Sundowning: How to help your loved one

Have you heard of Sundowner’s Syndrome? Sometimes it’s called Sundowning, and it’s usually associated with people who have Dementia or Alzheimer’s. For those people, sundowning can be a time of increased memory loss, confusion, agitation or even anger. For the family members who care for them, it can be a painful and exhausting experience.
What causes Sundowning?

  • Too much activity towards the end of the day can trigger sundowning. Even shift changes can lead to anxiety and confusion for those in a memory care facility.
  • Fatigue is also a common factor. Perhaps they are tired from the activities of the day, or even the sudden lack of activity after dinner can be a contributor.
  • Too much sleeping during the day and inactivity can also disrupt a good night’s sleep.
  • When the sun goes down, shadows may increase and the amount of available light makes already challenged vision that much more difficult to see.
  • Hormonal imbalances can cause disruption in the internal biological clock. This imbalance can lead to confusion between waking and sleeping hours.
  • Even wintertime and its shorter days can make sundowning worse for some people. This is also an indicator that the syndrome may have something to do with Seasonal Affective Disorder, a common type of depression caused by lack of exposure to natural sunlight.

How can you help reduce Sundowning symptoms?

  • Sticking to the same schedule every day can help your loved one feel more calm and oriented. If a routine much change, try to adjust them gradually and with as small of an impact as possible.
  • Adjusting the lighting in their room or home could also help with sleep and wake cycles if their circadian rhythm gets out of sync. According to the a research review published in Psychiatric Investigation, some studies suggest light therapy to reduce agitation and confusion in people with dementia.Placing a full-spectrum fluorescent light a few feet away from your loved one for a couple of hours each morning could help with sundowning symptoms. Even brightening the lights may help. when they feel confused or agitated.
  • Walking in the park and other activities during the day might improve their sleep at night and reduce sundowning symptoms.
  • Consuming large meals, caffeine, and alcohol can also interrupt the sleep patterns of someone with Sundowning symptoms. Limiting evening food to a healthy snack or a light meal might help them rest easier, too.
  • Encouraging evening activities that aren’t too stressful can help reduce confusion and irritability. If they have mid-stage or advanced dementia, watching television or reading a book could be too difficult. Try playing soft music to calm and soothe them. Snuggle time with a family pet could also help reduce stress.
  • If a loved one has moved into a hospital or assisted living facility, furnishing their space with some of their treasures like a favorite blanket, and family photos, can help ease the transition and help with sundowning symptoms.
  • Medication may be helpful in some cases of sundowning, especially when it’s associated with depression or sleep disorders. Consulting a physician is important since some medications may actually disrupt sleep patterns that can make symptoms worse.

Looking for patterns of sundowning in your loved one can help you identify the triggers.Track behaviors and activities with a journal or smartphone app to learn what makes symptoms worse or better. Once you know which activities or environments are triggers, it’s easier to avoid those situations and events.
Managing a loved one’s symptoms can be exhausting for the caregiver, so it’s important to take good care of yourself. Be sure to eat a well, get regular exercise, and get plenty of sleep every nights. It’s okay to rely on other family members or seek respite care so you can take regular breaks.