Sundowners, A Tropical Drink? Unfortunately Not.
Sundowners Syndrome or sundowning is not a tropical drink. As the name implies, it happens in the evenings, most often to people with dementia. As daylight fades, those with Alzheimer’s and other forms of dementia have periods of agitation, increased confusion, restlessness and may become combative. It usually begins in the evening, and can continue through the night. It is common in hospitals, nursing homes, other care facilities and of course, at home.
Why does it happen? I’m not sure and from what I’ve read, I’m not sure the medical establishment is either. Some say it’s related to circadian rhythms but whatever the cause, it is a common reason the elderly are institutionalized. It’s hard on caregivers. There are recommendations to help manage it but I wonder if the people with the suggestions had experience as caregivers? I’m guessing, no. I’ve listed the tips. I hope they work for you. We haven’t had success at our house as you’ll see.
- Keep the elder on a consistent schedule for meals and bedtimes. I think this is hard in northern latitudes when the length of days differs so drastically. We do keep a schedule but it flexes in the summer.
- Expose the elderly to sunlight during the day. Nice if there is daylight, tough in the Pacific NW in winter. We open their blinds every morning but I haven’t noticed it makes a difference.
- Avoid daytime napping. Ha! If someone can tell me how to keep two elders awake all day, I’m listening. They fall asleep eating, sitting (even sitting on the toilet), watching TV, reading and listening to the radio. If they go on an outing, they are so tired when they get home they sleep for two or more hours.
- Limit caffeine and sugar to morning hours. Caffeine, no problem, we only have decaf, though I know there is some caffeine in decaf. Sugar? The highlight of the elder’s day is dessert after dinner. Please see What To Eat When Nothing Tastes Good
- Keep a nightlight on. OK, no problem, but it didn’t change things.
- Avoid TV viewing in the evening hours especially before bedtime. Another, Ha! This generation has spent the last fifty years watching the evening news before bedtime. I know it affects my mom. I asked Dad not to watch it at bedtime. He starts out listening to it on his headphones but sometime during the evening they come off. I know Mom has nighttime confusion related to news shows, mixed with dreams. She obsesses over violence and natural disasters on TV. During baseball season we get a reprieve of sorts. She listens to baseball until bedtime (or later if the game goes into extra innings). When baseball’s over it’s back to news.
- Play relaxing music or nature sounds at bedtime. It works during dinner because we control the devices playing the music. At bedtime, let’s just say you can lead a horse to music but you can’t make him listen.
- Talk to the elder’s doctor about an underlying condition, such as a UTI. We talked to Mom’s doctor. There was no infection. Mom had become combative and aggressive at nighttime. Her doctor prescribed medication. Medicated, she is simply, pleasantly confused.
I wish the above ideas worked for us but they didn’t. We deal with our situation the best way we can. I know many people object to medications for the elderly and they don’t always work. I understand, but for us it’s what keeps the behavior manageable and lets us keep Mom at home.
Now maybe it’s time for one of those tropical drinks? I should Google it. Maybe there really is a drink called a Sundowner–probably invented by a caregiver.
*For those who don’t know me, I’m not advocating drinking for caregivers. You need all your faculties for caregiving.. I wouldn’t say no to some passion fruit/orange/guava juice, though!