- Affect memory, problem solving, and overall function.
- Increase the risk of falls and fractures.
- Contribute to depression, irritability, and aggression.
People with dementia can also become confused, restless, or agitated late in the afternoon or early evening. This
late day behaviour change is sometimes called sundowning. Late day restlessness can cause behaviour changes
such as:
- Increased aggression
- Trouble understanding
others - More impulsive behaviour
- Changes in language abilities
If you have noticed any of these symptoms, you may be wondering:
What Causes Sleep Disturbances and Late Day Restlessness?
The causes of sleep disturbances and late day restlessness can be very similar. Trouble sleeping can contribute to exhaustion which makes restlessness worse. Symptoms may be due to:
- Physical or medical causes. Sleep changes can occur because of mental and physical exhaustion, illness, or hunger. Pain, depression, sleep apnea, and side effects of medicine can change the sleep cycle.
- Environmental causes. Room temperature and poor lighting can lead to restlessness. Boredom and anxiety can lead to restlessness too.
- Other causes. Going to bed too early, sleeping too much during the day, and lack of exercise can all affect sleep. Caffeine or alcohol can affect sleep too.
How Can I Help In The Moment?
If the person is awake during the night:
- Find out if there is something they need.
- Gently remind them of the time.
- Don’t use physical restraint. Supervise the person if they want to pace.
- Try offering alternatives like sleeping in a recliner chair.
If the person is experiencing late day restlessness:
- Ask if they are having discomfort such as hunger or pain.
- If restless, offer to take them for a walk.
- Use distraction techniques like asking for their help with a task.
- Make sure there is adequate lighting and try playing soft music.
Learn more about restlessness, types of dementia, and strategies
Here.
How Can I Help Prevent Future Symptoms?
Every person living with dementia is different. Prevention strategies often require trial and error. For some
people, the following strategies can help reduce late day restlessness and sleep problems:
- Arrange for a medical check-up. Ask the doctor about physical symptoms and the side effects of medicines.
- Assess the environment.
- Limit stimulating activities in the evening hours.
- Keep the home well-lit in the evening to reduce scary shadows.
- Maintain a bedtime routine, including calming music.
- Monitor food and drink habits.
- Cut down on caffeine and sweets during the day.
- If you think the person is hungry at night, try a light snack just before bed.
- Have a large meal at lunch and keep the evening meal simple.
- Keep a commode beside the bed if trips to the bathroom are frequent and disorienting for the person.
- Create daily routines.
- Plan more active days.
- Try to schedule appointments, challenging or upsetting activities in the morning.
- Use the A-B-C approach to tailor strategies to your unique situation.
More Information and Resources
- Sign up for Dementia Society programs and activities.
- For more information about behavioural and psychological symptoms, watch the Dementia Society’s Dementia Basics webinar series.
- For more information on support strategies and approaches, sign up for Supporting Dementia or one of the Dementia Society’s other education sessions.
- Learn about behaviour changes from American dementia specialist Teepa Snow’s video.
- Connect with others facing similar situations by registering for one of the Dementia Society’s caregiver support groups that suits you best.
- Talk to one of the Dementia Society’s dementia care coaches about your unique caregiving situation.
Ottawa: 613-523-4004 | info@dsorc.org | DementiaHelp.ca
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