One of the more concerning behaviors that senior adults exhibit in connection with Alzheimer’s or dementia is sundowning. This condition is marked by a radical change in an individual’s behavior as evening approaches, and sundowners syndrome only occurs in connection with some form of dementia.

The syndrome manifests from late afternoon into the evening and is characterized by a wide range of behaviors, including increased aggression, confusion, or anxiety. A more detailed list of the signs and symptoms of sundowning includes the following:

Anxiety or stress
Sadness
Delusions or hallucinations
Pacing or rocking back and forth
Bursts of anger, violence, or aggression
Restlessness behavior or spikes of energy
Disorientation or confusion
Yelling or crying without a discernible cause

A senior with sundowners syndrome most often exhibit several of the above signs. Typically, these behaviors will only be evident in the evening hours, and then they will decrease or recede. Mental health experts are uncertain as to why sundowning takes place. Several situations have been identified that appear to aggravate or trigger the symptoms of sundowners syndrome, including:

The individual has a medical condition or chronic pain.
They live in a room without adequate lighting.
They are often fatigued or overtired.
Their schedule has been disrupted (routine is essential to dementia patients.)
They cannot discern their dreams from reality.

Coping with Sundowners Syndrome

While caregivers may not be able to eliminate the behaviors of sundowners syndrome entirely, they can employ measures to help mitigate them.

Create a set, predictable daily routine. Begin with an alarm at the same time every day, establish a meal schedule, arrange structured activities throughout the day, and set a regimented bedtime.
Set up their living space with ample light exposure during the day. Open the blinds, ensure adequate lighting in their room, and try to get them outside in the sunshine. These measures will train the body to recognize the differences between day and night and enhance drowsiness once the sun goes down.
Try to reduce or eliminate naps during the day. If they get too much sleep during the day, they may have trouble falling asleep in the evening.
It is best if caffeine and sugar can be eliminated from their diet. However, if they do not wish to give up their coffee or cookie, make sure they consume these items early in the day.
Once the sunsets, create a serene atmosphere by turning off the television. The volume and light coming from the set will result in sensory stimulation that could trigger the sundowners.
If they are spending the night in an unfamiliar setting, encourage them to bring personal items that will comfort them, such as a familiar throw blanket or a favorite framed photograph.
Play calming music, nature sounds, or white noise in the evenings to create a peaceful sleeping environment.

Additional Recommendations for Dementia Patients with Sundowners

Minimize emotional anxiety by simplifying their surroundings. Declutter, avoid bright colors, and block light from other areas when it is time to sleep.
If they become disoriented or angry, change their focus with a favorite song, start a conversation by asking questions, or even bring in a service animal. If they agree to take a walk, that may also be helpful.
If their room is not adequately exposed to natural light, encourage daily outings to an outside bench or patio.
A gentle massage, essential oils, or acupuncture may ease symptoms, as may herbal supplements such as lemon balm, chamomile, kava, holy basil, and valerian. All of these methods reduce agitation and anxiety. Be sure to discuss any new treatments, even natural ones, with their personal physician.

Sundowning behaviors can be very overwhelming and even scary for caregivers. When a dementia patient exhibits these extreme behaviors, it may indicate that it is time to consider a professional memory care residence. But there is no need to face this problem alone.

My Care Finders is an active advocate for families exploring senior living options for their loved ones. We provide expert and informed guidance, FREE OF CHARGE – to help you determine which local memory care facility is best for you and your family.

Call today to schedule an appointment and learn more about how we can help.