The term “sundowning” refers to the state of confusion and changes in behaviors for those with dementia, usually during the late afternoon and evening. According to The Alzheimer’s Association, as many as 20% of people with Alzheimer’s will experience sundowning symptoms and can lead to:
- anxiety, restlessness
- aggression, irritability
- ignoring direction
- pacing and wandering
Scientists still don’t know exactly why it occurs. The Alzheimer’s Association list these factors that may be a cause:
- End of day exhaustion
- A thrown off “internal body clock” that confuses day and night
- Not getting enough sleep at night, creating restlessness during the day
- Evening changes in lighting and increased shadows creating confusion
- Reactions from verbal or nonverbal cues they get from exhausted caregivers
Managing these behaviors and changes in mood can be very frustrating and difficult for family Caregivers. Here are some strategies to cope with Sundowning:
- Keep your home well lit in the afternoon/evening. This could be pulling the curtains and turning on inside lights before major lighting changes happen.
- Maintain a schedule. This helps throughout the day, but especially at night. Having their body know when to expect meals, rest, certain activities and sleep is very important to avoid spikes in agitation and confusion.
- Avoid excess stimulation. Activities, clutter, loud noises and visitation during the late afternoon and evening can heighten sundowning symptoms. So can alcohol, nicotine and caffeine.
- Plan active days. If someone is idle or non-active all day, this usually leads to restlessness at night which then creates a cycle of exhaustion and aggravation due to sundowning.
- Make sure Caregivers are cared for as well. If a family Caregiver is frustrated and exhausted by the end of the day, that shows in their verbal and non-verbal communication and can sometimes exacerbate sundowning behavior.
- Track behaviors. Keep a journal and track activities, food intake and patterns along with the behaviors and sundowning symptoms that occurred. This helps you see any correlations.
- Create a calm environment. Try playing soothing music and/or diffusing calming essential oils like lavender right around the same time of the day that symptoms start to occur.
If symptoms are worsening, make sure to speak to your loved one’s doctor to get support, insight and other resources that can help.