset of darkness, hormonal imbalances, an upset in the internal body clock, and urinary tract or other infections.

Remaining calm when dealing with a loved one in the midst of a sundowning episode can deter the situation from escalating. Speak gently and reassure your loved one that they are safe. Turn on lights. If they need to pace, allow them to do so. Also, lock and alarm doors, block stairways with gates, and remove dangerous tools.

Practices to minimize future episodes include maintaining a structured day that includes exercise and short rest periods; a calm home environment; the avoidance of sugar, alcohol, and caffeine; and discouragement of lengthy daytime naps. As night approaches, gentle music and the avoidance of noisy television programs can be helpful.

*If you’ve read Navigating Alzheimer’s, or any of my books, I’d greatly appreciate a short a review. You may also be interested in The Alzheimer’s Spouse, and Inspired Caregiving. I wrote these books based on thorough research an my own experiences with fellow caregivers in mind.

*I find bison to be fascinating. Here’s what I learned about this animal-“Bison or Buffalo?”


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