How to Cope with Sundowning?

If your loved one has been diagnosed with dementia and he is showing signs of agitation, confusion, or anxiety during late afternoon or evening hours, he’s most probably experiencing ‘sundowning’.

Sundowners Syndrome is a state of confusion that people living with dementia experience in late afternoon, evening or at night. Due to this, they are unable to take directions, get upset easily and may even become aggressive.

While the exact cause of sundowning is unknown, many people living with dementia experience it. According to a research, the overall rates of sundowning among patients with Alzheimer’s or other types of dementia are as high as 66 percent!

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Factors that cause sundowning

To help someone who’s dealing with sundown syndrome, it’s important to understand the factors or events can trigger or aggravate the symptoms. Once you address these factors, your loved one will be able to function better.

One of the main reasons for confusion is fatigue. If they’re tired during the day, the exertion coupled with stress can trigger aggressive behavior. Though the opposite is also true; if they don’t have much to do during the day or have taken longer naps, they may get restless towards the end of the day.

Another important factor to consider is the absence of lighting and increased shadows. Improper lighting, particularly during winter, makes it harder for them to distinguish between what’s real and what’s not. For instance, hallucinations can be triggered when objects appear different in low lighting or when shadows form behind things.

Lastly, any disruption of their sleep cycle or daily routine can cause the symptoms of sundowner’s syndrome to appear. This is because disruption of the body’s internal clock makes it harder for them to focus.

What can help?

There are a few simple things that can be done:

Follow schedules – Familiarity is the key here. Having a set routine in place, helps the people living with dementia stay in control. Hence, it’s important to try and stick to the same routine to help them avoid situations in which they feel confused or stressed.

Ensure that they get their sleep – Getting ample sleep is crucial for anyone living with dementia. In addition to following sleep routine, try to limit things that can affect their circadian rhythms. For instance, give them simpler, easy to digest meals at night, avoid giving them caffeinated drinks later in the day, and limit consumption alcohol and smoking.

Brighten up the surroundings – According to the results of a clinical trial, exposure to bright light can counter the effects of sundowning. So, open the curtains during day time and during evenings ensure that the home is well-lit. Around sunset, you can also draw the curtains to eliminate shadows as they may cause confusion.

Keep them busy – To help them sleep better at night, arrange activities that keep them occupied during the day. Simple activities such as going for a stroll, singing their favorite songs together, or just folding towels can help them stay busy and not get over-exhausted. It is also recommended to minimize afternoon naps because they can negatively affect their sleep routine and trigger sundowning.

Trust your instinct

Providing home care for someone who is living with dementia is challenging and it can take a toll on the caregiver’s emotional and physical health. While these tips are helpful in dealing with the symptoms of sundowner’s syndrome, remember that you know your loved ones the best.

Sundowning triggers are different for different people. As you know your loved one’s preferences and dislikes, you can identify what’s bothering them by monitor their routine and looking for things that agitate them.

Sometimes, all you need to do is listen and understand what they’re trying to say. For instance, if shadows are bothering them, you can calm the down and then adjust the lighting. At other times holding their hand, talking to them or even a hug can help calm them down.


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Author: Erum Ansari is a public relations professional who specializes in technology comms. She is an avid reader, a travel enthusiast, and a self-proclaimed story-teller. Before joining the content team at Your Doctors Online, Erum was the PR manager at Hill & Knowlton Strategies and was handling communications and content strategy for a diverse portfolio of brands. She is also a new mom who is finding her way around motherhood.