1 week Ago By Carol Bradley Bursack
Dear Carol: My dad is in mid-stage Alzheimer’s and dealing with his late-day anxiety is driving me to the edge. For most of the day, as long as I remember what I’ve learned about caring for someone with dementia, he’s reasonably easy to satisfy. Yet once we get to late afternoon, he begins to pace and mutter, sometimes wringing his hands.
I’ve talked to his doctor about this behavior, and she says it sounds like what they call sundowning. Apparently, for Dad at least, there’s no good option for medication that won’t cause other problems. Can you point to reliable resources where I can learn more? – AU Dear AU: I’m sorry you and your dad are going through this extremely tough stage.
You were right to contact his doctor. Easy answers are hard to come by in dementia care, but a physician visit, while not providing a magic answer, is still a necessary step in the process. The doctor can attempt to rule out problems with current medications, look for new health concerns, and occasionally prescribe something that might help the person with dementia experience a better quality of life.
Sundowning behavior got this name because, as you said, this usually happens late in the afternoon. By this time, the person with dementia is likely tired and their system overloaded from the stimulation of everyday life. Some think it might relate to past activities like coming home from work while others point to the changing light as a trigger.
As with so many disturbances for people with dementia, the exact reason could vary with the person and the situation. Yet, the underlying cause is stress. Stay as close as possible to a routine during the day.
Schedule walks and other activities earlier so your dad can get some exercise. Then, aim to slow down activity as the day moves on. Since your days are going well, you likely know about the basics of dementia care such as reassuring him, never arguing, staying calm and always looking for the reason behind the behavior.
So, think about what’s different in the late afternoon and evening environment. Are family members coming home from work? Do friends drop by? Is there a big temperature shift? Even subtle changes can make a difference. You can’t eliminate all the changes, but if you have some idea of what might make the evening more stressful, you could attempt to find a quieter area for your dad during that time or adjust some of the activities.
Offer comfort foods for snacks and supper. Maintain a collection of old movies or music videos from an era he would enjoy and start playing one. That might distract him, gradually drawing him into soothing familiarity.
I’ll add some resources for you to investigate. Warm thoughts to you and your dad as you weather this difficult storm. Resources: https://www.
alz.org/help-support/caregiving/stages-behaviors/sleep-issues-sundowning 7 Steps to Managing Difficult Dementia Behaviors (Safely & Without Medications) ( https://betterhealthwhileaging.net/how-to-manage-difficult-alzheimers-behaviors-without-drugs ) 5 Types of Medication Used to Treat Sundowning & Difficult Dementia Behaviors (https://betterhealthwhileaging.
net/medications-to-treat-difficult-alzheimers-behaviors/#more-3485).
