March 25, 2023

Shadowing — My dear husband clung so close to me that I thought he might come between me and my shadow. And that’s exactly what this behavior is called—‘shadowing.’ It drove me nuts, I told him to go away, pushed him away, all but hid from him. At the computer, he’d be breathing down my neck; when I was in the bathroom he’d knock on the door, call to me. Maybe it should be called ‘smothering,’ because that’s what it does to the caregiver.

Alzheimer’s: Shadowing & sundowning…

Good grief, I thought, give me some space, some breathing room, but it wasn’t until I went for a doctor’s appointment one day and left him home alone that I began to understand. He was in a panic when I came back, terrified that I’d left him, and I knew I could never leave him alone again, he had to have me in his sight at all times; I was his tether to safety.

Long before I knew he had Alzheimer’s, I’d often see fear in his eyes. Why? He was a brave, strong man; he’d fight to the death for me and the children. True, we sometimes had difficult financial times, but it was more than that—we lived a safe ordinary life–it would be years before I’d learn that he knew he was losing his mind, that he had a brain disease neither one of us understood nor suspected.

The time comes when the Alzheimer’s individual realizes that he has no control, nothing makes sense, things are not where they should be, familiar people are strangers, he’s often lost–even in his own house. It’s has to be like tumbling in space, not knowing which way is up or where the earth is. So they cling to the one person who has been a constant in their life, the one they can trust to keep them safe and secure.

It will help if you speak frequent reassuring words: You are safe, I am here, I won’t let anything bad happen, I’m glad you are with me, everything is OK, I love you. Further, do not make changes in the home or daily routine; try to keep it all simple, familiar and calm. Eventually it stops.

Sundowning – If you’ve had a baby, you may have noticed that they often start to fuss about dinner time, the end of the day when everyone had had it. Same with Alzheimer’s. Obviously it could be fatigue; they spend so much of their time trying to fit in, to understand what is happening around them, it’s exhausting. Low lighting adds to their confusion, more shadows appear and sleep patterns are disrupted. Plan outdoor activities in the sunlight to encourage nighttime sleepiness. Lack of sunlight for anyone can cause people to feel depression during winter weather. Get as much sunlight as possible during the day and at night keep lots of bright lights on.

As night comes on, draw drapes so that reflections in the windows do not frighten them; keep a night light on in the bedroom and bathroom, limit caffeine and sugar to morning time; have dinner early and maybe a light bedtime snack; in an unfamiliar place, like a hospital, bring familiar items, a photo album, a small radio, their pillow, robe and slippers.

Often people have done the same thing at the same time for decades. Perhaps at 5:00 p.m., Mom has always started dinner. Now she’s forgotten what she has to do. She knows it’s important, people are depending on her, but she can’t remember what it is. Frustration and agitation set in, she’s worried, starts pacing. If it’s possible, let her help with dinner, or do something domestic to make her feel useful. With Dad, he could have closed his office every day for 30 years, put away the open files, locked his desk, the windows and doors, checked that the alarm was set. He’s all primed and ready to—to do what? You might give him some junk mail and ask him to open and sort it. Again, it can make him feel useful. When you understand why they exhibit these behaviors, you can think about what you can do to help them and help yourself at the same time.

I don’t remember sundowning problems with my husband, but I well recall being awakened at 3:00 or 4:00 in the morning to find that he was fully dressed and ready to go to work. Getting him all reversed and back into bed was a challenge. So it wasn’t at sundown, does it matter! No wonder caregivers are often sleep-deprived—and that’s never good for anyone.

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