Management of Sundowners
Pay attention to any patterns in the behaviors. It may help to keep a diary of activities and behaviors during the day and evening in order to determine if the behavior occurs after a specific event or activity. You may have to avoid visitors, children, and certain activities to prevent symptoms, or you may have to restrict certain foods that appear to be causing symptoms.
If your loved one is repeatedly irritable, and none of your efforts work to prevent the episodes, physical discomfort could be the cause. An elderly person who is confused may not verbalize pain or discomfort, but that could very well be the reason for the behavior. Try asking questions of your loved one - preferably those that will elicit “yes” or “no” answers, such as: “Does your stomach hurt?” “Does your head hurt?” A physical examination may be helpful to determine if there is some problem that can be alleviated with medication. If the behavior comes on suddenly and remains consistent for a period of time, a new physical ailment may very well be the culprit. Every minor physical difficulty can contribute to Sundowner’s symptoms, so be sure to see a physician if you suspect a physical problem.
Tell the person what you want him or her to do, not what you don’t want. Positive instructions will be easier to remember. You may also need to be specific in your instructions, just as you would with a small child. As difficult as it can be, remain patient with your Sundowner’s sufferer. Speak slowly, clearly, and calmly. No matter how agitated or angry he or she becomes, it will only make things worse if you match the emotion. Remaining calm will help the episode to pass by faster.
If someone you know exhibits symptoms of confusion or memory loss, see a doctor immediately. Obtaining a proper diagnosis in the early stages of the disease is very important. Some forms of dementia are reversible, and in rare cases, the symptoms are even caused by a reaction to a medication.
The Dangerous Symptom of Wandering
Wandering is a symptom of Sundowner’s Syndrome that can put your loved one in danger. You may have to install a fence with locked gates if you need to give the Sundowner’s sufferer access to the outdoors. Put an identification bracelet on the person’s wrist, and alert the neighborhood about the possibility that your loved one may get lost.
Of course, locks that can’t be opened from the inside are your best bet. This is difficult, as it may cause stress to the Sundowner’s sufferer, but it’s a better solution than the dangers of wandering. It also will offer you a better night’s sleep than warning bells on the doors, which will only awaken you every time your loved one tries to leave.
Just as you wouldn’t leave a small child alone in a car, never leave a person with any type of dementia alone in a car. Confused people can much too easily forget they’re waiting for someone and start the car or wander off.
Note that there is some evidence that wandering at night can be an indication of congestive heart failure. If your loved one begins to wander, your first action should be a cardiologic examination.
People with Sundowner’s Syndrome may lose their ability to understand your need for privacy, especially if they wander. While you work hard to be sensitive to your loved one’s needs, don’t forget your own. If necessary, install locks on your bedroom and bathroom doors. If this proves stressful for the Sundowner’s sufferer, you can try setting a timer to reassure the person that you will return when the timer goes off. This may or may not work, but there’s a good chance it will alleviate the stress by giving a specific time for your return rather than something open-ended and abstract.
