Sundowning, Wandering, and Clothing Choices: Preventing Seasonal Catastrophes with Dementia.
Even though it doesn’t feel like it in the DMV, autumn is officially here. For most of us this means pumpkin flavored everything, boots, and admiring the fall foliage. For someone with dementia, the colder weather brings more complications such as: an increased risk of wandering, sundowning, and risk for hypothermia. Before we know it, there will be snow on the ground, so now is the time to start preparing. In this post, I will outline some of the changes that can be made to prevent major changes for someone with dementia.
Most of us have heard of it. Sundowning is a dementia-related symptom that refers to increased agitation, confusion and hyperactivity that begins in the late afternoon and builds throughout the evening. Now with the sun setting earlier there is an increased risk of sundowning. Here are some things to consider when addressing sundowning:
- Sundowning typically starts when the sun goes down as that impacts the circadian rhythm.
- The summer is great because we have more time to complete some appointments with the person with Dementia because we have more sunlight. However, the sun setting earlier also creates a glare from the sun while we are driving.
- Sunglasses can make it too dark, but without them it is too bright
- Plan activities and appointments earlier in the day, specifically in the morning
- Ensure that the person is well hydrated and well fed before the sun starts to set
- Remove excess stimuli and clutter
- Keep the person awake during the day by having stimulating activities
- During the afternoon hours as the sun starts to set, shift the activities to something more calm and relaxing (lavender essential oils in a diffuser are a natural remedy for creating a more calming environment)
- Ensure that the glare and harsh sunlight is minimized, close curtains if necessary, and keep the room well lit with artificial light. Especially before dusk.
- Be more patient during these hours. So prepare yourself if necessary by ensuring this is your most calm and relaxed time.
- A dementia expert can help assess the environment and make person-specific recommendations. www.TrovatoLLC.com
Inappropriate Clothing Choices
Clothing choices can be difficult for someone with dementia. Once a person with dementia dresses, it can be difficult to have them change I had a client who would walk outside in shorts, a t-shirt, and slippers when it was 40 degrees outside. For someone with dementia, their sense of temperature and their judgment and reasoning may change so shorts and a t-shirt may seem reasonable to them when it is 40 degrees outside. In order to prevent a potential battle to change clothes, here are some steps we can take:
- Remove clothing that is obviously for warmer weather such as shorts and sandals
- Begin introducing jackets, cardigans, and zip-ups into the wardrobe. You can suggest a jacket over a t-shirt.
- Create simple outfit options in the closet
- Declutter the closet and minimize distractions
- Use simple instructions for getting dressed. One instruction at a time.
- Choose clothing that is easy to remove and easy to put on
- A dementia expert can help choose clothing that is appropriate for the needs of the person with dementia.
Because of the increased risk of sundowning and the confusion and agitation that may come with it, wandering is a greater risk as well. Additionally, the cooler temperatures and risk of inappropriate dressing may result in hypothermia for those who do wander. While the suggestions listed for sundowning and clothing choices should be utilized, there are also some environmental changes that can be made to reduce the risk of wandering:
- Install door alarms- they should be a noise loud enough for you to hear as well as a noise that is not pleasant to the person with dementia. This way, they will close the door to stop the noise.
- A deadbolt may prevent wandering but be aware that it may also increase agitation
- Engage the person with dementia throughout the day and especially during sundowning hours. This way, they will sleep at night to prevent nighttime wandering.
- Utilize overnight care assistant (from friends, family, or a home care company) to monitor the person with dementia and reengage them if they begin to wander.
- Consult with a doctor for medications to encourage sleep at night if nighttime wandering is an issue.
While some of these suggestions are appropriate for all environments, some pertain to a home-environment. It is important to know when the home is no longer appropriate for a person with dementia. If you’re not sure, Trovato, LLC can help you determine that and explore other options.
By utilizing some of these suggestions, you can enjoy all things pumpkin flavored this autumn!