Alzheimer’s and Sundowning

Transcript of Interview: “Alzheimer’s and Sundowning”

Mike Barnes:

You know, it was about 10 years ago when my mom started showing some signs of Alzheimer’s. I guess you could say it got worse and worse and worse. Five years ago, my sister and I talked my parents into moving into independent living just to give my dad a little bit of help. Then this March, my mom moved into memory care. It’s been tough for the family, and I know Alzheimer’s isn’t easy for anyone at all.

Kim Barnes:

I’m so excited to introduce you to my friend Nancy Turco, who has been working in memory care communities for 15 years. She has so much experience interacting with people with Alzheimer’s and dementia and can really give us some insight into what they might be experiencing because I think it’s really hard for us to understand and know how we can best help them. So, thanks so much for being with us and sharing your wisdom.

Nancy Turco:

Thank you for having me.

Kim Barnes:

One of the terms that we hear a lot is sundowning. Let’s talk a little bit about what that is.

Nancy Turco:

Okay. Well, sundowning has been studied for about 60 years now, and it does have to do with the lighting and the time of day. One of the things I want to mention that helps is to have those daylight bulbs, those new kinds of bulbs, to put those in the corners because people with dementia get scared with shadows.

Kim Barnes:

Interesting.

Nancy Turco:

When they start to sundown, they get very nervous and fretful about wanting to go home and asking about their mother and father and things like that. So, closing the shades is important because people can see themselves in the television. It’s best to have the television on something non-threatening like Andy Griffith and certainly not the news.

Kim Barnes:

Right, right, right.

Nancy Turco:

The main thing to do is to have the lighting just right for them.

Mike Barnes:

I know my mom enjoyed having the TV on, having that noise, the sound, but she also gets fidgety at times. How do you deal with that?

Nancy Turco:

Having an activity in the afternoon helps. There have been a lot of studies about music and having music about a half hour before supper time is always good—something that they enjoy, not what a 30-year-old enjoys.

Kim Barnes:

Is sundowning just something that happens in their brain? Where does it come from?

Nancy Turco:

It does have to do with the rhythm of their bodies, especially if they haven’t had a good night’s sleep or if they’ve been overstimulated during the day, like visiting with family or going out shopping at too many different places. The idea is to limit those activities to the morning and also let them have a nap, but no more than half an hour, and that’s about a half hour before their typical sundowning starts.

Kim Barnes:

And sundowning can happen at different times; it’s not necessarily just at sundown, right?

Nancy Turco:

Yes, that’s correct. We’ve had people who start sundowning at about two o’clock in the afternoon, looking for their mother and wanting to go home. Then we’ve had others who are fine all day long until about five o’clock, and then they start looking for their babies, very stressed and frightful about that.

Mike Barnes:

I know a lot of people in our group are dealing with Alzheimer’s and trying to figure things out. Everyone has a different situation—not only with their parents but also some parents are in memory care, some are living at home with their kids, and some are living by themselves. Does it matter in that respect how you handle the different situations, especially with sundowning?

Nancy Turco:

Well, if you’re at home with your parent, try to make sure that the light is even enough in the mid-afternoon if no one is going to be there. It’s probably best to have the shades down in the afternoon and make sure they get some sunlight during the day, which is also very important wherever they’re living.

Mike Barnes:

I was just going to say, it’s kind of funny for us that my mom has always loved a schedule, but she really loves a schedule now where she’s looking at her clock or her phone that has the clock on it. Even though she’ll forget some things, she knows it’s noon, it’s time to eat, or it’s five, time to eat, or it’s three, and it’s time for something else. Does that play a factor also in sundowning as far as just being regulated and structured?

Nancy Turco:

It sure does. Having structure like that is very important. I’m glad your mom has that because most people who are in their own home or by themselves especially don’t have that structure, and that’s when things really go haywire with sundowning because they aren’t sure what they’re supposed to do next. It’s neat that your mom can still tell time because a lot of people cannot tell time.

Kim Barnes:

What advice would you have if your parent is still living with you? Obviously, in a memory care community, they know how to handle these things and can be on top of it, but if you are caring for your parent with Alzheimer’s, what advice would you give when you notice they are having these issues with sundowning? Besides keeping the drapes drawn and making sure there are no shadows, are there ways you should communicate with them?

Nancy Turco:

I think reassuring them that things are going to be okay and having them help with simple activities, like folding towels, rearranging a drawer, or sorting laundry, even if it’s laundry from the other day that’s already been washed. We’ve had people say, “Gee, again? I just folded these yesterday, and here they are back again.” But they are willing to help. Rolling yarn is very good—it sounds very simple, but it’s not all that simple sometimes, trying to get it into a ball and telling them that this is for the kids, doing crafts and things like that, and telling them you’re getting it ready for a preschool. That way, it saves their dignity. It’s not anything babyish. I remember one time doing books for the ESL kids at one of the elementary schools, and our residents really enjoyed that. They made up simple sentences, and then I typed them up, and they cut out pictures. There was a real sense of importance. I think that is key for people, especially during sundowning—that they are needed, there’s nothing to worry about, that they’re safe, and they are home, as comfortable as home is.

Mike Barnes:

Yeah, my mom’s over 80, and she’s done laundry for more than 70 years. Yet she was visiting my sister just for an afternoon—my mom and dad were there before she moved to memory care—and my sister was doing some laundry, and my mom just started helping. She had this sense of accomplishment and felt better. My sister was like, “Mom, you don’t have to help with this,” but my mom wanted to, and you could tell it also made her feel better.

Nancy Turco:

Right. A key to that is we’ve had families where I’ll say, “Have them empty the dishwasher or fill the dishwasher, clear the table,” and so many times they mean well, but a family member will say, “Oh, she does it all wrong.” Well, then do it again after she goes to bed.

Mike Barnes:

Exactly.

Nancy Turco:

It’s that dignity factor and them knowing that they are being helpful. It’s the process and not the end result of what they’re doing, and that’s very important to remember when you’re working with someone with dementia.

Kim Barnes:

Such good advice.

Mike Barnes:

Nancy, thank you so much. We’re going to have you back to talk some more because there is so much to talk about with Alzheimer’s. Thank you so much.

Nancy Turco:

Thank you.

Mike Barnes:

Thank you. I’ll tell you what, the hardest thing with Alzheimer’s is that everyone is a little bit different depending on their situation and what their memory problems are—if it’s short-term, if it’s long-term, if it’s both. Then there’s the environment they’re in—if they’re still living by themselves, if they’re living with their kids, if they’re living in independent living, assisted living, or memory care. There are just so many factors. I know that’s the hardest thing for us with my mom, and it’s hard for everybody. So, there are so many things that we’re still going to talk about with Alzheimer’s. Be patient because there’s a lot more to come.

Kim Barnes:

All right. Well, thanks. So many things to be able to address, and if you have suggestions or ideas of specific things that you’d like us to cover, just let us know.

*This transcript is auto-generated. Please excuse any typos or mistakes.