Autumn is a season that many people cherish once they start seeing the leaves start to fall and the air turning crisp. However, for older adults it is important for them to be aware of the seasonal challenges that also come with the change in season. For instance, cold and flu season is just getting started, and there are other cold-weather threats to a senior’s health and safety that can be minimized by following a few basic guidelines. This is especially important if you or your loved one has cognitive challenges that make it difficult to comprehend, remember, or adapt to changes in routine. If you are a caregiver of someone with Alzheimer’s disease, you may additionally be concerned about sundowning and how it impacts your loved one in this new season.
As noted above, another area of concern is sundowning which is a common symptom of Alzheimer’s and other forms of dementia. Sundowning involves an increase in symptoms of agitation and confusion, which occur during the early evening hours or late afternoon hours. The time span between sunset and twilight can be particularly disturbing for people with Alzheimer’s and sundowning. Here are some of the symptoms that are common:
· Agitation
· Confusion
· Disorientation
· Hallucinations
· Pacing back and forth
· Paranoia
· Restlessness
· Shadowing
· Wandering
If you notice a worsening of behavioral symptoms starting in the late afternoon hours, it can be a clue that sundowning may be starting. Fading light seems to be a trigger for sundowning and symptoms get worse as the night goes on. The symptoms usually begin to improve by morning. Sundowning can put a lot of stress on caregivers, as well as anyone who spends the evening or nighttime hours with a person who has Alzheimer’s. The goal is to help the loved one who is experiencing sundowning to maintain a sense of calmness and help them stay oriented to place and time. You should always inform your medical treatment team if the individual is experiencing new symptoms that they had not previously been displaying. These changes may be reflective of sundowning, but the medical professionals on your treatment team can also help rule out other causes of seasonal sundowning, like medication side effects, pain, urinary tract infections (UTIs), or vitamin deficiencies, which can be common causes of symptoms that mimic sundowning.
Ways to Manage Seasonal Sundowning
Alzheimers.net put together some good “steps that you can take to help manage seasonal sundowning symptoms. Some measures that have been known to lessen the symptoms of sundowning include:
1. Adhere to a regular schedule.
A person with Alzheimer’s is prone to react to unfamiliar places, people and things. Sticking to a routine and involving the same time for a daily ritual in the same location will help a person who is reacting negatively to stress with confusion and anger. Avoid making changes if at all possible, but if you must change the daily schedule, try to change things gradually, instead of all at once.
2. Adjust an eating schedule.
Avoiding large meals late in the evening can lessen symptoms of sundowning. Be sure to avoid giving a person with Alzheimer’s alcohol and caffeine particularly late in the day. Plan for the biggest meal as early in the day as possible and offer a light snack in place of a large meal as the day becomes later.
3. Administer medicine.
Administer a parent or senior loved one’s medicine as prescribed by their healthcare provider. Some doctors may recommend trying a natural supplement, such as melatonin for sleep, but never give a person with dementia any type of supplement without first consulting with the prescribing physician.
4. Encourage activity.
Keeping a person with Alzheimer’s active during the daytime hours — by taking walks, working in the garden etc. — will help improve the sleep quality at night, while helping to reduce seasonal sundowning symptoms.
5. Keep track of causative factors.
No two people with Alzheimer’s are exactly alike and what frustrates one person may not bother another. Identify factors that contribute to agitation, confusion and other symptoms of seasonal sundowning, then keep a record of triggers to share with all other caregivers.
6. Minimizing stress levels.
Avoid giving a person with Alzheimer’s complicated things to do that could cause frustration, particularly later in the day. Frustration can add to the symptoms of seasonal sundowning. Keep in mind that even things that are not considered very complicated, such as reading or watching television, may be too difficult for a person with late-stage dementia. Keep the environment as calm and quiet as possible.
7. Using full-spectrum fluorescent lights.
A recent study found that light therapy can lower agitation and confusion in those with dementia. Healthline recommends using full-spectrum fluorescent lighting for a couple of hours each day and the Alzheimer’s Association suggests brightening the lights when a person with Alzheimer’s feels agitated or confused."
In addition, here are three other tips for older adults to follow to stay healthy and safe during the colder seasons.
1. Get the flu vaccine. The Centers for Disease Control (CDC) recommends that adults aged 65 and older get a flu vaccine each year, ideally by the end of October. Seniors are especially at risk for complications from the flu, such as pneumonia, bronchitis and ear infections. In addition, the flu can also make many chronic health problems worse.
2. Be aware of tripping hazards. People generally experience stiffer joints in colder weather. Not only might it be a bit harder to move around, but it gets dark out early, the ground is often wet or frozen, and fallen leaves create slipping hazards or even cover up hazardous rocks that you can trip on. Head injuries from falls may also create cognitive difficulties or exacerbate already present cognitive challenges. Be mindful of tripping hazards and make a plan to keep pathways cleared and clean to reduce your risk of sustaining a head injury.
3. Stay warm and dress appropriately outside. As people get older there is an increased risk of suffering hypothermia. Hypothermia can be a life-threatening condition that occurs when an individual’s body temperature drops below normal and remains low for a period of time. Being over the age of 60, having health conditions like diabetes or hypothyroidism, and taking certain medications all make you more susceptible to the cold. Therefore it is important to be mindful about your clothing when going outside. Check the temperature (on your smartphone, on the internet, or on tv) before leaving the house. Dress in layered, loose-fitting clothing and wear warmer garments when going outside.