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Dementia tips: Coping with sundowning

Sundowning describes an increase in agitation, confusion or irritability that sets in towards the end of the day as the light starts to fade, and gets worse during the evening and night.

Experienced by as many as 1 in 5 people living with Alzheimer’s Disease, it is most common in the mid to later stages of the disease, and although particularly associated with Alzheimer’s it also affects people living with other forms of dementia as well.

Coming as it does at the end of the day or middle of the night when carers are already tired and less able to cope with the inevitable frustration and interruption to sleep, it is often cited by loved ones as one of the most upsetting and troubling effects of dementia.​

Sundowning and dementia
Medics are unsure about the causes of sundowning but most agree that fading light in the evening and darkness at night are the main triggers.

Signs of sundowning to watch out for


Confusion

Irritability

Agitation

Distress

Disorientation

Becoming demanding or suspicious

Hearing or Seeing things that aren’t there

Yelling or Pacing


Factors that might contribute to sundowning behaviour


Less light and more shadows in the house can lead to confusion and fear.


An upset to the ‘internal body clock’, resulting from the disease’s damage to the brain, can cause a biological mix-up between night and day.


Disorientation resulting from an inability to distinguish between dreams and reality.


Reduced need for sleep and disturbance in sleep patterns common in older age.


Reaction to unintended body language from a carer as frustration and tiredness kick in at the end of a long and busy day of caregiving.


Discomfort (caused by thirst, hunger, pain), depression or boredom could all make the symptoms worse.

Coping strategies for dealing with sundowning behaviour

* First and foremost seek help…

In exactly the same way that airlines instruct those looking after others to put on their own oxygen mask before attending to others, carers need to look after their own needs first. If you are emotionally drained and physically exhausted, you won’t be in the best position to stay calm and collected under pressure.


All carers need help, either from other family members or a home care provider to give you a little respite. Take a nap if possible during the day, and try to keep in touch with friends and/or a support group to keep your spirits up.


* Talk to your doctor.

It is important to rule out physical ailments (such as urinary tract infections, sleep apnea, incontinence etc) that could be contributing to sleep problems, and then discuss possible ways forward to help your loved one.


*Try to work out the particular triggers that prompt the agitation and confusion, and attempt to alleviate them.

Ways to help

Here are our some tried and tested coping strategies that can really help…

Keep household lighting bright and avoid dark shadows.

Everyone’s eyesight deteriorates with age, so increasing light levels by adding extra lamps and using brighter lightbulbs can reduce the potential for upset and confusion caused by darkness and shadows as the light begins to fade.

Close curtains as it becomes dark to reduce the possibility of confusion caused by reflections or glare.

Do everything you can to aid sleep at night.

Stay active during the day, discourage napping and encourage gentle exercise.

Avoid, or limit, things that could disturb sleep. Try to avoid alcohol or tobacco as far as possible, and limit caffeine intake to mornings only.

Have your main meal at lunchtime and keep the evening meal small and light to aid digestion before bedtime.

Create a comfortable and reassuring sleep environment. Ensure the temperature is comfortable, fit night lights to reduce darkness, and make sure a clock is easily visible.

Keep things calm in the evening.

Relaxing music, playing cards or dominoes, or even folding laundry can all provide gentle stress relieving activities to help you wind down in the evening before bed.

Bear in mind watching TV can cause stress if the person watching can’t follow what’s going on.

Avoid arguments, keep things calm and provide lots of reassurance to maintain a calm atmosphere.

Ensure a safe environment.

Set up a baby monitor, motion detector or door sensors to alert you if your loved one is moving about in the middle of night.

Fit window locks, use a gate to block the stairs and put away anything that could prove dangerous.

Use night lights to light up dark corners in the bedroom and mark the pathway to the bathroom.

If someone wakes up agitated....

Approach with a quiet, calm, and reassuring manner.

Find out if the person is uncomfortable or needs something.

Gently tell the person what time it is.

Don’t argue.

Provide reassurance that everything is ok.

Avoid any temptation to use physical restraint. If the person needs to pace, let them do so while providing reassurance and reminders that it’s still bedtime.

Article courtesy of www.localdementiaguide.co.uk

New app provides virtual reality view of dementia

Alzheimers Research UK have developed a virtual reality app that helps you experience the world through the eyes of someone living with dementia.

A Walk through Dementia​

A Walk Through Dementia is an Android-exclusive app which gives users a 360-degree video experience that shows how simple tasks can become extremely complex for people suffering from the disease.

Featuring 3 everyday situations - At the Supermarket, On the Road, and At Home - the app aims to demonstrate how dementia goes beyond simply forgetting things, but compromises your senses and thereby affects your perception of the world around you.

Narrated by Olivier Award-winning actress Dame Harriet Walter, the 5 star rated app is free to download from the Google Play Store. It is available as a video version which you can view on your phone or tablet, or by purchasing a cardboard headset, you can experience the film in full virtual reality.

Watch the launch clip for the app here.

Trina Armstrong, who is living with posterior cortical atrophy, a form of Alzheimer’s disease, and advised on the project, said:

“Anyone living with dementia will experience it uniquely, but I hope A Walk Through Dementia will provide people with an idea of what the world is like for me. Everyday things like popping to the supermarket or making a cup of tea are things I used to take for granted, but dementia presents a real barrier to my everyday life in ways that people often don’t realise.

It’s been empowering for me to feed some of my symptoms and experiences into the app and see them re-created. I hope it will encourage the public to think differently about dementia and the people living with the condition they might meet.”

Click here to visit www.awalkthroughdementia.org/ for details on how to download the app and get hold of the cardboard headset priced £5.99.

Volunteers urgently needed to take part in dementia research

SCIENTISTS are urgently seeking people to take part in dementia research amid a surge in studies into the disease.

The number of drug trials to treat Alzheimer’s disease has almost doubled worldwide since 2013 with 19 studies on potential treatments currently underway in the UK alone, putting pressure on scientists to recruit enough suitable participants to help develop new therapies.

Now dementia sufferers or those without diagnosed dementia but who are experiencing memory problems are being invited to sign up to Join Dementia Research, a service aimed at pairing volunteers with suitable clinical trials.

Changes in the brain in diseases like Alzheimer’s can start many years before symptoms show, so studying people with mild memory problems gives researchers the best chance of understanding how dementia develops and finding ways to stop it.

There have been no new drugs to treat dementia in over a decade however.

Professor Craig Ritchie
Edinburgh University

Dementia research is critically important, not least because of the huge number of people it affects. Although we have some drugs that manage some of the symptoms of dementia, we have a long way to go in terms of modifying the course of the disease.

However, only by conducting high quality research will we be able to get conclusive evidence and move treatments forward. To do this research we’re relying on people who are experiencing the very earliest stages of memory problems to come forward and offer to take part.​

Anyone interested in taking part in a research study can sign up to Join Dementia Research online at www.joindementiaresearch.nihr.ac.uk

Join Dementia Research is open to anyone over the age of 18 and people can act as a representative to register a loved one, including someone who has dementia who may find it difficult to register themselves.

To date, 19,711 people have registered and 5,498 taken part in research studies.

Wendy Mitchell, who has young onset dementia, is among the volunteers.

She said: “There currently is no cure and without willing volunteers to try out new drugs there will continue to be no cure. Taking part in research is my way of feeling useful again and contributing to finding that elusive treatment which in turn will create a better world for my children.”

Article by Helen McArdle, first published 19th July 2016 Herald Scotland