Tips for Reducing Sundowning
What Is Sundowning?
Sundowning is a symptom of Alzheimer’s disease and other forms of dementia. Confusion and agitation worsen in the late afternoon and evening, or as the sun goes down. Symptoms are less pronounced earlier in the day.
Sundowning most often affects people who have mid-stage and advanced dementia. The phenomenon of sundowning is also sometimes called “late-day confusion.” Reducing sundowning behavior can benefit both the person with dementia and the caregiver.
Stick to a Schedule
Dementia can make new routines difficult to put into place. Confusion and anger are common responses to the stress of encountering an unfamiliar place or food, for example. Stick to the same schedule every day to minimize sundowning symptoms.
Try to avoid making changes if a “tried and true” method of doing things works for your family. If altering your routine is necessary, try to change as little as possible at once. Stress and fear play large roles in sundowning.
Light Up the Night
Sundowning is thought to be related to changes in the body’s circadian rhythms, or the sleep-wake cycle. Keeping your home brightly lit in the afternoon and evening may help reduce the symptoms of sundowning syndrome.
According to studies published in Clinical Geriatrics, people who were exposed to more light late in the day showed less agitation. Light exposure helps your body recognize the difference between day and night.
Many people who suffer from sundowning syndrome have trouble sleeping. Elderly people who have dementia may not be very active during the day and may rest a lot. Daytime napping, confusion, and agitation can make it hard to settle down to sleep at night.
Fatigue is a common trigger for sundowning. Being well rested can help combat symptoms. Stay active during the day with activities geared to your level of physical and mental health to improve sleep quality and reduce sundowning symptoms.
Try to stay calm in the evening hours. Stick to simple activities that aren’t particularly challenging or frightening. Frustration and stress can add to confusion, delirium, and irritability in people who are affected by sundowning.
Put on soft music to create a calm and quiet environment. Watching television or reading a book may be too difficult for someone with dementia to follow.
Adjust Eating Patterns
You may be able to manage symptoms of sundowning by adjusting eating patterns and mealtimes. Large meals—especially those that contain caffeine and alcohol—can increase agitation and may keep you up at night. Enjoy these foods during lunch instead of dinner. Limit evening intake to a light snack that fills you up but won’t interfere with your rest.
Provide Comfort and Familiarity
Think back to the last time you were sick and wanted to surround yourself with comforting thoughts and objects. For someone with dementia, the world is suddenly a scary place. Comfort and familiarity are keys to helping your loved one through this difficult time.
Senior citizens who live with sundowning syndrome in a hospital or assisted living facility need comforting through the familiar objects of their everyday life. Bring cherished items such as blankets or family photos to the new facility to help ease the transition and curb symptoms.
Write It Down
Each person has different triggers for sundowning. As caretaker for someone in the earlier stages of dementia, you may not have figured out which triggers worsen your loved one’s behavior.
Keep a journal of activities, environment, and behavior to identify triggers. Once the triggers are known, it’s easier to avoid situations that promote agitation and confusion.
Caring for the Caretaker
Sundowning syndrome can be exhausting for the people who suffer from dementia as well as their caretakers. Caretakers need to take care of themselves too.
Ask your doctor or your loved one’s physician about respite care and support groups that will help you take time out for yourself occasionally. You’ll be in a better position to give your loved one the patience and support they need when you’re rested and healthy.
- Behavioral Changes: Coping With… Sundowning. (2013). Alzheimer’s Foundation of America. Retrieved August 7, 2013, from http://www.alzfdn.org/EducationandCare/sundowning.html
- Kim, P. et al. (2005, April). Sundowning Syndrome in the Older Patient. Clinical Geriatrics, 13(4), 32-36. Retrieved August 7, 2013, from http://www.clinicalgeriatrics.com/articles/Sundowning-Syndrome-Older-Patient
- Sleep Issues and Sundowning. (2013). Alzheimer's Association. Retrieved August 7, 2013, from http://www.alz.org/care/alzheimers-dementia-sleep-issues-sundowning.asp
- Sundowning: Late-day confusion. (2011, April 28). Mayo Clinic. Retrieved August 7, 2013, from http://www.mayoclinic.com/health/sundowning/HQ01463