The most common causes of wandering for loved ones with Alzheimer’s and other types of dementia (for which there are many) are as follows:
- Sundowning - Sundowning is when people with dementia feel more confused, anxious, or restless in the late afternoon or evening. Dementia is a disease that affects the brain and makes it hard to remember things, think clearly, and communicate with others.
- Unmanaged pain and anxiety. Since loved ones with dementia are unable to accurately articulate discomfort, sadly unmanaged pain and anxiety are quite common in loved ones with dementia.
- Incontinence - as Alzheimer’s and other types of dementia progress, the loved one with dementia will become incontinent of bladder and bowel; and feeling the urge to go or at least to be clean when one has gone in their bedding or clothing is a common feeling for those of us who want to be dignified.
What are the ways to address the above issues?
Sundowning can be hard for both the person with dementia and their caregiver. You may feel stressed, tired, or helpless. But remember, you are not alone. There are many resources and tips that can help you cope and provide the best care possible. Some of the tips are:
- Keep a routine: Having a regular schedule for meals, activities, and bedtime can help a person with dementia feel more secure and calm. Try to avoid changes or surprises that may confuse or upset them. Plan activities that they enjoy and can do safely, such as listening to music, reading, or gardening.
- Minimize stress: Try to create a peaceful and comfortable environment for the person with dementia. Reduce noise, clutter, and distractions that may overwhelm them. Use soft lighting, soothing colors, and familiar objects to make them feel at home. Speak slowly, clearly, and gently, and use simple words and gestures to communicate. Avoid arguing, criticizing, or correcting them, as this may make them feel angry or defensive.
- Encourage good hygiene: Helping a person with dementia maintain good hygiene can improve their physical and mental health. Assist them with bathing, dressing, and grooming, and respect their privacy and dignity. Choose clothes that are easy to put on and take off, such as those with elastic waistbands or Velcro fasteners. Use a shower chair or grab bars to prevent falls in the bathroom.
- Seek professional help: If the person's sundowning is severe or affects their quality of life, you may want to consult a doctor or a dementia specialist. They may be able to prescribe medication or other treatments that can help reduce sundowning or agitation. They may also refer you to other services or support groups that can help you and your loved one.
Sundowning is a common and challenging problem, but it can be managed with patience, compassion, and understanding. By following these tips, you can help the person with dementia feel more comfortable and relaxed and improve your relationship with them. Remember, you are doing a great job, and you deserve to take care of yourself too.
Unmanaged pain and anxiety involve understanding how to assess if your loved one is uncomfortable or anxious and properly treating the pain and/or anxiety; I’ve linked several articles below including the habitual restless article for which the sundowning information above is pulled.
Having a toileting schedule where you frequently check if your loved one with dementia is clean and making sure they are taken to the bathroom, especially before bedtime will help, and also learning how to recognize the common symptoms of urinary tract infections (which often results in frequent bathroom trips) can be helpful.
Dementia Care for loved ones who are habitually restless
Unmanaged Pain in Dementia Patients
Assessing pain in non-verbal patients
Understanding Discomfort: Distinguishing it from Pain While Caring for Your Terminally Ill Loved One
Managing Infections in the Geriatric Population
Detecting Infections in Terminally Ill Geriatric Patients with Dementia
Caring for a Loved One with Alzheimer’s Disease: A Guide from Onset to End-of-Life
Understanding Hospice Care: Is it Too Early to Start Hospice?