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