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What is Sundowning and How Can I Support my Client Through it?
It is late afternoon, you and your client have had a lovely day, but now she is starting to get restless again. It happens most days, around the same time. She starts getting a bit agitated, perhaps confused, and can’t settle down. You offer a cup of tea, you try various distractions, but the daily restlessness continues. She enters the ‘red zone’ and you do not know why or what caused it. You also do not know what to do or say to help her go back to peaceful ‘green’.
This is called sundowning, or late-afternoon confusion and is quite common in people living with Alzheimer's or other forms of dementia. Exactly what causes it is unknown, but possible causes may include fatigue, too little or too much light, medication, or loss of routine at a previously busy time of day.
Late afternoon and early evening are typically busy times of day in most households. The evening meal is being prepared, children are tidying up their toys and having their bath, one or both parents are coming home from work, and so on. Now those days are long gone, but the memory of activity and family life is still there, only it's just the client and the carer at home, life is quiet, the bustle has gone.
To maintain a peaceful state of mind, make this a more meaningful time of day. If the client is able to leave the house, it is a good idea to go for a walk, out to the shops, or to a coffee shop. Avoid noisy, violent television shows as people living with dementia often think they are part of the 'reality’ they see on the screen. Perhaps listening to their favourite music, or doing a jigsaw puzzle, or playing cards, whatever activity your client enjoys.
I had this experience with my client, we'll call him Jack. Every afternoon at 4 pm, when the sit-in carer left and I came back from my break, Jack would get up and announce that he was going home. Jack had lived in that house for over thirty years, yet in his mind, his home was his childhood home in the village that he grew up in. Unfortunately, Jack was now unable to leave the house, he used a Zimmer frame and had a partially paralysed leg and he could not go down the very steep driveway.
Instead, we would go for a walk through the house. We would walk to the front room and look out of the window. I would engage him in conversation about the scenery, the fields and farmland, all very familiar to him. We would have a 'gossip’ about the neighbours and perhaps even rummage through a few drawers. After a few minutes, he would start to recognise where he was, that it was all familiar and safe. He would happily go back to his den, back in the ‘green zone’, feeling peaceful.
Every individual who experiences sundowning will experience it differently, you must learn to stay patient and determined to find certain tactics to help your client through it. Try out as many different activities and phrases, until you find the right one, that you will be able to use, again and again. When you find something that works, the biggest reward will be seeing your client or loved one happy and peaceful.
- ‘green zone’ a state of calm contentment and peaceful relaxation
- ‘red zone’ a state of heightened anxiety or distress
Laetitia Hannan is one of our very own Professional Carers who has worked with The Good Care Group as a Relief Carer on the Senior Care Team for over 3 years. Laetitia strongly believes in providing an outstanding service to the clients she cares for, and provides a fascinating insight into the role of a carer. We hope that you enjoyed this blog as much as we did and find it both interesting and useful. If you have any comments or questions please feel free to leave below!