Sundowners Leisure Activities

For the Alzheimer patient and caregiver the hard work begins as the day ends. The Alzheimer's Association suggests as many as 20 percent of all patients suffering Alzheimer's disease will experience symptoms of sundowners syndrome. These sleep disturbances, coupled with caregiver exhaustion, may eventually lead to nursing home placement. Implementing effective sundowners leisure activities may increase the amount of time an elderly person can stay in their own homes.

Sundowning

• Scientists have not yet discovered how or why this behavior occurs but experts have noted certain factors influence the onset or severity of the behavior known as "sundowning." Mental or physical exhaustion, poor lighting, a disruption in the patient's internal body clock, disorientation and a naturally occurring reduced need for sleep contribute to increased agitation and confusion during the evening hours. Create leisure activities specifically designed to address these factors to provide a more restful night for your patients and for the caregiver.

Walking

• Walking or other physical activity is vital to a good night's sleep, especially for the patient battling sundowners. Physical activity will reduce restlessness. Depending on your patient's personal schedule, plan physical activity in the early afternoon to give her time to unwind before the sun goes down. It will also give her maximum exposure to the bright light of sunshine if she is ambulatory enough to walk outside. Duration and level of activity will largely depend on the patient's abilities.

Naps

• Take care when scheduling naps. While exhaustion leads to sundowning symptoms, your patient may find it hard to sleep at night if he takes an afternoon nap. Sundowning is often a response to a corrupt internal body clock and scheduling regular sleep patterns may be difficult, if not impossible. Try implementing rest periods, where your patient simply sits or lies quietly instead of falling fully asleep.

Music

• The National Institute on Aging suggests calming or familiar music in the afternoon and evenings. Allow the patient to choose the music, and invite her to sing along. Singing favorite songs provides double benefit in that it stimulates the brain and has a calming effect.

Movies

• Start a favorite movie in late afternoon, just before agitation typically sets in. Close the curtains to block out the setting sun, turn on bright lights to reduce shadows and turn off all other radios, televisions or music players. The 90 minutes in the typical movie may be enough to carry your patient through his most difficult time of sundowners.

Timing

• Note the time of day agitation begins and time leisure activities accordingly. The Mayo Clinic suggests that staff members leaving at shift changes may trigger symptoms in Alzheimer's patients in nursing homes. Caregivers should plan activities during this time to make shift change less traumatic. Perform bathing and serve family meals early in the day so these hectic events do not occur in the late afternoon or evening.