Sundowning is a symptom sometimes experienced by those living with dementia. It is a syndrome that disrupts the body’s sleep-wake cycle, which can result in behaviors later in the day. Common behaviors of sundowning include increased confusion, agitation, anxiety, and pacing which all typically occur in the late afternoon or evening hours.
There are a few different possible causes of this syndrome. One main cause is mental and physical exhaustion from the day. As dementia progresses, a person living with the disease has to work harder throughout the day to maintain functioning. Nonverbal behaviors of others, such as stress and frustration, may be identified by the person with dementia and cause them to be agitated as well. Reduced lighting in the evenings can produce more shadows and result in confusion.
There are some actions that caregivers can take to help lessen the severity of sundowning symptoms. One factor to be mindful of is paying attention to the caregiver’s own nonverbals and trying to remain calm. Also, try to schedule activities and appointments earlier in the day. Offer a larger meal at lunch so the person isn’t overwhelmed by a bigger meal later in the day.
In addition, it may be helpful to allow the person to take a nap after lunch to recharge. Keep the home well-lit to prevent excess shadows. Try to identify triggers of agitation in order to avoid them in the future. Allow the person to pace and possibly take a walk. Soothing therapies to prevent stress may also be helpful. These may include massages, aromas, pets, music, and art. It is important to consult a physician if symptoms of sundowning come on suddenly as this may be a sign of infection, pain, or medication interactions.
For more information about sundowing, contact the Alzheimer’s Association at 1.800.272-3900 or visit alz.org/Dayton.
Resources:
http://www.alz.org/cacentral/documents/Dementia_Care_36_Sundowners.pdf
https://www.alz.org/documents/national/topicsheet_sundowning.pdf
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