Alzheimer’s brings with it a lot of difficult territory for caregivers to navigate. One thing many family caregivers quickly learn about the disease is how common it becomes for loved ones to exhibit strange behavior in the evenings.
What Sundowners Syndrome Is
While seniors with Alzheimer’s often show the better-known symptoms of the disease throughout the day, like memory loss and confusion, at night, they often demonstrate a different side of Alzheimer’s. Sundowners syndrome describes the personality change that often comes into play with Alzheimer’s patients late in the day.
When experiencing sundowners syndrome, patients can be irritable, easily angered, restless, demanding, or suspicious. All those different emotions and personality traits can become common, even if they’re out of character for the patient. For caregivers, seeing a loved one who’s usually soft-spoken and kind suddenly become someone prone to yelling or hurling accusations every time the sun goes down can be understandably disconcerting.
While we don’t entirely understand why sundowners syndrome occurs, doctors and memory care workers have figured out a number of techniques you can employ to reduce its frequency and handle it when it does happen.
What You Can Do to Prevent Symptoms of Sundowners Syndrome
Prevention is always preferable to treatment. You can take a few steps to avoid you and your loved one having to deal with sundowners syndrome at all – or at least reduce the likelihood and severity of it. Here are some habits to work into your caregiving schedule.
Spend time in the sun.
Exposing an Alzheimer’s patient to the sun can help set their internal clock, so get outside during the day. Consider what habits you can take on to encourage you to spend more time outside together. Take up gardening or find a nearby park to make regular visits to. And when you’re home, open the blinds to let more sun into the house.
If your loved one is spending most of their time inside without ever seeing the sun, it’s likely to make sundowners syndrome worse.
Keep their schedule for sleeping and waking up consistent.
This may be difficult to enforce, but it makes a big difference. Instead of simply letting your loved one fall asleep and wake up whenever they feel like it, implement a specific bedtime and wake-up time. And do your best to keep them from taking naps at all. A consistent sleep schedule reduces the likelihood that they’ll wake up in the middle of the night feeling restless, and ensures they’re more likely to feel well rested in the evenings.
Go for walks.
Daily walks are both a great way to get some sunlight exposure into your day and an easy option for getting some exercise as well. A daily walking habit will keep your loved one healthier, help them gain more energy during the day, and make them more likely to be tired and ready for sleep at night.
It can be easy to forget to work physical exercise into the day when their disease and your caregiving seems to eat up so much of your time and energy, but it can do a lot to improve the health and mood of both of you.
Get in the habit of having quiet evenings.
Shut off the TV early and avoid playing any music unless it’s something peaceful and calming. Re-work your evening routine to minimize noise and emphasize relaxation. That will help your loved one get into the mindset of bedtime and ease them toward sleep.
Try to move dinner up in the day or keep it small. On the one hand, you want your loved one to get enough to eat so that they don’t feel hungry in the evening, but you also don’t want them waking up in the night due to digestive needs. Try to find the right balance with bigger meals earlier in the day, and smaller healthy snacks or light meals in the early evening.
No caffeine after noon.
Caffeine is often lauded as a savior for helping us all get through our busy days, but it’s also notorious for causing problems sleeping. For Alzheimer’s patients at risk of sundowners syndrome, you should be especially careful with when and how much caffeine they consume. Institute a strict rule of no caffeine after noon and make sure to have alternative options around for them to drink instead, like decaf tea or carbonated water.
Avoid sugar late in the day.
Sugar’s in a lot of things. Once you start paying attention to ingredient labels, you’ll see it everywhere. You may not be able to cut sugar out of your loved one’s afternoon and evening diet completely, but try to avoid it as much as possible. Insist on no desserts or sodas in the late afternoon or evening, and try to find recipes and meal options for the last meal of the day that use minimal sugar.
Some supplements are believed to help with the symptoms of sundowners syndrome. Be sure to check with a doctor before introducing any new supplements into your loved one’s diet. If your doctor gives you the go ahead, then give a try to gingko biloba, St. John’s Wort, vitamin E, or melatonin.
How to Manage Sundowners Syndrome When it Occurs
While prevention is ideal, even if you do everything right you may find yourself dealing with sundowners syndrome some days. When it does happen, there are a few things you can try to help calm your loved one down.
Put on calming music.
Try to find something classical or soothing to play for them. Music apps like like Pandora, Spotify or Amazon Prime’s music feature can help you find playlists that bring together calming music (although beware of the ads on Spotify and Pandora if you’re not a subscriber, they could jolt your loved one out of the calm the music helps bring).
Talk to your loved one in a comforting, calm tone.
No matter how worked up they get, be careful to keep your own tone calm and comforting. Tell them it’s ok and do your best to address any concerns they communicate. You want to respond to any irritation or anxiousness they express with as calm of a response as you can manage, and try to change the room’s atmosphere to one of restfulness.
Bring in a pet (or robot cat).
Pets have a special power to help relax someone who’s feeling anxious or upset. If you have a cat or dog you can bring into the room to spend some time with your loved one, their presence could help. If you don’t have a pet, robot cats have been shown to have a similarly calming influence on people with Alzheimer’s. Consider if getting one for your loved one might be worth it.
Taking care of a loved one with Alzheimer’s is a lot of work. Know that they’re lucky to have someone who cares for them enough to put in the effort, but also remember that if it ever starts to feel like too much, it’s ok to consider investing in memory care for your loved one. People who are specifically trained to take care of Alzheimer’s patients and can treat it as a full time job are often in a better position to take on the work than busy loved ones. It’s ok to accept help.