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Sundowning

What is Sundowning?

Dementia is a general term for any condition encompassing memory loss, mental confusion, mood changes and other cognitive impairment issues that increasingly have a detrimental effect upon the ability of the person living with the condition to maintain a normal daily life. Within the scope of dementia, Alzheimer’s disease accounts for possibly up to 80 percent of all dementia cases.

Every person and every case is unique, but some symptoms will be common across many people living with the condition, and one of them is known as Sundowners Syndrome, or Sundowning.

Sundowning is the term given for a situation where a person living with Alzheimer’s disease may start to experience a worsening of symptoms as the day begins to draw to a close and nightfall approaches. At present, there is no definitive explanation as to why Sundowning occurs, but it is believed that it affects something like 20% of all Alzheimer’s patients.

The progress of Sundowners Snydrome often appears to be in step with the progression of the Alzheimer’s disease itself. As the dementia worsens, so often does the recurrence and severity of the sundowning.

There is still a degree of mystery and uncertainty as to what exactly causes sundowning; there are a number of scientific and medical theories as to what may cause the phenomenon, and there are also believed to be certain “triggers,’ which can either cause or exacerbate it, but it is certainly something that Caregivers should be aware of and ready to try and manage, as far as possible.

The leading theory is that, as the condition of the Alzheimer’s patient worsens, the disease causes neuro-chemical changes in the brain that start to affect the internal biological “clock” of the patient; this can interfere with the part of the brain that would normally signal to a healthy person that it is time to wake up or go to sleep.

When someone experiences sundowning, it does not create any new symptoms, but rather it tends to exacerbate certain of the existing symptoms that the person has already been experiencing, particularly symptoms that adversely affect behavioral characteristics, rendering the person increasingly agitated, irritated, reckless and more and more difficult to manage.

Caregivers have reported that some people experiencing sundowning can become increasingly angry, irritated, anxious, agitated, paranoid and depressed; some even can become violent, hallucinatory, or overly emotional or upset and unable to sleep. Sleep deprivation itself can then contribute to a vicious cycle that can trigger further sundowning episodes.

Sundowning can start to occur from late afternoon and continue until late at night, and this can be especially challenging for a caregiver who may be already exhausted. It then tends to fade and the patient will return to a more normal state.

Sundowning can also potentially be triggered by certain situations or circumstances, and these could include:

Fluctuations in light levels – both low light and too much light have been found to be a trigger
Depression
Boredom
Lack of sleep
Hunger
Pain
Raised stress levels
Social isolation
Infection, such as a urinary tract infection

There is no cure yet for Alzheimer’s disease and, as sundowning is a known symptom that may manifest itself as the disease progresses, there is nothing that can be done to eliminate the phenomenon. All a caregiver can do is be aware of the potential triggers and avoid them as far as possible, and to be ready to deploy strategies that have in some cases been seen to help manage the symptoms. These would include:

  1. Try to remain patient and calm

This is perhaps the most difficult of all things to implement, as dementia patients can often be extremely difficult to manage. In such circumstances, patience can be extremely elusive, but a raised voice, or sudden movement or changes in circumstances can worsen the situation

  1. Are there any immediate needs that can be met?

As mentioned above, feelings of hunger, thirst, lack of sleep, or pain, can potentially trigger a sundowning episode.

  1. Create a peaceful and tranquil setting as the day moves into the afternoon

Perhaps consider drawing the curtains early – this will reduce any lowering of light levels in the room as the outside light fades, as this has been noted as a potential sundowning trigger. A tranquil environment, with no distractions also can help, as will reducing noise, or the number of people in the room.

  1. Try to keep the patient active during the day

If possible, try to engage the person you are caring for with activities that will occupy their attention. One of the challenges in caring for someone with dementia is that they are often likely to nap during the day; this makes it harder for them to sleep at night. Board games, puzzles, craft exercises, even watching a favorite movie or TV show can all help. A Mind to Care was born from a desire to make simple games and activities available to carers seeking to engage and retain the attention of people in their care – many studies have confirmed that activities that engage the mind can significantly increase general well being. Regular physical exercise can also help.

