Creating A Safe And Comfortable Sleeping Environment
An individuals sleeping area should be as comfortable as possible.
This should include ensuring the bedroom has comfortable temperatures.
To INCREASE safety, caregivers can offer nightlights and make sure that window and door locks are secure.
Motion detectors and door sensors can alert loved ones when a person with dementia is wandering.
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If youre experiencing memory loss, you should go to a doctor. Your doctor will perform a physical exam and ask about your symptoms. He or she will also ask you about your medication and any stress youre experiencing. After the exam, he or she will likely ask you to make an appointment with a neuropsychologist. If youre unable to recall the details of your doctor, you may want to consult another healthcare provider.
Can Medication Cause Sundowning
Side effects of both prescription and over-the-counter medications may cause behavior changes in people with dementia. For example, medications used to treat incontinence, depression, or insomnia may increase agitation in someone who has dementia.
If your loved one is showing signs of sundowning, its a good idea to discuss their medications and potential side effects with a doctor.
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Understanding Dementia: What To Expect With Sundowning
President & CEO of HealthCare Chaplaincy Network, Chairman of Alzheimers Global Initiative
When a loved one is diagnosed with Alzheimer’s disease or dementia, there are a number of side effects that can accompany this devastating disease. One of the most important side effects to understand is something known as sundowning. This is something that impacts many but not all individuals with Alzheimer’s disease, and the best way to deal with sundowning as a friend or family member of someone with dementia is to be prepared and to have a full understanding of what this condition entails.
The name sundowning was developed to explain the increased agitation, confusion and sometimes even hyperactivity that take place with individuals with dementia during the later afternoon and the evening. As a loved one of someone with Alzheimer’s disease, you may notice very drastic personality changes when sundowning occurs or you may notice a much more subtle change in tendencies. Many times, sundowning will start to take place during the late afternoon and the evening however, each individual is different when it comes to when they will experience sundowning, how long it will last and how severe sundowning will be. Typically sundowning begins to set in during the middle stages of dementia and typically worsens as the disease progresses.
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At What Stage Of Dementia Does Sundowning Occur
We get many questions asking at what stage of dementia does sundowning occur? Unfortunately, it is a syndrome unavoidable for many.
Sundowning MOSTLY AFFECTS people with middle-stage or advanced dementia.
Individuals living with dementia may start to exhibitchanges in behavior in the evening hours as the sun starts to set.
This type of behavior change is referred to as sundowning.
Generally, sundowning can be described as a GROUP of SYMPTOMS that may include confusion, agitation, irritability, and restlessness.
Affected persons will typically start to experience these symptoms around dinner time.
It can continue into the night.
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When Should Sundowning Be Treated By A Healthcare Provider
Sundowning symptoms should be addressed by a healthcare provider as soon as possible to create a treatment plan. Contact your primary healthcare provider, or talk with a geriatrician .
Keep in mind that your loved one with sundown syndrome may not understand or be able to communicate that theyre extra agitated because, for example, theyre in pain from a urinary tract infection or other condition. They may need an advocate to prompt a healthcare provider for appropriate tests.
Sundowning And Dementia: What To Do About Late
A caregiver comforting an older adult
For many people, the evening is a restful time of day. After a hectic work day and the scramble to get dinner on the table, the hours before bedtime are often precious moments to relax, unwind and enjoy personal interests like reading a book or chatting with loved ones.
For those with dementia and their caregivers, however, the late day hours can often be a disorienting, stressful time. When the sun goes down, individuals with dementia may become agitated, restless, confused, irritable and at times even deliriousseeing and hearing things that are not thereto a greater extent than they do early in the day. This symptom of dementia is known as sundowning or Sundowners Syndrome. For individuals with dementia and their caregivers, it can be a scary, upsetting nightly occurrence.
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What Are Specific Care Needs At Each Stage
An individual may not require care assistance after the initial diagnosis of dementia, but that will change as the disease progresses and symptoms become worse. There are about 16 million unpaid caregivers of people with dementia in the United States. While many caregivers are providing daily help for family members, they also hire someone to help. There are many options of care assistance, such as in-home care, adult day care, and nursing home care. There is also financial assistance available.
Early Stage DementiaAs mentioned above, in the early stage of dementia a person can function rather independently and requires little care assistance. Simple reminders of appointments and names of people may be needed. Caregivers can also assist with coping strategies to help loved ones remain as independent as possible, such as writing out a daily to-do list and a schedule for taking medications. Safety should always be considered, and if any tasks cannot be performed safely alone, supervision and assistance should be provided. During this period of dementia, its a good idea for caregivers and loved ones to discuss the future. For example, a long-term care plan should be made and financial and legal matters put in place.
What You Can Do For Your Loved One
As an individual with dementia declines, you can help them by providing a loving and supportive presence. Sit with them. Hold their hand. Play music they enjoy.
