Plan activities of the day so that there is less to do in the late afternoon
Always keep in mind that fatigue plays a major role in sundowning. Alzheimer's is often characterized by a downhill daily course from morning competence and cooperation to evening confusion and irascibility.
Schedule appointments and trips for the earlier part of the day
Plan the person's day so that less is expected at night. Consider controlling the number of people who visit in the evening hours or confining noisier family activities to another area of the house.
Control the person's diet
Reduce foods and beverages with caffeine (chocolate, coffee, tea and soda) or restrict them to the morning hours.
Help the person to use up extra energy through exercise
For the person who tends to pace or wander in the evening, you may want to arrange at least one or two brisk walks during the day.
Play quiet music in the late afternoon instead of loud television
Be sensitive to environmental factors that might confuse the person more at night.
Try to make the person feel secure and well protected
Keep orienting people confused by sundowning to where they are and what is happening. Do not ask what is bothering them; they probably don't know and can't tell you. Never restrain them unless absolutely necessary.
Do not argue with the person
This rule of thumb becomes more crucial with sundowning's intensifying behavioral problems.
Try quelling restlessness by interesting the person in some quiet activity.
Try whatever works to calm the person, from a favorite pastime to simply folding towels.
It's important to always keep in mind that people with Alzheimer's do not have control over their behavior, and that their annoying behavior stems from the inability of the brain to sort out a confusing environment.
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