  1. Diet

Pay close attention to diet. Try to avoid caffeine or high sugar intake, particularly in the afternoon and strive where possible to maintain a good nutritional diet. Avoid alcohol.

  1. Stay Secure

One adverse effect of sundowning is that the patient may become prone to getting up at night, and pacing the room, or trying to leave the home. It may be wise to fit locks on doors and windows, and perhaps a gate to prevent access to stairs, to avoid an accident or the patient wandering away and getting lost.

  1. Get some air

A brief walk or a short sit outside can be beneficial, as it is believed that exposure to daylight can help the body to reset its internal clock.

There are many online resources providing advice and support on this and other issues facing caregivers; if you need help finding advice, let us know and we will steer you in the right direction.

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Benefits of Activities: Benefits for Caregivers

It is the hope of most folks to be in their own home for as long as possible. Home caregivers (usually family members) make this possible longer for people who suffer from dementia or other neurological or physiological conditions by helping their loved ones adapt to and cope with limitations in ability, mobility, communication and cognition.

The caregiver is constantly working to stabilize or lessen the progression of disorders with exercise, nutrition, activity, hygiene and generally some mix of medicinal schedules. It can be a very hard and often heartbreaking job, yet so many take it on as a labor of love.

Studies have shown that “the health and general well-being” of a family caregiver can have a direct impact on the quality of life and success of therapy for dementia patients in their care.

Additionally, research indicates that dementia patients have higher rates of behavioral symptoms and mortality when cared for by carers who are stressed, use emotion-based coping (e.g., wishing that the disease would go away), or negative communication strategies.

Finding an effective coping mechanism for both the patient and the caregiver are important for all involved, as everyone’s health and well-being are inter-connected and inter-dependent.
Happily, there are many resources for the family caregiver to call on to help with the daunting and difficult task of providing home care for their loved one. Understanding the changing needs and communication strategies of their charges is an important factor in successfully managing a home care situation.

One such sources was provided by the Lewy Body Dementia association, found online here (http://www.lbda.org/content/understanding-behavioral-changes-dementia), the document helps to set expectations about caring for people with dementia, and also offers a helpful section titled “Care for the Caregiver” that includes common sense suggestions for maintaining personal equilibrium in the face of such demanding and difficult work.

Many other sources for information and helpful resources for the caregiver can be found online, with many different organizations providing helpful resources for home caregiving needs.
If you need help with finding and connecting with useful resources, drop us an email at customerservice@amindtocare.com and we’ll be happy to pass on any information we have available.

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Dementia and Excessive Sleepiness

Excessive daytime sleepiness can be a problem for many folks, especially the senior population. This condition is often related to inadequate or fragmented night-time sleep and can be a resulting condition of a number of other related conditions, including Alzheimer’s disease and a number of other dementias.


Here are some non-drug treatments tips to help your loved one stay active throughout the day so they and you get a full sleep at night, hopefully without interruption:
• Participate in activities that may be helpful in providing stimulation to prevent daytime dozing.
• Get physical exercise appropriate to your level of functioning, which may also promote daytime wakefulness.
• Avoid sedentary activities during the day.
• Establish good sleep hygiene, including a set bedtime and wake-up time.

Of course, treating the issues preventing adequate nighttime sleep will go a long way toward alleviating the issue of excessive daytime sleepiness. In addition to and parallel to that treatment, the tips listed above may help mitigate the issue, even if there is also a pharmacological element involved as medicine prescribed for other conditions may contribute to sleep disruption issues.


In addition to the non-drug treatment tips offered by the National Parkinson Foundation, the Alzheimer’s Association also suggests other ways to improve sleep routines such as discouraging intake of alcohol, caffeine, nicotine, and other stimulants in the hours before bedtime and limiting television viewing during periods of wakefulness during regular sleeping hours.


