What can I do to minimize the agitation associated with sundown syndrome?
To make someone more comfortable, try to find out what triggers his agitation and confusion. To help calm down the man who thought robbers were descending on his home, for example, Morley and his colleagues devised a simple solution that helped the distraught man understand that the robbers were an illusion. "We taught him to take his cane and brush away the stick figures," Morley says. With a wave of his cane, the man understood that the shadows were stick figures on the wall, and his sundown symptoms and urgent calls to the police stopped.
Researchers have also found that placing a full-spectrum fluorescent lamp (between 2,500 and 5,000 lux) about 1 meter from the person suffering from sundown syndrome and within his visual field for a couple of hours in the morning can work wonders at getting his biological clock back on track and making him less agitated at sundown. Try turning it on while the person you're concerned about is watching television or engaged in some other daily activity.
Another good tool to ease sundown syndrome is to help the person relax. If he's agitated because he's hungry, for example, try serving food earlier or offer him a snack or something to drink until dinner is ready. If there's a lot of commotion in the house, try taking him to a quieter room. If he likes music, keep a CD player and some of his favorite songs at hand. If he isn't a music fan, a recording of ocean waves or a mountain stream might calm him down. If he's arguing with you or making unrealistic demands, try letting him know that you're listening and talk to him in a calm voice. You might try a five-minute hand massage, or just hold his hand, or stroke his arm for a few minutes. A little reassurance can go a long way in keeping someone calm.
Sources:
A. Bianchetti, A. Margiotta, et al. "Clinical characteristics and risk factors of delirium in demented and not demented elderly medical inpatients." Journal of Nutrition, Health and Aging, Nov-Dec 2006.
D. G. Harper, L. Volicer, et al. "Sundowning and circadian rhythms in Alzheimer's disease." American Journal of Psychiatry, 2001.
M. L. McGonigal-Kenney and D. Schutte. "Non-pharmacologic management of agitated behaviors in persons with Alzheimer disease and other chronic dementing illnesses." University of Iowa Gerontological Nursing Interventions Research Center, Research Dissemination Core, National Guideline Clearinghouse, 2004.
J. E. Morley. "Nocturnal agitation." Sleep Disorders and Insomnia in the Elderly, Facts and Research in Gerontology, Volume 7, 1993.
While I was changing planes in Atlanta, I was asked by an elderly gentleman to please talk with his wife, who had Alzheimers and was having sundown. The husband and wife were supposed to catch a plane to Chicago, to meet their daughter. The wife had insisted on getting out of her wheelchair, to sit in an airport chair, that was halfway to their gate. The wife refused to go to the gate to get onto their plane. She said that their daughter would come to Atlanta to meet her. The airline employees said that they would never force a person to board a plane against their will. (Which I can understand.) The husband tried to reason with his wife, which of course did not work. I had to catch my plane, so I did not see the end. My mother now has Alzheimers and my father has Parkinson's. What can a care giver do in a simular situation, when the person with sundown will not move, when it is necessry?
My mother-in-law has had 3 bad spells of hallucinations, after those 3 days she calmed back down and hasn't had anymore since. They were always after sundown. Is this common for them to come and go like that?