One of the greatest gifts you can give your loved one is helping to get their affairs in order. Ensure that financial and healthcare powers of attorney are put in place, so you can make decisions when your loved one is no longer able. Look into funeral arrangements before you need them, so you dont need to make important decisions in a time of crisis.
Talk to your loved ones physician about the possibility of palliative care support in the home and hospice care when your loved one is ready.
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Medication And Medical Conditions
Medication may also be a risk factor for sundowning. Medications are dispensed in different dosages and may have differing concentrations throughout the day. So, people who are getting morning medicines may experience a drop in concentration by 4 pm.
A patients medical conditions may also impact sundowning. Imagine someone with congestive heart failure, arthritis and type 2 diabetes that causes their blood sugar levels to swing. Imagine theyve had a hip replacement and a knee replacement. Even if they wake up feeling refreshed and full of energy, they may begin to experience pain as the day wears on. This could contribute to an episode of sundowning.
What Are The Signs Of End
It is important for caregivers to know when an individual with dementia is close to the end of their life, because it helps ensure they receive the right amount of care at the right time. It can be difficult to know exactly when this time is due to the variable nature of dementias progression, but understanding common end-of-life symptoms of seniors with dementia can help. Below is a timeline of signs of dying in elderly people with dementia:
Final Six Months
- A diagnosis of another condition such as cancer, congestive heart failure or COPD
- An increase in hospital visits or admissions
Final Two-to-Three Months
- Speech limited to six words or less per day
- Difficulty in swallowing or choking on liquids or food
- Unable to walk or sit upright without assistance
- Incontinence
- Hands, feet, arms and legs may be increasingly cold to the touch
- Inability to swallow
- Terminal agitation or restlessness
- An increasing amount of time asleep or drifting into unconsciousness
- Changes in breathing, including shallow breaths or periods without breathing for several seconds or up to a minute
Patients with dementia are eligible to receive hospice care if they have a diagnosis of six months or less to live if the disease progresses in a typical fashion. Once a patient begins experiencing any of the above symptoms, it is time to speak with a hospice professional about how they can help provide added care and support.
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Variables Impacting Life Expectancy Calculations
Gender. Men dont live as long with Alzheimers as women. A study of more than 500 people diagnosed with Alzheimers disease between 1987 and 1996 found that women with Alzheimers live, on average, 20% longer than men. Age. Someone diagnosed at 65 lives an average of about eight years, while someone over 90 who gets a diagnosis typically lives about three-and-a-half more years. Strength of Symptoms at Diagnosis. If someone is showing especially severe dementia-related problems at the time of diagnosis, this usually leads to an earlier death. Someone who wanders, is prone to falling, and experiences urinary incontinence , will typically not live as long. A lower mini-mental state examination score at the time of diagnosis will also not live as long. Other Health Problems. A person with a history of heart problems or asthma or diabetes, for example, will not live as long as someone without those underlying issues.
What Can Help Someone With Dementia Sleep Better
Sleep hygiene is the primary treatment for sleep concerns in people with dementia. Sleep hygiene is a collection of practices and environmental considerations that promote good sleep quality. The following sleep hygiene tips may help a person with dementia improve their sleep patterns:
Some of these sleep hygiene practices may be difficult for someone with dementia. For example, it may not be possible to control the bedroom noise level in a nursing home or assisted living facility. Consider adding a white noise machine to mask outside noise. A person with dementia may also have a difficult time maintaining a regular bedtime due to napping or varied daily activities, but keeping wake time consistent can still help to stabilize the circadian rhythm. A physician or sleep specialist is in a good position to provide individualized sleep hygiene recommendations for a specific situation.
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How Hospice Can Help With End
In addition to helping you in recognizing the signs of dying in the elderly with dementia, bringing in hospice care will help with the physical and emotional demands of caregiving. Nurses will be able to adjust medication and care plans as the individuals needs change. Aides can help with bathing, grooming, and other personal care. Social workers can help organize resources for the patient and family. Chaplains and bereavement specials can help the family with any emotional or spiritual needs. Additionally, family members can contact hospice at any time, and do not need to wait until it is recommended by the patient’s physician.
To learn more about the criteria for hospice eligibility or to schedule a consultation, please contact Crossroads using the blue Help Center bar on this page for more information on how we can help provide support to individuals with dementia and their families.
Are There Resources To Help Families With Sundowning
Having a family member with sundowning can be very frustrating for everyone involved. Families arent alone. There are some great resources through Norton Healthcare, including the Norton Neuroscience Institute Resource Center, the Alzheimers Association and others. The patients primary care physician is a great resource to make a referral for more assistance with those kinds of things.
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A healthy diet can be a great memory loss remedy. Eat plenty of fruits and vegetables, as well as low-fat proteins such as nuts and seeds. Drinking plenty of water is also beneficial. The environment and personal experiences can affect the way your brain stores information, and this can lead to memory loss. There are many other causes of temporary memory loss, and it is important to get help as soon as possible. You should consult a medical professional to determine what the best treatment will be for your particular situation. How Long Does Sundowning Last in Dementia?
