By Jane Verity ©dementiacareinternational.com
In many facilities at the day’s end, people with dementia may gather around the front door, rattling on the handle and pleading to go home. This behaviour can have many variations such as, ‘My babies are crying,’ or ‘My children and husband will be home soon and I have to cook dinner.’
Though little is known about Sundown Syndrome, many are quick to attribute it to being another anticipated symptom of dementia or Alzheimer’s disease where nothing can be done. If we shift our focus to the person with dementia, another simple and logical interpretation can be found. Just as creatures in the animal world return to their nests and burrows at the end of day, humans also seek out ‘home.’ If a person with dementia does not feel ‘at home’ in their environment, the natural urge to return to their sanctuary or place of nurturing will be very strong.
The urgency to return ‘home’ is a powerful emotion. For most people, regardless of dementia, home represents unconditional love, security, and a feeling of self-worth. In the absence of ‘home’, distress is a normal reaction to feeling displaced. (It must be noted, the urge to go home, in the very rarest of situations, could indicate a wish to die.)
Many unmet emotional needs can lie behind the desire to return ‘home’. These may include: to feel needed and useful, to be able to care, to love and be loved, to have one’s self esteem boosted, and to have the power to choose. If a person with dementia is not having these needs fulfilled in the present, they may go back into their memory and imagination to recreate a time when these needs were being met.
For a woman who has spent the larger part of her life preparing for the return of her family in the evening, the coming dusk heralds a period of intense activity. A lack of such purposeful tasks and a “home” environment will naturally result in her becoming restless and agitated.
At sunset, men are used to heading for home and returning to their families and ‘castle’. Logically, they are going to be unsettled if they are not experiencing a “home” environment where they live now, and they too will rattle on the door to get out or go home.
Creating the experience of ‘home’ does not mean providing colour-coordinated furnishings with chandeliers hanging from the ceilings and tablecloths on the tables. While these all count towards making a facility attractive, they do not make a home. The experience of home comes through the emotional qualities that home represents, such as love, appreciation, sanctuary, fun, and freedom.
For most people, late afternoon and early evening signify a time of activity and socialising, interacting with people who genuinely care them and their day. Accordingly, the solution to Sundown Syndrome is simple and even better, it works.
Spark of Life Sundown Solution
To solve ‘Sundown Syndrome’, create a warm and homely environment where people with dementia can have their emotional needs met. You can set up an ‘At Home’ Club specifically designed to provide emotional support and activity at the end of the day.
To set your club up for success, follow the same guidelines as for the Spark of Life Club Program*. The following are tips specific to the success of an ‘At Home’ Club.
‘At Home’ Club
- Start the club half-an-hour before restless behaviour usually sets in.
- Run the club throughout the entire evening until residents are ready to go to bed.
- Draw the curtains and use soft lighting.
- Play gentle music from a suitable era softly in the background.
- Create a beginning ritual where you might share a platter of fresh fruit.
- Read a story (Chicken Soup for the Soul by Jack L Canfield is very suitable) and encourage any thoughts and emotions to be shared.
- All together, set the table for the evening meal and dine together as a group. After the meal, do the dishes together. Remember to take these to the kitchen to go through the dishwasher before being put away. However, never let your residents see this as it will undermine their self-esteem.
- All together, with appropriate assistance, make a hot drink to each person’s special liking. Do the dishes together afterwards.
- Make time for another story or special song while waiting for other staff members to come in and invite each club member to bed, one at a time.
*Click here for detailed information on the Spark Of Life Club Program