Module 4 Lesson 5. Daily routines At sundown Sometimes people with dementia become more agitated, aggressive or confused in the late afternoon or early evening. This is often referred to as ‘sundowning’. It can be particularly distressing for carers. The exact cause of sundowning is not yet clear but a loss of routine might be one of the reasons. Try to give the person something meaningful to do at this time of day. Let’s look at an example Shireen likes to go to a community centre every day from 12:00 until 15:00. She has lunch there and meets friends to play ludo together. At first Shireen walks there by herself but as her memory loss becomes more severe, she cannot find her way to the centre anymore. Asma asks another family member to take Shireen to the centre and bring her back home. This works well for a while but eventually, the family member is unable to take Shireen. Asma does not know what to do since she cannot be with Shireen every afternoon. Check your understandingMaintaining activities and interests outside the house. What suggestions do you have for Asma? Please select the correct answer from the responses below. Asma could tell her mother to do a quiet activity in the afternoons such as watching television or listening to the radio.Asma could ask other people outside the family to walk with Shireen to the community centre, such as a neighbour.Asma could ask another family member to help Shireen.Check Asma could tell her mother to do a quiet activity in the afternoons like watching television or listening to the radio. This is not likely to be a good solution at this time. It isolates Shireen from other people and doesn’t allow her to engage in the activities that she enjoys. It might be a better solution in the later stages of dementia, when Shireen’s abilities change. Asma could ask other people outside the family to walk with Shireen to the community center such as a neighbour. This is a good response. Family is not always available and sometimes other people don’t know how they can help. This is a concrete way that Asma could ask for help. Asma could ask another family member to help Shireen. This is a good idea. If others can come on a regular basis, this is the best solution for Shireen as it maintains her routine and adapts to Shireen’s changing abilities. Error: Please select at least one option.Please click ‘check’ to view the answers before continuing.Error: Please type your answers in the text box. Keep in Mind It is important to respect the daily routines of the person you care for and maintain them for as long as possible. When this is no longer possible, adapt the routine to the best of your ability so that the key activities that are important to the person with dementia are maintained for as long as possible.