Welcome to my latest blog.
This month I’d like to talk about a syndrome which although commonplace in residential nursing homes, gets very little attention. It’s called ‘sundowning’ and I’ll return to it shortly.
Before I do so, just a quick recap on events at our lovely three homes. It’s very much been business as usual with our regular package of assistance, activities and entertainment. They say ‘March comes in like a lion and out like a lamb’ but this old ‘wives’ tale’ didn’t come to fruition this year. Quite the contrary, it has been largely quiet and unusually dry, though I dare say this might all change soon! So watch out for March going out like a lion instead!
Amongst other things we have celebrated St David’s day, always close to the hearts of our Welsh friends, and by the time this blog goes live I expect St Patrick’s day will be on the horizon too.
So,on to ‘sundowning’. Many of you I’m sure will be wondering what on earth this is. Dementia Uk sums it up as ‘a term used for changes in behaviour that occur in the evening, around dusk. Some people who have dementia experience a growing sense of agitation or anxiety.’
It is recognised now as a very real issue, although there is still some debate about what the causes are. In general terms, causes are a mixture of the efforts of the day, getting increasingly tired, the falling of the sun, changes in hormones and confusion over ones internal ‘body clock’. More research is being done on causes, and more is definitely needed. Putting cause to one side, I’d like to say a little more about my own experience of witnessing the syndrome, and how our own care homes deal with it.
In managing and supporting people with dementia, what is now referred to as the ‘sundown’ part of the day can be a very challenging time. We have seen evidence of this at first hand, with some residents finding it harder to relate to staff, and to each other. Some become agitated and ill at ease with themselves, for no other apparent reason. Mood disorders can become more extreme, side effects of prescribed drugs can worsen, and on some occasions, sensory impairment, such as additional problems with sight or hearing can occur.
All this can result in a more challenging set of behaviours, for the residents themselves, and for their professional carers. Some who experience sundowning can also lose their sense of ‘personal navigation’, become confused about the location of their rooms or other places within their home. In more extreme cases, some are prone to venture beyond what should be familiar surroundings, and out into unfamiliar territory.
Though additional vigilance and security protocols help stop this from happening in our own care homes, I have seen at first hand just how real this problem can be. One morning at around 4am, I was on my way to work when I came across an elderly gentleman who seemed very confused. He was dressed in a suit, but wearing slippers, and told me he was ‘on his way to the market.’ Realising he was in a confused and agitated state I took him with me to a warm and safe place, and tried to find out a little more about where he had just come from. It took a while, but eventually I found out, and managed to secure his return, via his family, to his residential home.
That experience has always made me doubly sure that we have measures in place which acknowledge the very real issues sundowning can pose for care professionals. For example, we have higher staffing levels in the evening to support people during these times. In fact, across our three homes we ensure that we support our residents by creating a care plan tailored to each individual – as a person’s experience of sundowning isn’t always the same.
For anyone involved in caring for others, they can find some helpful tips on both the Dementia UK and The Alzheimer’s Society websites. I just wanted to use this blog to draw people’s attention to it, in the hope it can help others. In fact, I’d encourage anyone who is professionally involved in caring for people with dementia to call for more research and resources on the sundowning syndrome.
All best for now, and catch up with you again soon.
Marta
