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  • Karen McPhail, RN, MSN


Have you begun to notice a recent change in your loved one? Does their behavior become different throughout the day? Or do they seem slightly confused, anxious, upset, apprehensive, or unsettled as evening approaches? Do they begin to nervously pace or walk throughout your home without a real purpose or reason? If so, they may be experiencing Sundowning.

Sundowning is something that often occurs in those with Dementia. No one can clearly explain why this occurs, but it is frequently difficult for many caregivers to understand and manage this behavioral change, especially being at the end of day. I often hear caregivers say, "you would think that they would be exhausted? I am." And they probably are! So how does one manage these changes in a loved one? Here are some recommendations that may help in managing this phenomena:

1. To avoid frustration, plan and focus your time in the evenings on your loved one's needs. Block out time in your calendar if you need to. Try to get rest at night to avoid fatigue and maintain patience. You cannot be distracted in the evenings as your focus needs to be on supporting and giving attention to them. If you cannot be there in the evenings ensure that you have a caregiver present who understands the pm needs of your family member.

2. Manage your home environment. Ensure that your home is quiet and peaceful as evening approaches. Play soft music. Control television programming to ensure that it is peaceful and appropriate. Try to avoid anything that can cause excitement or anxiety.

3. Avoid a great deal of visitors and activity in the evening as this can cause excitement. Keep a calm , steady routine in the evening. Plan any appointments or visitors for earlier in the day.

4. Involve your family member in a consistent routine. Helping with simple tasks or doing a fun activity can be helpful. Assisting with dinner preparation or folding laundry may keep them busy, distracted, and engaged. Make sure that it is an enjoyable activity that you can do together.

5. Avoid fatigue in your family member. Often times a short early afternoon nap will help. You want to avoid your family member from having fatigue as this can often times make the evenings worse.

6. Find joy in the simple things and point out and express these to your loved one. A light and relaxed attitude will create and foster a positive culture at home!

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