Robyn Taylor, one of our regular activity coordinator columnists, talks about how to manage the often tricky and troubling sundown hour, when residents can feel at their most vulnerable and uncertain.
Sundown hour is the time of day where the daytime leads to nighttime, often causing a person with dementia to feel disorientated – as the change in light means their mind can’t determine whether it is time for bed or a new day. This period of the day can result in residents feeling and acting out of character. As the light gets gloomier, they are tired from a long day and have less energy or things to distract them during the evening.
Certain behaviours can occur during this spell which are unsettling for the resident and can also be strenuous on the carers. Residents might become aggressive and demanding, hallucinating or having delusions. Many residents tend to pace around the hallways and rooms, repeatedly asking to go home or asking for their husband/wife. It is harder to communicate with residents during sundown time as they struggle to understand you, and start reacting on impulse. Residents also struggle to do certain tasks which they can easily achieve in the daytime.
This is a well-known condition that affects people with dementia, but is there anything we can do to ease this transition? We can certainly try!
After the residents have enjoyed the evening meal, the majority of the care staff will be cleaning up, writing care plans and supporting the residents to get prepared for bed. So, there may not be as much stimulation as there would be in the day when all other departments are pottering around creating a buzzing atmosphere. Many homes now have activity coordinators delivering activities in the evening, or have a designated staff member to keep the residents engaged during this time. If you do, this is a wonderful help with the sundown period.
- Movie night: Close the curtains, dim the lights, offer around a cup of Horlicks and get everyone in pyjamas. Some residents don’t have the attention span to watch a full movie, so think about films which have songs to sing along to. Or play movie clips and reminisce about favourite films.
- Pamper evening: Relaxing music in the background, mood lighting and lava lamps. Scented sticks and perfumes. Painting nails and giving hand and foot massages.
- Hold a reminiscence session: Get photographs of friends, family and familiar places. This provides comfort and familiarity.
- Pet therapy: Do carers or staff have a dog or a rabbit they could bring in for an hour around this time?
- Evening concert: Sing along to some Frank Sinatra, Louis Armstrong, Billie Holiday.
- Book club: Pick something memorable and easy to read, with big print and a clear story.
- Taking a resident with you to make sure the doors are locked in the evening.
- Washing up after dinner.
- Closing all the curtains.
- Tidying up.
- Watching TV in bed with a hot drink.
- Sitting next to a carer while writing care plans, while the resident copies a story from a book.
There are also lots of things out there which can make life a little bit calmer for those who may need extra reassurance.
- A day and night clock, which indicates the time as well as the period of day.
- Memory boxes with photographs and fond items which provide comfort.
- Life story books to read when residents are not at ease. (Always remember to put back in the care plan.)
- Research into the residents routines. Did they used to go for an evening walk? Watch Coronation Street every evening? Put on a face mask and listen to Mozart? Whatever they did before being diagnosed with dementia, fit it into their daily routine.
It is important for staff to stay calm and caring during the sundowning occurrence. You may feel exhausted after a long and tireless day, however the residents need your comfort and reassurance in a kind manner. Remember our residents do not live in our work place, we work in their home!