This column highlights early to mid-stage dementia. There are 3 areas I will focus on: Sundowning, Watching TV and making the bathroom a comfortable place to be in.
Sundowning (Confusion and agitation worsen in the late afternoon and evening, or as the sun goes down) is a psychological phenomenon associated with increased confusion and restlessness in patients with some form of dementia. Beginning early evening and continuing throughout the night, as many as 20% of dementia patients will at some point experience periods of:
increased confusion, disorientation, anxiety, agitation, restlessness, insecurity, suspicion, delusions and hallucinations.
Here are some recommendations for Sundowning (late afternoon, early evening, or as the sun goes down) :
- Plan your activities for the day so that there is less to do in late afternoon. Remember that tiredness plays a significant role in sundowning. Dementia is often characterized by increased confusion and irritability as the day progresses.
- Reduce food and beverages that contain caffeine - or only have these in the morning hours. Serve dinner early and offer a light snack before bedtime.
- Use up any surplus energy via exercise, such as 1 or 2 brisk walks during the day.
- Play quiet music in the late afternoon instead of any loud TV programme, which could cause confusion later in the day.
- Help your love one feel secure and well protected. As the darker hours can sometimes bring about feelings of insecurity and loneliness.
- Never argue, as obviously this will only ever intensify behavioural issues.
- Reduce restlessness with some quiet activity, such as undertaking your favourite pasttime or a simple, quiet task like folding towels.
- Some people with dementia lose the ability to tell the difference between what is real and what is on screen and can become distressed or show increased anxiety and confusion, especially with the news stations/programmes.
- The bathroom and personal care tasks can often be a cause of distress as well. Making some environmental changes can help
Reduce the following:
Declutter - means less confusion and more room to move about
Ensure adequate lighting and a warm temperature
Set hot water settings to low in order to prevent scalding, and ensure all taps are labeled "hot" and "cold."
Lay out personal grooming items in a logical way. Such as toothbrush, razor/shaver, shampoo then soap. This makes grooming steps easier to follow and less confusing.