Sundowning is what bothers my father-in-law often. The home care nurse always says it is sundowning. But his memory is deteriorating so it is getting worse. Not just sundowning. He does not know where he is sometimes. It is disorientation plus sundowning. I think he is getting worse slowly entering the severe stage and it is not just sundowning.
Nina
Dear Nina.
I am one of the authors (Barbara Manning then, not my married name now of Agarwal) on a few of those prominent articles you have probably read regarding your father's) sundowning. The more that the caregiver is able to control the circadian rhythm--keep the person fully awake in normal hours so that sleep (usually with some medication prescribed) occurs in "normal sleep hours" the bettter the delay of the disease progression somewhat. Because the caregiver is often "worn out" by the repetition or vocalization, allowing the pt to "nod off" or sleep in the day becomes easier for the caregiver. However, Nina, the end result is that the circadian rhythms become "way off" and the pt declines more quickly. I hope that you will consider becoming part of our Alzheimer's Association. I also highly recommend all articles and books by Ladislav Volicer, MD, still teaching at USF in Tampa.... If the pt becomes combative, you must consider the protection of not only the pt but all those in his immediate setting. I hope that you have advanced directives in place with your father's physician. My best to you as you cope with your father's disease.
Check out this article on the A Place for Mom website: http://alzheimers.aplaceformom.com/articles/sundowners-syndrome
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I have my own theories on this. Alzheimer's patients look at the world totally different, in that they mostly live in fear, even thought they may be in a caring and loving environment. Isn't everyone alittle afraid of the dark?
It is always important to make sure they have the most control over their life that they can. Ensuring that they can be an active participant in what they like, the type of room they sleep in, and what they wear to bed can make a big difference. Keeping the house lighted during the night will help as well.
Also, keep them on a routine, where they can anticipate what will happen so that they won't be as frustrated and afraid when the night time comes.
And above all, show them love and kindness. Make it a time they look forward to and the nights will be better for everyone involved.