Helping to Manage Sundowner’s Syndrome

Living with Alzheimer’s can be a challenge for the entire family. Whether your family has professional Alzheimer’s care assistance or if you are caring for your loved one alone, it can seem as if each day is full of new challenges and developments. 

One of the things that makes Alzehimer’s care so challenging is that those living with the disease can have different needs at different times of the day. Late afternoon and early evening can be especially hard for those who experience Sundowner’s Syndrome.

What is Sundowner’s Syndrome?

It is a change in behavior, temperament, or personality that occurs in the late afternoon or early evening.  This occurrence is also known as “sundown syndrome” or “sundowners” or “sundowning.”

The experts at WebMD cite that 1 out of 5 people in need of Alzheimer’s care suffer from Sundowner’s Syndrome. Doctors do not know what causes the sundowning behavior. However, the part of the brain that tells you if you are awake or asleep typically breaks down in Alzheimer’s patients. Some scientists think these neurological changes affect the inner body clock. 

Sundowning can manifest in several ways. Your loved one may become:

• Agitated
• Restless
• Irritable
• Confused
• Disoriented
• Demanding
• Suspicious

People with Sundowner’s Syndrome may even yell or pace around the room, sometimes hearing or seeing things that are not there. They may also exhibit mood swings. These behaviors can become progressively worse and can range in duration from a short time to the entire night.

Suggestions for Managing Sundowner’s Syndrome

As a family caregiver, you will need to demonstrate flexibility and empathy to help your loved one feel as peaceful as possible.

1. OBSERVE
   Take careful notice of events that trigger the behavior. Does the evening news instigate agitation? Is the late afternoon a time of significant activity in your home? Anything that disturbs the regular order of the day could prompt a behavioral change. Nutritional triggers can also stimulate behavior. Assess and possibly limit caffeine, sugar, and alcohol intake.
   
   
   
2. DISTRACT
   If this is their new reality, you must endeavor to understand it. Don’t express frustration with your loved one, but use activities, such as music or television shows, they enjoy as a calming tactic. It will divert their attention from troubling thoughts yet soothe them with the familiar things they love. Consider companion care from a professional home care agency to assist your loved one during the most challenging hours of sundowning behavior.
   
   
   
3. ADJUST
   In addition to natural light, the use of bright lights in the room during the day will ward off the evening shadows and maintain the daytime glow until it is time for bed.
   
   
   
4. SIMPLIFY
   Adjust their sleep environment to one that is welcoming and serene. Light-blocking curtains can create a cocoon-like setting that encourages a restful night’s sleep.
   
   
   
5. CONSULT
   Check with your loved one’s doctor* about natural supplements and discuss the possibility of recommending anti-anxiety and even anti-depressant meds. Use caution when purchasing anything over the counter unless the doctor has confirmed there is no interference with already prescribed medications.

Finally, try to have patience. It may take a little time to figure out what combination of solutions works for your loved one. When it comes to Alzheimer’s and dementia care, everyone is different. If you need professional at-home living assistance, we are here to help.

Together with your family, we will give your loved one all the respect and love they deserve with the finest in Alzheimer’s care. To request a free in-home consultation, and find out more about our caregiver services, call us today at 617-795-2727.

About Visiting Angels Newton/Canton:

Visiting Angels Newton/Canton MA is an award-winning local home care agency providing high caliber in-home care services to the elderly and people with disabilities. Countless families have benefited from our dementia and Alzheimer’s care, companion care, respite care, transitional aid, and elder home care services in Brookline, Watertown, Needham, Dedham, Canton, Stoughton, Natick, Wellesley, Newton, Chestnut Hill, Roslindale, Westwood, Norwood and nearby towns. While non-medical in nature, the care provided by Visiting Angels Newton/Canton can make a significant impact on your loved one's happiness and quality of life. If you find yourself or a loved one in need of in-home senior care services, don't hesitate to contact us!

* This article is for information purposes only and should not be considered an endorsement or recommendation for treatment of any kind. If you are concerned about your loved one's health, a diagnosis of dementia or Alzheimer’s, or about their progression after diagnosis, please contact their physician. Visiting Angels does not provide medical care and does not provide recommendations on the type of treatments available for dementia or Alzheimers, nor do we endorse any specific treatments.

Physical vs. Mental Aging

As we grow older, our minds and bodies tend to age at different rates. Some of us slow down physically years before we lose any of our mental quickness. Others stay active well into old age but start to lose their memory earlier. The distinction between physical and cognitive aging can be an issue for friends and family of older adults. Because of this, recognizing and assessing physical and cognitive abilities is crucial in professional home health care.

How we distinguish between physical and mental aging has a significant effect on the way we treat our older loved ones. If we confuse symptoms of physical decline as signs of cognitive aging (or vice versa), we can inflict much unintentional damage. On the one hand, we might underestimate our loved ones’ abilities, treating them as less-than-capable adults. On the other, we might miss symptoms of a serious problem, like early-stage Alzheimer’s.
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An understanding of this distinction is equally vital for senior home care providers. Caregivers who don’t fully understand the difference between physical and mental decline are liable to provide their clients with substandard care. Meanwhile, caregivers who recognize the difference between aging bodies and aging minds can personalize care according to their clients’ needs.

