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Night-Time Activities to Soothe an Agitated Senior with Dementia

by Martha Stettinius, Dementia Expert
July 05, 2013

Question: I have noticed that my mother who has been diagnosed with dementia, gets increasingly agitated at night. What kind of nighttime activities can help her relax?

Answer: Agitation is extremely common in the middle and late stages of dementia, especially in the evening (“sundowning”). However, if your mother’s agitation has gotten much worse all of a sudden, the first thing to do is make sure she does not have a medical condition, such as a urinary tract infection, dehydration, hunger (from not eating properly), constipation, or bronchitis, that can cause discomfort and a change in behavior. Medication interactions can also cause agitation. It’s very important to have your mother’s doctor complete a thorough exam, and to not allow her doctors or other caregivers to blame her agitated behavior on dementia. Often there is a real need underlying such behavior.

If your mother does not have a physical problem causing her agitation, it might be helpful to look at the environment. People with dementia prefer a calm and quiet atmosphere, a steady routine, and patient caregivers who talk to them in short sentences in a gentle voice. Break each task down into simple steps and give your mom time to complete each task before talking about the next task. Also, people with dementia are often quite tuned into the emotions of others, so remember that if the person caring for your mother is agitated or impatient late in the evening—as we all are from time to time—your mother may pick up on that and mirror those emotions. A person with dementia may also act agitated if they are physically uncomfortable where they are sitting, or if they are too hot or too cold. Sometimes, if you can’t figure out what the person needs, it’s helpful to try to “redirect” their attention to something that you know they will enjoy.

My mother, who had vascular dementia and probable Alzheimer’s disease, seemed to find classical music calming. I tried to make sure that the staff at her facilities seated her far away from the TV, which many people with dementia find too stimulating. Often, people with dementia find it soothing to have their hair combed, to be read to, or to be given a hand or arm massage with lotion. Mom loved to have my miniature Schnauzer on her lap.

When my mother was living with the middle stages of dementia, she began to stay up until 2 or 3 a.m., sleeping in until noon. Such restlessness late at night is common in the middle stages. In my mother’s case, she began to go to sleep at a normal time and rise for morning activities after she was started on a nightly dose of melatonin. Check with your doctor if you think that might be helpful for your mother.

For more guidance on how to deal with nighttime agitation, I highly recommend the article “Treatment of Dementia and Agitation:  A Guide for Families and Caregivers.”  I also recommend connecting with your local Office for the Aging to talk to other dementia caregivers in a support group. Caring for someone with dementia at home around the clock can be very stressful, and you will need plenty of support.

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Martha Stettinius was a “sandwich generation” caregiver for 8 years for her mother with dementia, and is the author of the book “Inside the Dementia Epidemic: A Daughter’s Memoir.” An editor with a master’s in English Education from Columbia University, she blogs for caregivers.com and serves as a volunteer representative for New York State for the Caregiver Action Network.

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