Fall Back - Time Change
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Fall Back - Time Change

I am sure you have noticed that our daylight hours are getting shorter and shorter. Tonight I observed that it was turning dusk at about 7:30PM. I also noticed that I began to yawn, and I believe that my energy level decreased too. It couldn't be time to go to bed already, could it?

Later I spoke with my friend who is a dementia expert and she said, imagine what it must be like for some with dementia. She went on to say that often, as the seasons change and daylight hours grow shorter caregivers may notice an increase in  sundowning in the person for whom they provide care.


WEB MD states,"If you’re caring for someone with dementia or Alzheimer's disease, you may have noticed big changes in how they act in the late afternoon or early evening. Doctors call it sundowning, or sundown syndrome.It seems to be triggered by fading light, and the symptoms can get worse as the night goes on.

Sundowning can make caring for someone extra-challenging. They may be:
  • Agitated
  • Restless
  • Irritable
  • Confused
  • Disoriented
  • Demanding
  • Suspicious

 They also may
  • Yell
  • Pace
  • Hear or see things
  • Have mood swings
Up to 1 out of 5 people with Alzheimer’s get sundown syndrome. But it can also happen to older people without dementia.It usually starts during the middle stages of Alzheimer’s disease. Sundowning symptoms fade as the disease gets worse. What Causes It?We don’t know for sure why sundowning happens.Some scientists think that changes in the brain of someone with dementia might mess up their internal body clock. The area of the brain that signals when you’re awake or asleep breaks down in people with Alzheimer’s. That might cause sundowning.Other things might trigger it, such as being:
  • Too tired
  • Hungry or thirsty
  • Depressed
  • In pain
  • Bored
Sleep troubles can also play a role. About one-third of people over age 65 have problems nodding off and staying asleep.What’s happening around someone can also set off sundowning symptoms. Some triggers are:
  • Less light and more shadows in the house. This can cause confusion and fear.
  • Trouble separating dreams from reality. This can be disorienting.
  • When you're tired or frustrated at the end of a day caring for someone, he or she can pick up on it, even without you saying anything. This can make them agitated too.


What can a caregiver do to help a loved one who is sundowning?

  • Note what things seem to trigger it.
  • Keep a daily routine with regular times for waking up, meals, and going to sleep.
  • Schedule appointments, outings, visits, and have bath time in the earlier part of the day. That's likely when they’ll likely feel their best.
  • Avoid giving your loved one stimulants like nicotine and alcohol. Make sure if they have sweets and caffeine that they just do it in the morning.
  • Either avoid naps or keep them brief and early in the day.
  • Make a big lunch, but keep their evening meal smaller and simple.
  • Don’t let them exercise later than 4 hours before bedtime.
  • In the evening, close curtains and blinds and turn on lights. Darkness and shadows can make agitation worse.
  • In the late afternoon and evening, cut out as much distraction as you can. Limit things like TV and loud music. Tell other family members (especially kids) or visitors not to make too much noise.
  • Get rid of clutter in your loved one's room.
  • Fix the room temperature so they're comfortable.
  • Try calming things: Put on relaxing music, read, play cards, or go for a walk to wind down.

How Should a Caregiver React?
  • Stay calm.
  • Ask your loved one if they need something.
  • Remind them what time it is.
  • Don’t argue with them.
  • Be reassuring. Tell them everything is OK.
  • If they need to get up and move around or pace, don’t try to hold them back. Just stay close by to keep an eye on them.
  • Keep them safe with night lights and locks on doors or windows. Use a gate to block the stairs, and put away anything dangerous, like kitchen tools.
Also, consider getting a baby monitor, motion detectors, or door sensors. They can let you know if your loved one is walking around.