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A Caregiver’s Guide to Sundowning

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If you have a loved one with a later stage of Alzheimer’s disease or dementia, you may have already witnessed sundowning or heard about the possibility of these symptoms happening around the end of the day. In this blog, we’ll delve into what sundowning is, what its potential aggravators are, and some tips to cope with symptoms.

What is Sundowning?

Sundowning is a group of symptoms that can occur for people with Alzheimer’s disease or another dementia as daylight begins to fade and disappears. During a sundowning event, you may find your loved one pacing, wandering, shouting, or other displays of agitation, confusion, or distress in the late afternoon or early evening. As many as 20% of people living with Alzheimer’s experience these sundowning events.

Unfortunately, the root cause of sundowning is unknown, but it could be due to brain changes occurring with their biological clock and disrupt sleep-wake cycles. The symptoms may begin consistently around the same time of day and continue into the night, placing immense strain on those affected and their caregivers.

Understanding Potential Aggravators

Some things that aggravate sundowning may be more easily avoided than others. It’s important to be aware of aggravators that may be exacerbating your loved one’s feelings and behaviors, including:

  • Mental or physical fatigue after a full day of various activities
  • Being in a new, unfamiliar environment
  • Hunger, thirst, boredom, or pain
  • Having an infection, such as a urinary tract infection
  • Depression
  • Drinking caffeine late in the day
  • Alcoholic drinks – We recommend not serving alcohol to those with dementia, as they can increase confusion and anxiety
  • A shift in the internal body clock that leads to a person living with this disease to feel more awake at night
  • Low lighting and increased shadows, which may cause confusion or hallucinations
  • Recognizing stress or frustration in the people around them
  • Dreaming and confusing dreams with reality
  • Less need for sleep, which is natural for many older adults

Coping with Symptoms

A number of coping strategies may reduce your loved one’s sundowning symptoms. These include:

  • Maintaining a predictable daily routine for going to bed, waking up, eating meals, and doing activities
  • Helping your loved one get exposure to bright sunlight during the day to correct their internal clock and encourage a healthy sleep-wake cycle
  • Helping them get physical activity or exercise each day
  • Limiting daytime napping to ensure they get enough rest at night
  • Limiting caffeine and sugar to morning hours
  • Turning on a night light to reduce shadows and dark, unfamiliar surroundings
  • Bringing familiar items, such as photographs or small objects, when staying in a new place
  • Joining in soothing activities with your loved one as daylight fades, such as listening to calming music, looking at photographs, or watching a favorite movie
  • Taking a walk to help ease your loved ones’ restlessness
  • Making evening a quiet time by reducing background noise and stimulating activities
  • Taking notes on what happens before sundowning events to see if you can identify triggers

The best way to soothe someone during a sundowning event is to remain calm, avoid arguing, and offer reassurance. You might try gently reminding them what time it is or reducing the amount of noise, clutter, or other people in the room. It may also work to distract your loved one with a favorite snack or a simple task, such as folding towels.

If sundowning continues to be a problem, it may be time to call the doctor. A professional medical exam could determine if the symptoms are being caused by pain, a sleep disorder, medication side effects, or another illness.

Personalized Memory Support at WSL

Because everyone is unique and seniors living with Alzheimer’s or other dementia have specific needs that change over time, we take a highly personalized approach to care at Wentworth Senior Living (WSL). Our All Points Program™ focuses on ensuring that residents with cognitive impairment continue to live fulfilled, dignified lives by meeting them where they are and working closely with their families and loved ones. Learn more about the exceptional care and enriching environment at Wentworth Senior Living for seniors requiring memory care.