Sundowning and Seniors With Alzheimer's

Understanding my own Grandmother's absentmindedness in the beginning stages of her dementia was relatively easy. When she began to hallucinate is when things started to turn for the worse. I was walking with her in her assisted living facility when she told me about a recent hallucination.

"The other day, late in the afternoon, perhaps it was early evening, 3 people came into my room asking if they could share my bed and live with me," she said. "They had to ask Nancy (the admittance lady) first but I told them we couldn't all fit and they could not stay. I saw them as clear as day and then they vanished! It was then I recognized that perhaps they weren't real. But it sure seemed it was."

No wanting to upset my Grandmother, I said "I'm glad you recognized that!" Grandma said she agreed.

Those afternoon hallucinations marked the beginning of sundowning- early evening or late afternoon confusion in individuals with memory impairment or dementia. Regrettably, sundowning is not just hallucinations, it can be irrational ideas, agitation, wandering, and confusing dreams and reality. At times, people sundowning may become upset, suspicious, demanding, or disoriented.

My Grandmother did have a number of these behaviors. At one point she began to think people were robbing her room in the middle of the night while she slept. She began to forget names and people she'd known for years. She also began to shadowing me when I came to visit on a few occasions. She followed me so close that I almost tripped over her a few times, and telling some of the same stories again and again. So, what are some causes of sundowning?

Mental and physical exhaustion are two primary causes, in accordance to the Alzheimer's Association. Poor indoor and diminishing afternoon day light also contributes to sundowning. Another found cause are daytime naps.

LOOK OVER MEDICATION. A physician should review the medications as some may lead to sundowning. They also may prescribe a medication for sleep in order to prevent sundowning.

NAPPING IS DISCOURAGED. Daytime naps should be replaced with walking, group activities or some pet-therapy. After my Grandmother was unable to read she was still delighted listening to them read. One reader read a suspense-thriller. "I can't remember the title," my Grandmother said, "but it's got me on the edge of my seat."

STAY AWAY FROM CAFFEINE. Individuals with memory disease should abstain from caffeine. They also should not drink alcohol.

IMPROVE THE LIGHTING. People walking around the halls may be searching for the restroom, so be certain that all hallways have plenty of light. Night-lights also help the residents safely find the restroom.

LOWER AMBIANCE NOISE. Loud TVs, a blaring radio, and the noise of lots of people talking, can very well disturb and upset people with memory disease. Radios and TVs can be substituted with soothing CD music. Some facilities have a volunteer who comes in to play music and sing for residents.

REASSURE SECURITY. If the individual is concerned and upset about the hallucinations, be sure to assure them that they are in a secure and safe place where they are loved.