Knowledgeable caregivers can also serve as a resource for families, providing advice and guidance about age-related concerns and challenges. This way, families are less likely to confuse signs of physical and cognitive decline, making it easier to care for their loved one.

Different Types of Aging Requires Different Types of Senior Care

There’s a significant distinction between physical aging and mental aging. While interrelated, these two types of aging often take place at different speeds. If someone is going through a severe physical decline, it doesn’t mean that they’re also experiencing cognitive decline. Likewise, if someone is declining mentally, they might remain physically healthy.

To illustrate, let’s look at a couple of hypothetical examples.
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Example 1:
Judy is a 72-year-old woman. Two years ago, her husband passed away, and Judy has been living alone. Recently, joint and back problems have made it impossible for Judy to get around without a walker. What’s more, she’s no longer able to perform simple chores and errands.

Given Judy’s physical state, some may assume that she’s also experiencing cognitive decline. However, thankfully, Judy’s family hired an experienced senior home care agency to provide her with care.

Judy’s caregiver not only offers physical assistance but also recognizes that Judy has complete cognitive function. During visits, Judy’s caregiver provides her with stimulation by playing cards with her, helping her browse the internet, and engaging in thoughtful conversation.

Example 2:
Mark is a 62-year-old man. Recently, Mark has shown signs of early/mid-stage Alzheimer's disease. He has become progressively forgetful, and he’s starting to mix up words and is having a hard time remembering people’s names. Occasionally, he gets confused by time and place.

An avid outdoorsman, Mark has enjoyed long walks outdoors and activities like birdwatching for much of his life. Mark’s family worries that physical activity is increasingly unsafe for him.

Luckily, Mark’s senior home care provider is knowledgeable and skilled in providing Alzheimer’s home care. Mark’s caregiver sees that he’s still physically fit and gets joy from these activities. After discussions with Mark’s family, his caregiver starts accompanying him for outside activities, giving Mark a positive outlet that he would not have if he were utterly homebound.
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In both cases, a senior home care provider can spot the difference between physical and mental aging. Having done so, they adapt their care services to the recipient’s needs, significantly improving the quality of care.

Common Mistaken Assumptions 

While you might think that cases like these are rare, inaccurate assumptions about aging are more common than you’d expect.

Compare the way people approach a 30-year-old in a wheelchair to an 80-year-old in the same situation. While most people will engage with the 30-year-old as an equal, a surprising number will talk to the 80-year-old as if they’re speaking to a child, which can be a profoundly humiliating and alienating experience for seniors, especially those who are cognitively functional.
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For another example, look at the way that many people treat individuals who have dementia. Many people assume that individuals with mid-stage or late-stage dementia are incapable of simple activities. Many of these individuals remain skilled in activities like painting, gardening, or baking, even as they lose some cognitive function. What’s more, these activities can prove sources of great happiness for those with dementia. A well-trained HHA or CNA-certified caregiver can provide appropriate dementia home care services for these seniors.

​Do you have an elderly loved one in need of senior home care in Wellesley, Natick or other cities and towns in the Greater Boston area? Contact Visiting Angels Newton/Canton today to schedule a free senior home care consultation!

Differences between Dementia Care and Regular Home Care

If your elderly loved one is showing signs of dementia, he or she may need more than regular elderly home care services.  A high quality home care agency will do a thorough assessment of individual needs to design a customized home care plan for each client. But still, it is important for you to understand the different types of care available.  Home care needs are different for healthy seniors vs those suffering from Alzheimer’s disease or dementia.

Regular Home Care Services

​Regular in-home care is intended for individuals who require assistance with certain tasks but are able to maintain some independence.  A home caregiver provides help with activities of daily living, such as bathing and dressing, and with household chores like light housecleaning, grocery shopping, and meal preparation. This type of care might also provide medication management and transportation to medical appointments. Regular home care may be appropriate for someone in the early stage of Alzheimer’s disease, but as the disease progresses, more specialized care is needed.

​Dementia Home Care Services

Dementia home care is tailored to the challenges related to the different types of dementia and the changing needs through the progression of the disease. Dementia caregivers are familiar with the stages of the disease, common behaviors, and safety issues related to dementia as well as how to handle erratic moods and behavior. Care plans focus on the specific needs of an individual with dementia, including likes, dislikes, and personality. Dementia care incorporates activities designed to stimulate memory such as looking at family photo albums or listening to music, doing art projects, or reading. Using social media technologies to engage social with friends and family, eating a brain-healthy diet and physical exercise are also ways to help seniors with dementia live at home longer.

In early stage dementia care, the caregiver may need to provide simple memory assistance such as appointment reminders, organization, and money management along with regular home care services.

In middle stage dementia care, it is important for a person with dementia to follow a structured schedule to reduce the stress and anxiety. Individuals may also need increased assistance with dressing and feeding themselves.

In late stage dementia care, individuals typically need 24-hour care to cope with extreme confusion, inability to process information, and difficulty communicating verbally.

Visiting Angels Newton/Canton offers 24-hour home care as well as live-in and live-out homecare for the elderly with dementia. For more homecare information, please call 617-795-2727.