A healthy diet is another effective memory loss remedy. A healthy diet should include plenty of vegetables and fruits. A healthy diet is a key component in memory improvement. This is the best way to prevent memory loss. The best way to do this is to incorporate more fresh fruits and vegetables into your daily routine. If you cant eat fruits and vegetables, you should avoid them altogether. They are packed with antioxidants that can help your brain.
Tips For Caring For Someone With Sundowning
Sundowning syndrome is not a simple condition, but it is a common occurrence that many loved ones and caregivers struggle with. While you may not be able to stop sundowners syndrome completely, Nisson provided seven ways you can help prevent, reduce symptoms and best cope.
1. Look for triggers
Certain activities and environments can trigger your loved ones sundowning, things like fatigue, loud noises, discomfort, taxing activities or changes in environment or caregivers. Use your smartphone or journal to track what triggers or worsens symptoms so you can avoid situations that promote agitation and confusion.
2. Create structure in the day
Daily routines can help your loved one feel safe by minimizing surprises and reducing anxiety and confusion. Offer structured meaningful activities earlier in the day, including physical exercise and movement.
3. Get outdoors
Take a walk and get some sunlight and fresh air. Sunlight can help set their internal clock as well as help reduce pent up energy.
4. Support good rest
Fatigue and lack of sleep can worsen symptoms. Alternate activity with brief periods of rest and ensure your loved one gets a good nights sleep.
5. Limit stimulation in late afternoon and evening
Lower lights, limit caffeine intake, close curtains or blinds, minimize noise and reduce clutter. Use soothing scents like lavender and soothing touch when appropriate.
6. Be gentle
7. Seek support
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Sunrising And Dementia Behaviors At Other Times Of Day
Im not a doctor, but I have a theory about sunrise syndrome, because my mother does it. I think, because her brain has been able to run wild while shes sleeping, that when she awakens, opens her eyes and takes in her surroundings, she must determine what is real, what is new and what is a dream from the night before. She takes a little while to get her land legs, as I call it, and then she does better by about 10 a.m. Her mood is definitely different when she is sunrising compared to when she is sundowning. She experiences confusion over re-figuring out her world but without the irritation or perseverance she experiences in the evenings. EdithFrances
Sundown syndrome is a collection of behaviors that tend to happen later in the day, but they dont have to be isolated to that time. It can happen at any time of day. Definitely bring up sundowning behaviors to the doctor whenever they occur. There may be medication that can help reduce the severity of symptoms without making your loved one sleepy all the time. Make sure you are keeping a journal each day of what you see, hear and sense with your loved one, especially if something strikes you as new, different or super strange. The doctor is going to want to know how long something has been going on, what precedes the behavior, when it normally occurs, etc., and its too hard to remember the details correctly when you are up to your eyeballs in caregiving. sandwich42plus
Tips For Coping With Sundowning
Late afternoon and early evening can be difficult for some people with Alzheimers disease. They may experience sundowningrestlessness, agitation, irritability, or confusion that can begin or worsen as daylight begins to fadeoften just when tired caregivers need a break.
Sundowning can continue into the night, making it hard for people with Alzheimers to fall asleep and stay in bed. As a result, they and their caregivers may have trouble getting enough sleep and functioning well during the day.
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Understand What Sundowning Involves
Dementia creates many different symptoms that can make life challenging. During any part of the day, your loved one may have difficulty with memory loss or confusion. However, sundowning tends to involve an increased amount of negative symptoms and behaviors that can quickly escalate. For instance, seniors may suddenly become aggressive if they think they must get to a job they retired from years ago but cant leave the house. Your loved one may also become increasingly antagonistic and refuse to do things you ask him or her to do, such as bathe.
If your senior loved one has been diagnosed with a serious condition and needs help with tasks like meal prep, transportation, bathing, and grooming, reach out to Home Care Assistance, a leading provider of home care Tucson, AZ, families can trust. We also offer comprehensive care for seniors with dementia, Alzheimers, and Parkinsons.
Watch Your Loved Ones Patterns
You can sometimes stay one step ahead of sundowning by getting to know your loved ones normal time for the behaviors to start. Start a journal and note when you see your loved one beginning to get agitated. You can also try to notice whats happening at that time and if its the same every day. For example, your loved one may begin to respond negatively to shadows being cast in the room as the sun goes down. You may also find that your loved one gets upset about an hour before eating, and feeding him or her a little sooner may minimize the behaviors.
Some family caregivers may have a difficult time managing their loved ones dementia-related behaviors. Caring for a senior loved one can be challenging for families who dont have expertise or professional training in home care, but this challenge doesnt have to be faced alone. Family caregivers can turn to Home Care Assistance for the help they need. We provide high-quality live-in and respite care as well as comprehensive Alzheimers, dementia, stroke, and Parkinsons care.
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