what to do?

[OT Lindsey Skelt]

Rodge, you are right. It is hard we seem to be on a constant learning curve, trying to find what works with our loved one, and the goal posts often shift. Thank you for mentioning 'Sundowning', it is a term that is used to describe the behaviour of those people both men and women who become increasingly confused, restless and maybe agitated towards the late afternoon and evening. It is a symptom, the cause is not fully understood but thoughts are it can be influenced by fatigue, the person tires at the end of the day so is less able to deal with stress; low lighting, increased shadows, common place objects may appear changed. The person may not be able to distinguish night from day, or even for some if they are involved in activities all day they grow restless if there is less to do in the evening. You mentioned good ideas to help manage the sundowning, in additon other things people have found helpful are; making the afternoon schedule less busy, trying to keep appointments and trips in the morning. Help the person use up extra energy by going for a walk if they tend to pace around the house. Try to provide some meaningful activity regularly throughout the day, for example setting the table, folding towels, pairing socks etc. But on the other hand do not over stimulate, so maybe reduce the noise from TV, radio and noisy family activities in the evening. Keeping rooms adequately lit may reduce confusion and for some a nightlight is reassuring.

As you rightly mentioned reassurance and comfort is important, letting them know you will remain there and avoiding arguments or asking for explanations. The confusion and restlessness can be because the person's brain can no longer sort out the cues in their environment especially if they are tired.