Sundowning-could you enlighten me please?

Discussion in 'I care for a person with dementia' started by Selinacroft, Oct 17, 2015.

  1. Selinacroft

    Selinacroft Registered User

    Oct 10, 2015
    936
    Hi
    From quite a newbie, I have heard this term mentioned and had a best guess as to its meaning but could someone clarify please ?
    My guesses include, loss of sense of time and being awake at night and vice versa, or possibly being a little extra potty at evening time which my father seems to do.
    Another guess was getting timelines mixed up and thinking they were back in the 1930s or something.
    Would appreciate some definition or explanation.

    Many thanks
     
  2. Spamar

    Spamar Registered User

    Oct 5, 2013
    6,982
    Suffolk
    Morning selina,
    Sundowning is the downturn that often appears at early evening time, hence the name. It is usually being extra difficult, more fretful, more demanding, never satisfied, having hallucinations or delusions maybe. As you will have gathered, each person is different! So some or only one of these things. More difficult to deal with anyway!

    Going back in time usually takes a while to happen, but recent memories are lost first, then progressively backward. So a person with dementia may live in the present at the beginning, then gradually slip further and further back in time as more memories are lost ( they cannot make new memories, by the way).
    Many end up thinking they are young children, for instance. If you get called mother, then he/she is thinks they are young, so any adult female is logically ( to them) mother. I became the carer, which his wife had brought in while she was busy, which lead to some surreal conversations!

    Welcome to TP, it's a great place!
     
  3. Ann Mac

    Ann Mac Registered User

    Oct 17, 2013
    3,693
    Hi Selina,

    Sundowning is the term used to describe a period of time, usually late afternoon/early evening, where the person with dementia suffers increased agitation. Often they fixate on a desire to 'Go home' - even if they are in the 'home' where they have lived for years and years. Some think that by 'home' the person actually is seeking to go back to a time when they weren't so confused, when they felt safe and probably in control - but no one knows for sure. With my Mum in law, its usually demands that we take her home, that she wants to go home, that she has to go home, but sometimes its her fixating on a child that she thinks has suddenly gone missing, and she needs to either go home to find this child or go out and look for it. Occasionally, she becomes certain that her son (my hubby) is HER husband and she has got really cross and upset at what she see's as him 'carrying on with another woman' (me!). Although its usually early evening, it can actually start at any time in the day. She's incredibly resistant to any sort of distraction or love lies, no logical argument will work and we have found at times that she can get angry and agitated to the point where she puts herself at risk - banging on doors and windows leading to bruising and skin tears, for example. We've also had her phoning the police to report that she is being held prisoner - we now have the phone hidden! With Mil, her face is very 'fixed' and determined, she can become very articulate and verbally offensive and - prior to a recent deterioration in her mobility - she would even walk in this very brisk, determined manner - someone described it as the person acting like they are 'on a mission' - I found that very apt! We find that when asked, Mil will describe 'home' as being anywhere from the house she previously lived in for over 40 years, to her childhood home in Ireland and even occasionally as a location that she has never, ever lived in. She will put coat and shoes on, as I said, hammer at doors and windows, loom over me with her face inches away and repeat 'Open the door please, open the door please' over and over for 10 minutes or more at a time. She may become really, really upset, sobbing and begging us to 'let her go' and asking why we are keeping her prisoner?

    Mils sundowning has been - and still can be - pretty extreme, and has occasionally lasted for 20 hours plus at a stretch. Because of this, she has medication which 'tones down' the impact, though nothing has yet stopped it completely. The only response that sometimes brings relief is firmly telling ehr to go to her room. Sometimes it seems that taking her out of the environment and removing any sort of feedback can break the cycle for her. Not ideal, not pleasant, but desperate times call for desperate measures! Others have said that taking their loved one out for a drive or other forms of distraction can help. But I don't think anyone has found an absolutely 100% foolproof way to stop it happening, sadly.

    Its an absolutely foul, terribly cruel and frustrating part of this illness for some poor souls - and just horrible for carers to try and cope with too :(

    HTH xxxx
     
  4. lin1

    lin1 Registered User

    Jan 14, 2010
    9,320
    Female
    East Kent
    Hi It is a truly horrible time for both the person with dementia and their family.
    Though it is called Sundowning, in reality it can happen at anytime of the day or night.
    It can come on at a regular times too , I could set my watch by When mum started Sundowning each day.

