Winter and Sundowning

What is your favorite season? Unless you are an avid skier or live in a temperate climate, winter probably wasn’t your first choice…or second. For those of us living in the Midwest, winter has a bad reputation, and rightfully so. It always seems to outstay its welcome, by weeks or some years, even months. The running joke in Chicago is that the city has four seasons, almost winter, winter, still winter and roadwork. Natives to the area are well adapted to the snow and ice and most everything that winter throws us. However, there is one aspect of winter that is hard to overcome and that is the lack of direct sun light. For those with dementia, such as Alzheimer’s, this holds especially true in the form of sundowning.

Sundowning (or sundowner’s syndrome) is a symptom of Alzheimer’s in which the changing light outside affects the circadian rhythms of the individual causing confusion, agitation and/or anxiety. Many family caregivers come to notice that their loved one becomes agitated later in the afternoon or early evening. As mentioned earlier, winters are long in these parts and we can go weeks without ever seeing the sun. Gray, cloudy skies dominate the days, causing even the most optimistic souls to become depressed and weary. For those with Alzheimer’s, sundowning may become more persistent and severe.

If the person you are caring for is showing signs that they are sundowning, regardless of season, there are many ways to deal with this symptom. (A Place for Mom) offers several suggestions to alleviate and minimize the effects:

1. Encourage a little healthy (not exhausting) exercise during the day to get the senior’s endorphins going and blood flowing. This will promote a relaxing and low-key evening to help switch the body to end-of-day focus.

2. Turn lights on in the rooms you and your loved ones will be occupying during the evening.

3. Try to keep the Alzheimer’s patient engaged in something, whether it’s a specific task or focus like folding laundry, looking at pictures or playing a game. This helps to create new thought patterns.

4. Select one area of a room to become a “quiet place” where there is a bright light and soothing music.

5. If this time marks a particular trend in your loved one’s life, try to mimic what they may have done. From setting the table to preparing for dinner or reading the newspaper, these ‘normal’ life activities may be comforting.

6. Only allow cat naps during the day of 20 minutes or less. Hours of sleeping can confuse the body’s circadian rhythms and keep the senior too awake at night.

7. If your loved one paces at night, make sure there’s a clear path and accompany them—to let them know they’re not alone.

8. If you sense your loved one is getting frustrated; hold his or her hand or put your hand on his or her back or knee. Sometimes a a soothing hand or shoulder massage can be comforting and can lesson any tension that may be building.

9. Promote evening activities of positive interactions and memories. Whether it’s watching movies, listening to music, looking through family albums or calling loved ones.

10. Maintain a comfortable temperature in the house.

11. Talk to your doctor about medications that may help with sundowner’s syndrome.

Many caregivers suggest keeping a journal or log to document episodes of agitation, anxiety or confusion. They suggest it may help to determine causes, which in turn can lead to preventive measures. Sundowning, like many symptoms of Alzheimer’s can vary from case to case so it is crucial that caregivers are flexible. What works today, may not work tomorrow. Seeking support, answers and tips from professionals and other caregivers will make life easier for you as well as the one you care for.

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