With sundowners, your loved ones living with dementia may increasingly perseverate on issues, become very anxious, ask the same questions repeatedly, say they need to go somewhere or do something urgently, or become more scared and confused. It can be very hard on us as caregivers as we struggle to comfort them and ease their anxieties. My 5th tip is:
Validate, Address Needs, Divert or Distract, Stick to Routines
Simply trying to reason with someone or set them straight or trying to convince them of “the truth” in the midst of sundowning probably won’t work. Remember that it’s the disease affecting their thinking, causing confusion and fears. They really can’t help it. You’ll likely just wind up making them more frustrated, angry and confused.
Validate. Instead, try to validate your loved one’s feelings (even if they don’t make sense to you) to let them know you are listening. Meet them where they are – in other words, join them in their world. A few examples:
If they are angry, say something like, “I can see you are feeling very angry. You must feel so frustrated!”
If they are scared, say something like, “I’m so sorry you’re feeling scared. Feeling scared is an awful feeling. I’m here for you…”.
If they want to see their parents, say something like, “I remember your mother, she was a great person. She sure made good pie! Look at this great photo we have of her. I miss her too.”
Address Needs. Try to figure out what their current needs are. Are they tired? Hungry? Cold or hot? In need of a restroom? Do they need stability because there is a change of shift/care happening? Do they feel the need to be doing something but not quite sure what it is? Perhaps they have that “end of the day” feeling like when they used to head home from work. Or maybe it’s getting dark, and they need more lighting. If, in their minds, they are at work, validate what a great job they’ve done and celebrate that it’s time to stop working and relax a bit now. Try to address their basic and also more complicated needs.
Divert or Distract. Try to draw them away from troubling thoughts and anxieties by diverting or redirecting attention to favorite activities, foods, animals and people. You might be able to connect the distraction or diversion to something they are perseverating on. For example, referring to the example above, you might say, “Your mom made great pie – how would you like a piece of pie?!”. Or perhaps you can offer up a soothing cup of tea, a favorite TV show, calming music, a walk, feeding a pet etc. Just be sure you don’t invalidate their feelings as you do so. My dad loved The Lawrence Welk Show; we would give him TV earphones to amplify the volume and limit other sounds. It was almost always an effective distraction.
Stick to Routines. There is comfort in routine. So, you might find some things that work when sundowners starts to set in and make a routine of doing them. For example, we found that if we took a walk around 3pm and then gave dad a foot soak and foot massage around 4pm every afternoon he breezed through his usual sundowners time period with much less anxiety. A regular restroom routine is helpful also.
Let us know in the comments below how these techniques have worked for you! It may be a struggle for you at first, but believe me, over time it becomes second nature and you will do these things automatically!