    I never found anything that I said or did helped mum, except for when she thought intruders where in the house, then dad and I shouted at them to get out using lots of choice words :eek: ,to never come back etc etc and pretended to chase them down the stairs, then I lay beside her to reassure her that we'd chased them out and locked up so they couldn't get in.

    Their are a couple of causes that I know may cause Sundowning, but IMO not too much is known about it

    Pain or tiredness are two I know of.
    When we changed mums pain meds, the worst of Mums Sundowning die ease up a lot

    I hope this helps
     
  5. Izzy

    Izzy Volunteer Moderator

    Aug 31, 2003
    59,718
    Female
    Dundee
  6. Selinacroft

    Selinacroft Registered User

    Oct 10, 2015
    936
    #6 Selinacroft, Oct 17, 2015
    Last edited: Oct 17, 2015
    Thank you all for your helpful replies
    It is interesting to hear your comment about being unable to make new memories. Is this new shport term or new long term or both? This is something I have not heard before and may just have experienced an example a few minutes ago. I told Dad I had bought some "tree bands" which are sticky wax bands you put round trunks of fruit trees to stop wigglies climbing up and laying eggs . It took some time for deaf father to get what I was talking about but sure he heard right in the end. Five minutes later on I was talking about tree bands again and he asked me if I had any this year. I am sure it was more of a memory thing than a hearing issue. He also told the dentist this week that he hadn't broken any bones when he fell down the stairs about 3 years ago but he broke tib and fib and was 3 months in hospital rehab.
    I haven't had any examples of Dad regressing to earlier times besides at the memory clinic appointment when he called me his wife (who passed away 30+ years ago)
    It has been a gradual realisation that a lot of Dad's moods, grumbles, episodes of dippiness and constant griping are part of this dementia sundowning business. There are times when absolutely nothing will stop him grumbling away.
    This morning I was at work and when I came home I got an earful of how bad, uncaring, rushed, useless the carer had been and could I stop them coming because they were a waste of time etc. The journal showed everything went to plan-apart from washing up not getting done but essentials were managed. He said she got a phone call and rushed off leaving him. I rang the agency to complain and turns out lady who visited was care plan manager and she assured me she had been there half an hour and had a nice chat with him. I suspect the truth lies somewhere in between but very difficult to guage.
    I haven't had any of the going home bit yet but he has lived here for 60 years. He did say the other day it would be nice to be 4 years old with no worries and everything was done for you. I felt like saying- everything is done for you now!
    Yes it is possible both pain and tiredness play a part- he definitely steps up a gear in the evenings with the pottiness.
     
  7. canary

    canary Registered User

    Feb 25, 2014
    10,712
    Female
    South coast
    Hi selinacroft. With dementia it is the most recent memories that are most quickly lost. I wouldnt say that someone with dementia cant make any new memories, but it is very hard for them and the memories get lost very easily. Mum has learnt to get around her care home and to recognise the carers, but she very seldom remembers things that have happened to her, or conversations that she has had. Sometimes, though it can be surprising what they do remember.

    I found this to be a useful explanation of what happens
    http://www.cofeguildford.org.uk/ass...nt/Dementia/MEMORYSTORAGE BOOKSHELF MODEL.pdf
     
  8. Selinacroft

    Selinacroft Registered User

    Oct 10, 2015
    936
    Hi Canary
    Thanks so much for the link. I went to a St John Ambulance course on dementia and they showed this video. I tried to google it when I got home to send to my employer (care agency) but couldn't find it anywhere. Many Thanks
     
  9. Grumpy Gramps

    Grumpy Gramps Registered User

    Oct 30, 2012
    175
    West Yorkshire
    Well it looks like another visit to the GP. Just read something about urge incontinence which sounds like something I should by looking into. OH is very amiable and friendly all of the time. My only problem is that when we get to bed she in up and down constantly to the toilet for a wee. Gets back into bed then gets out immediately to go for a wee. This goes on from 9:00 pm ish until 3:00 am ish. She then sleeps soundly until dinner time when I have to wake her. Will keep you posted on results.


    Sent from my iPad using Talking Point
     

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