Try: Check whether the cr appears to be too hot or cold on awakening internal thermostat may change with dementia provide adequate lighting during evening hours shadows glares or poor lighting may contribute to agitation and hallucinations provide nightlights or soft lighting while sleeping to cut down on confusion during night and to aid in finding bathroom make sure there is a clear well lit pathway to the bathroom practice the route during the day place a commode or hand held urinal next to bed if finding the bathroom is a problem make sure the cr goes to bathroom before going to bed try to change environment as little as possible have the cr spend less time in bed try getting the cr out of bed at an earlier hour of keep him her up later until they are tired many people require only six to eight hours of sleep per night make sure that the bed and bedroom are comfortable and familiar to the cr a favorite blanket or pillow or bed clothes may be helpful maintain a set bedtime and waking routine once a good routine is established continue bedtime rituals from the past e g a glass of milk before bed or music on radio at bedtime try bedrails they may help to remind some people that they are in bed for others however bedrails may be confusing and may lead to falls if the older adult tries to climb out of bed try to prevent daytime napping unless person seems very fatigued in evening hours then try a short rest or nap after lunch make sure the cr is getting adequate exercise try to take one or two vigorous walks a day cut down on caffeine coffee tea or soft drinks during day and eliminate any after 5 00pm make sure the cr is not hungry at bedtime try a light snack before bed some herbal teas may have a calming effect warm milk often helps promote sleep avoid bathing or other upsetting activities in late afternoon or evening unless warm baths relax the cr allow the cr to sleep on couch or in armchair if refusing to get into bed make the house or an area of the house safe for the older adult to wander in alone at night safety proofing a house for a safe night of wandering may include gating off stairs special locks or alarms on doors to outside blocking off kitchen or locking up dangerous items making sure windows are locked try a softly playing radio beside the bed hire a companion at night or work out shifts so that primary caregiver can get sleep gently remind the cr that it is dark out and time for sleeping consider allowing the cr to be up at night if this can be accomplished safely and without destroying the caregiver’s routine for sundowning agitation and wandering in the late afternoon evening try to distract put on music give the older adult something to hold feel or fiddle with; go for a walk; try a craft activity; turn on the television try closing blinds or curtains to shut out darkness turn lots of lights on to brighten atmosphere and combat shadows try to be rested for better coping at the most agitated time of day try to minimize noise confusion and the number of people around during the most agitated time of day try a rocking chair in nursing homes or adult foster care homes increase staffing volunteers or family visits at that time of day to permit more one-to-one attention try a breathing chair – they are soft comfortable and easily cleaned however older people may need assistance getting up be aware that shift changes are often noisy confusing times of day which can contribute to agitation

Materials: n/a

Categories: Behavior Challenging, Emotional Psychological, Medical Physical

Information: n/a

References: Mace nancy & rabins peter 1999 the 36-hour day baltimore the john’s hopkins university press robinson anne spencer beth & white laurie 1992 understanding difficult behaviors ypsilanti mi eastern michigan university

Keywords: Dementia sleep

*This information is listed as a Tip and is not explicitly medically licensed