Daytime napping and “sundowning” can be serious issues for those with dementia. As sleep and the quality of rest obtained can have a large impact on both physical health and quality of life, sleep issues can have a large impact on every aspect of an individual’s life.


In addition to careful consultation with your doctor concerning sleep disruptions and other medical issues and drug interactions, there are a number of non-medicinal approaches to improving sleep habits and minimizing sleep disrupting conditions. Among the recommendations of many sources offering suggestions for better sleep habits is the discouragement of daytime napping and the encouragement of participating in more activities during the day.

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New Patented Dementia Activity Therapy System Launched in California

A Mind to Care LLC, a father and daughter run business based in Redondo Beach, California, is delighted to announce the launch of a unique, patented, Activity & Game Therapy System, designed to assist people living with Dementia, Alzheimer’s, Parkinson’s, Stroke, ALS and other cognitive impairment conditions, and the Caregivers who care for them.

The Activity Therapy system was originally designed by Scott Silknitter, who saw at first hand the struggles that his mother went through as she cared for his father, who was diagnosed with early onset Parkinson’s disease.

The system is modular, consisting of a Console, hand-crafted from beautiful Baltic Birch wood, into which can be inserted a variety of different Game Boards and Dry Erase boards, offering a variety of activities including Peg Tic Tac Toe, a colored pegs sorting game, a dice game, jigsaw puzzles, craft boards, re-usable dry erase coloring boards, together with boards designed to hold playing cards, and a Feelings board, to help communicate how the User feels at any given time.

The system can be purchased either as an off the shelf kit, tailored to an individual Carer, or for an Assisted Living Facility or, alternatively, individual items can be selected from the A Mind to Care website and purchased independently, or as part of a custom kit to suit specific requirements.

Full details, along with demonstration videos, can be found here at the A Mind to Care website.

Our Mission is to help as many people as we can by improving quality of life through entertainment and activity.

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Benefits of Activities for Seniors: Social Interactions

Why is social interaction important for seniors? Humans are social creatures, and social interactions are important for all humans for a number of very important, very basic reasons.

Human society is based on our shared interactions: the coffee you drink in the morning, the clothes you wear, the car you drive, the book you are reading, the device you are reading it on – all were likely fashioned by a group of people, many of whom you may have never met, but with whom you have interacted – by the very process of buying, using and enjoying the fruits of their labor. No longer isolated hermits in caves, modern humans now depend on many interactions with other humans, directly or indirectly, to meet their daily wants and needs.

Studies have shown a positive correlation between social interaction and well-being, with research suggesting that a greater frequency of social interaction, and a greater variety of social interaction, especially when coupled with physical or mental activities, has a very positive effect on both mental and physical well-being.

Social interaction can become more difficult for those with impaired mental or mobile abilities. When you are having difficulty hearing a conversation, it is harder to participate in that conversation. If you have trouble finding or forming the right words, it is harder to participate in a conversation. The importance of social interaction becomes magnified when it becomes more difficult or infrequent. Opportunities for social interaction are naturally reduced when social activity declines. As the quantity of overall social interaction declines, the quality of the social interaction that does occur becomes more important.

Those who suffer from cognitive or mobility issues sometimes begin to withdraw from social interactions in reaction to their reduced capabilities. But, attention by the caregiver to the quality and quantity of the social interactions of the senior can make a significant impact in counteracting this tendency.

The A Mind to Care Activity Therapy System is a unique, patented, no-batteries-required game and activity system, designed to allow seniors to continue to enjoy the games and activities they used to.

Whether the activities are for those with Alzheimer’s, Parkinson’s, stroke or any number of conditions resulting in physical or cognitive impairment, the Activity System was designed to allow people with impaired ability to engage in activities and games more easily – enhancing the well-being of both the subject and the caregiver.

– Scott Silknitter