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How Person-Centered Care can Alleviate Sundowning in People with Dementia

If you have a loved one with dementia, you may have seen or dealt with the issue of sundowning—problems sleeping or increases in behavioral problems that start at dusk (sundown) and can last into the night. Sundowning usually peaks in the middle stages of Alzheimer’s and other dementias and eventually diminishes as the disease progresses. However, while sundowning is an active condition in the person with dementia, it can present challenges for caregivers and the patient.

Symptoms of sundowning are agitation, anxiety, and increased confusion, changes in sleep patterns, and nighttime restlessness. Because the sleep-wake cycle is often disrupted, this can lead to more behavioral problems.

Although the causes of sundowning are not totally clear, contributing factors may be:

  • Physical and/or mental exhaustion
  • Less need for sleep (common in older adults)
  • Reactions to nonverbal cues from tired caregivers
  • Misinterpretations of surroundings due to lower lighting or shadows
  • Disorientation stemming from the inability to distinguish dreams from reality during sleep
  • Disrupted circadian rhythms (one’s internal body clock), leading to a mix-up of day and night

Managing sundowning
There are some easy steps caregivers can take to reduce the symptoms of sundowning for persons with dementia. If disorientation caused by the dark is a problem, keeping the lights on in the evening can help. The sleep environment should be kept at a comfortable temperature and the overall environment should be calming. Having an active day helps anyone sleep better at night, as does avoiding stimulants such as caffeine, nicotine, alcohol, and watching TV during periods of nighttime wakefulness.

Physical factors that are disrupting sleep (such as sleep apnea or issues related to incontinence) can often be addressed medically after an examination by a physician. However, there’s another way to manage or even reduce sundowning: person-centered dementia care. In fact, this type of individualized care has been shown to greatly reduce—even eliminate—sundowning in residents in the Memory Care Suite at Lester Senior Living.

Person-centered care
The caregivers in our Memory Care Suite are all trained in the Comfort Matters™ approach, an internationally recognized dementia care program that emphasizes person-centered care. In fact, the Weston Assisted Living Residence, where the Memory Care Suite is located, recently received accreditation as a Comfort Matters provider.

This level of personalized care places the emphasis on the individual’s comfort at all times, catering to each resident’s preferences and needs in the moment. Because our memory care residents may eat or sleep when they want to, select the activities they wish to enjoy, and have the attention of a caring team in a soothing environment, they are happier, calmer, and less likely to experience the upset or disorientation associated with sundowning.

If you have a loved one suffering with a memory disorder, and would like to find out more about Memory Care at Lester, contact David Rozen at (973) 929-2725 or davidr@jchcorp.org.

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