Sundowning
Dementia Diaries
Circadian rhythms are defined as the physical, mental and behavioral changes an organism undergoes during a 24-hour cycle. While the biggest thing that affects circadian rhythm changes is light and dark, other things can also influence the changes. Food intake, stress, physical activity, temperatures and the social environment you find yourself in can also be key influencers to change. When circadian rhythms change it affects you tremendously and especially even more if you happen to be suffering from any health conditions like dementia.
So what happens to the dementia mind (DM) when the circadian rhythms change as the day comes to a close? The DM begins to experience sundowning. Sundowning behavior patterns start to happen in the evening, as the sun goes down. These behavior patterns can be irritation, restlessness, agitation or confusion/disorientation. Anyone experiencing these naturally show symptoms. It’s almost like being able to read the signs on your face or sensing the nervous energy in your body.
The absence of a partner for a dementia patient is unnerving. It’s scary. It’s lonely. Forgetting that the absence is permanent now increases those emotions two-fold. Now add the sundowning to the equation and one can only imagine how difficult it becomes for the dementia mind to process all the thoughts running around in the mind.
Sundowning makes retiring for the night even harder. Falling asleep or being able to relax as you lay down to sleep becomes increasingly difficult. So every evening the restlessness goes in overdrive. The confusion causes increased anxiety. Feeling lost adds to the insecurity.
Being mindful of the fact that the needs of a dementia patient increase as the day comes to a close is critical. Routine is important. Relaxing patterns important. Basic things like hydration, hunger, bathroom, temperature, pain, etc should be monitored. Keeping these factors as close to normal reduces the sundowning symptoms and helps relax the mind before bedtime. Caretakers need to be extra sensitive and relaxed in order to manage the distressed mind. As the sun goes down, the dementia mind, unlike a normal mind, struggles to relax and retire for the night.