As summer begins to draw to a close, the longer, sunnier days gradually give way to shorter ones, cooler temperatures and changing weather. While these seasonal changes can feel refreshing and familiar to many of us, autumn can be a particularly confusing time for people living with dementia.
Changes in daylight, temperature and daily routines can affect how a person with dementia experiences and understands the world around them. It is important that we understand these impacts, so that we can continue caring for our loved ones in the best way possible. So what are some of the ways dementia is affected by weather changes?
Seasonal Sundowning
As the day draws to a close, some people living with dementia may experience an increase in confusion, anxiety, restlessness or agitation. Sundowning or “sundowner’s syndrome” describes increased confusion and changes in behaviour during the late afternoon and evening, that is thought to affect 20% of people living with Alzheimer’s or other forms of dementia. We can seek to understand sundowning by understanding the personal triggers specific to that person.
While the exact cause is not fully understood, one possible explanation for sundowning is disruption to the body’s internal body clock, known as the circadian rhythm, which helps regulate sleep and wakefulness. The body relies on consistent environmental cues, such as sunlight and temperature, to regulate physiological processes. As the natural light fades and evening approaches, this disruption can make it more difficult for someone with dementia to distinguish between day and night. Other contributing factors include:
- Tiredness
- Hormonal changes towards the end of the day
- Poor sleep
- Medication side effects
- Overstimulation during the day, maybe from being in a busy environment
- Hunger
- Changes to routine
- Increased noise or activity in the environment
What Symptoms May Emerge?
Sundowning may cause a person with dementia to demonstrate mood swings. They May come to irritability, anger, or sudden sadness without a clear reason. Symptoms generally vary from person to person but also include:
confusion
Sundowning may cause someone with dementia to experience difficulty recognising familiar surroundings. They may believe they need to go to work, even though they are retired, or believe that they need to pick up their children from school, even if they’re adults.
Restlessness
During sundowning, a person with dementia may show behaviours such as fidgeting, plucking at their clothes or skin, becoming irritable, shouting or arguing. They may also pace around the home or follow a family member.
Hallucinations
A person with dementia may see thing that aren’t there, as a result of sundowning. This can be as little as seeing flashing lights, to seeing animals or people. It is important to note that what may appear to be a hallucination in a person with dementia may actually be the result of them misinterpreting something they have seen.
The transition into autumn can make some of these challenges more noticeable. As the days become shorter and colder, there may be less opportunity for outdoor activity and natural daylight, while familiar routines can also change. In addition, reduced physical activity and spending more time indoors may further affect sleep patterns and wellbeing. So what can be done to support this condition?
How To Manage Symptoms
Identify Patterns
Understanding what happens, when it happens and what may be causing it is an important first step in managing sundowning. Try to identify whether there is a pattern to the person’s symptoms and look for possible triggers; there is no right or wrong answer. Keeping a brief record of what happens before and during episodes can help you recognise patterns and understand what may be contributing to their symptoms.
Adapt the Environment
Creating a calm environment for that person goes a long way, as well. If children are in the home, encourage a calm and quiet environment in the evening, for example by using headphones when listening to music or playing computer games. An easily accessible dementia clock showing the day, date, time and time of day may also provide reassurance and help with orientation.
Affection and reassurance
Physical reassurance, such as holding their hand or sitting close and gently stroking their arm, can be comforting. In the confusion, a reminder that they’re safe and loved can help to settle their mood.
Exercise and physical activity
Keeping active during the day can help support a person’s body clock and improve sleep at night. Regular exercise and physical activity may also reduce daytime tiredness and evening restlessness, which can make sundowning more difficult to manage. Try to maintain a consistent daytime routine that includes activities the person enjoys, such as gardening, going for a walk or spending time with other people.
It’s not uncommon for dementia symptoms to change with the seasons. Small adjustments to routines and the home environment can make a meaningful difference for someone living with dementia. Most importantly, remember that every person with dementia is different, so taking the time to understand their individual needs, routines and triggers can help you provide the support and reassurance they need as autumn approaches.
Sundowning is a normal part of dementia and there are many other carers who share this experience. You may find joining a dementia support group, online or in person, helpful in reducing isolation and learning more. If you need extra support, dementia is also one of the many conditions we care for at SweetTree. Visit our home page or contact us to discover which of our services are suited to your needs or that of your loved one. You’re not in this alone.