May 8th, 2019 | BY: Allegra Chaney

Advice for Caregivers of Dementia Patients

Dear Allegra:

I am an in-home caregiver working with a client who has dementia. She experiences sundowner’s syndrome in the evening and becomes combative and verbally abusive.

It’s difficult to know how to manage these behaviors and it’s beginning to cause me to feel burnout. Do you have any suggestions for preventing and coping with sundowning?

Thanks much,
Mike

Caregiving for Someone with Dementia

Dear Mike:

Dementia caregivers face unique challenges. It isn’t uncommon for caregivers of dementia patients to experience the feelings you described in your letter. Sundowning can be especially tough to prevent and manage, but I have a few suggestions I hope you will find helpful.

While researchers aren’t sure what causes sundowner’s syndrome, they do have a few ideas:

  • Disruption in the body’s internal clock
  • Insomnia and other sleep disturbances
  • Inability to process a hectic environment
  • Severe tiredness
  • Excessive late day activity or stimulation

Researchers say a few steps caregivers for seniors with dementia can take to prevent or minimize sundowning include:

  1. Sticking with a consistent schedule: Routine provides those with dementia a feeling of security. They know what to expect each day and don’t have to rely on memory, which is often compromised by their disease. Having set times for waking up, eating meals, showering, exercising, running errands, and going to bed can make the days go more smoothly.
  2. Spending time outdoors: Sunlight exposure can help boost mood and reset the body’s natural rhythms. For adults with dementia, everything from sleep to stress can improve.
  3. Serving healthy meals: Diet may play a role in managing sundowner’s syndrome. A healthy diet can lead to better sleep, which lowers the risk for end-of-day agitation. Limiting your client’s sugar and caffeine intake might also minimize sundowning episodes.
  4. Scheduling activities in the morning: Caregivers dealing with dementia patients can arrange their client’s daily schedule so appointments and errands occur early. That can prevent tiredness in the late afternoon when the risk for sundowning peaks. Whenever possible, ask visitors to come during the first part of the day instead of the evening.
  5. Discouraging daytime naps: If your client has trouble sleeping at night, they might fall asleep during the daytime. This not only exacerbates their sleep problems, but also puts them at higher risk for late-day agitation and sundowning.
  6. Creating a positive environment: As the afternoon passes and the sun begins to set, close the curtains and turn on all the lights. Turn off the television and play soft music instead. That may help you get through the evening without a sundowning episode.

If these dementia strategies for caregivers don’t help, you might have to ask for input from your client’s physician. Their symptoms might be linked to an undiagnosed health problem or be a side effect of a medication.

I hope this helps, Mike!

Kind regards,
Allegra