How to Minimize Sundowner’s Syndrome

April 30, 2021 | BY PHS Staff

If you have a loved one who suffers from dementia, you may have heard the term “sundowning,” which refers to a state of confusion typically occurring in the late afternoon and evening. This period of agitation can spur many behaviors, such as anxiety, aggression, confusion, ignoring directions, pacing and wandering, according to the Mayo Clinic.

Sundowning is not a disease; rather, it’s a group of symptoms that happen at a certain time of the day, impacting people who have forms of dementia, such as Alzheimer’s disease. While the cause is not known, there is one common theory: many medical professionals believe that it’s the culmination of sensory stimulation the person is exposed to over the course of the day, building up and becoming overwhelming and stressful. This may be what causes Alzheimer’s patients to act out.

There are many factors that can aggravate this confused state, from fatigue and increased shadows to disruption to the body’s internal clock and the presence of urinary tract infections. Fortunately, Alzheimer’s in home care can help you through it.

In addition to the above, you may witness these other behavior changes in your loved one:

  • Anger
  • Emotional outbursts
  • Delusions
  • Fear
  • Depression
  • Stubbornness
  • Rocking
  • Restlessness
  • Visual/auditory hallucinations
  • Tendency to hide things
  • Paranoia
  • Violence
  • Crying
  • Insomnia
  • Yelling

Sundowner’s syndrome may start in the afternoon but can last well into the night, leading to sleep deprivation, which often worsens symptoms, points out AgingCare.

Tips to Reduce Sundowning Symptoms

As a family caregiver, you may dread this time of day, as your loved one typically gets more agitated, combative and stubborn. In addition to hiring Alzheimer’s home care, there are some things you can do on your own to minimize the effects of sundowning.

  • Keep up a predictable bedtime routine, as well as routines for morning wakeup, meal times and activities. Even the simplest of tasks such as washing up for dinner and putting on their pajamas can let them know gently that the day is winding down.
  • Plan on activities and exposure to light as much as you can during the day to promote nighttime sleepiness.
  • Limit their naps during the day.
  • Allow caffeine and sugar only in the morning.
  • Keep a night light on, which will decrease agitation in dark or unfamiliar surroundings.
  • Limit background noise at night, such as TVs, as well as stimulating activities.
  • Show your loved one familiar items, like beloved family photographs, to foster a relaxed setting in the evening.
  • Play their favorite calming music or nature sounds.
  • Talk to your loved one’s doctor if you think they may have a urinary tract infection, which is known to worsen sundowning behavior.
  • Talk to your loved one in a calm manner, without raising your voice or touching them unexpectedly.
  • Don’t rationalize, argue or ask for explanations for behaviors that aren’t making any sense.
  • Keep the curtain closed as evening approaches so they are unaware the sun is going down. However, be sure to keep the area well-lit so as to improve visibility and minimize shadows.
  • Avoid excessive commotion in the evening when they can become more agitated.
  • Keep your loved one engaged and busy during the day. Take walks, do crafts and schedule visits so they are less likely to nap excessively.
  • To stay occupied in the evenings until bed time, engage in simple and soothing activities, such as pet therapy, music therapy, or their favorite TV show.
  • Take note of patterns in sundowning, such as reactions to certain times, places, people, and activities that trigger difficult behaviors. Avoid those in the future.

Overall, you need to be flexible. Alzheimer’s disease and other forms of dementia don’t look the same in every person. For some, sundowning can occur during the day or even in the morning, while other people never show signs of sundowning. As a family caregiver, you know them best and can adjust their schedule in the most helpful way.

Contact Preferred HealthStaff

Our professional caregivers have training and experience in dementia care, and are extremely familiar with the effects of sundowning. For help with your loved one who has dementia, contact us toll free at 866-943-9791 or in Fairfield 717-642-8500 to learn more about our Alzheimer’s care services.