Managing Sundowners Syndrome Tip #2: Routines and Structure

[agoyer]

If you're caring for a loved one who is living with dementia, or another health condition, and they are experiencing Sundowners Syndrome, there are things can do to help manage it and minimize difficult behaviors and disruptions. Remember they are probably experiencing discomfort or a sense that they should be doing something or going somewhere. They may feel like there is something missing or it's time to go home. The key is to help them feel safe, secure, and "on top of things", and minimize triggers. That leads me to my 2nd tip:

Maintain Routines and Structure Activity 

There is comfort in routine and security in the familiar. It can help with that feeling that they should be doing something (but maybe they can't quite figure out what it is, so perhaps they fall back on the familiar - it's time to go home, I've got work to do etc.). Here are some tips around building and maintaining routines:

• You might find some things that work when Sundowners starts to set in and make a routine of doing them. For example, in caring for Dad (who lived with Alzheimers), 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.  
• Try to keep your loved ones active earlier in the day so they can better slow down as evening approaches. 
• Minimize napping, especially if your loved ones aren't sleeping well at night or seem to have their days and nights mixed up. If napping is a must, try to stick to a scheduled nap/resting routine.
• Alternating periods of activity with periods of rest or downtime can be very helpful.
• A regular restroom routine is a good idea.
• Try to avoid physically, emotionally, or mentally challenging, stressful tasks around dusk and at night. 
• If your loved ones start to become anxious in the afternoon or evening, validate how they are feeling, try to figure out what their needs are (tired, hungry, need to go to the bathroom, thirsty, scared, confused, need to be productive or do their job...) and try to meet the need. Then you can try to distract them with calming and reassuring activities like a favorite TV show or music, food, nature or a hand massage. (See more about this in my Sundowners Tip #5).

Let us know how you structure your loved ones' days and manage routines! What works to help them feel more in control of their day?

Take care,

Amy Goyer, AARP Family & Caregiving Expert

Author, Juggling Life, Work and Caregiving