What Is Sundowning in Dementia? Understanding Late-Day Confusion In People With Dementia

What is sundowning in dementia? “Sundowning” or “Sundowner’s Syndrome” is a term that describes a symptom of dementia. It is characterized by increased confusion, anxiety, and agitation that typically occur in the late afternoon or evening.

As the day progresses, you might notice that someone with dementia exhibits more intense and often challenging behaviors. This phenomenon can be distressing for both the individual experiencing it and their caregivers. This is because it often coincides with the time when the home environment transitions from day to night.

Understanding that this behavior is a common experience in dementia is crucial for effective management. Certain factors, such as fatigue, lower lighting, and the body’s internal clock may contribute to the onset of sundowning symptoms.  

Additionally, learning how to identify and adapt to these triggers is vital for reducing the impact of late-day confusion.

What Causes Sundowning In People With Dementia?

Sundowning is a symptom of Alzheimer’s disease and other forms of dementia. Here are some causes of sundowning in people with dementia.

• Tiredness, hunger, pain, or other unmet physical needs often exacerbate symptoms of dementia.
  
• A new or uncomfortable environment might trigger anxiety and agitate individuals with dementia.
  
• Confusion or hallucination induced by shadows becomes more prevalent as natural light decreases.
  
• Stress and frustration from others, such as caregivers, can also contribute to sundowning. Your emotional state can influence the individual with dementia, so remaining calm and supportive is important.
  
• Limited exposure to sunlight during the day can disrupt the body’s natural rhythm. This in turn affects the mood and sleep patterns of the patient.
  
• Overstimulation during the day might lead to increased confusion and irritability later in the day.
  
• A disturbance to the person’s body clock, which regulates sleep and wakefulness.
  
• Changes in hormone levels, such as cortisol.
  
• Sensory impairment makes processing information more challenging, exacerbating confusion as the day ends.
  
• Mood disorders (anxiety or depression) frequently accompany dementia.
  
• Lack of caregivers in the evening can leave individuals feeling isolated and scared, increasing agitation.
  
• The side effects of prescribed drugs taken for various health issues can interact with dementia symptoms.

According to Alzheimer’s Association data from 2006, between 2.4% and 25% of patients diagnosed with Alzheimer’s disease exhibited sundown syndrome.

How to Manage or Reduce Sundowning?

Sundowning can be a challenging aspect of dementia care, but there are strategies that may help in managing its symptoms. Your approach should be empathetic and understanding, recognizing that each person’s experience with dementia is unique.

• Maintain a positive, predictable routine: Establishing a regular schedule for daily activities can provide a sense of stability and security for someone experiencing sundowning.
• Stay calm: During episodes of confusion or agitation, staying calm can significantly influence the individual’s ability to regain calmness.
• Encourage good sleeping habits: Ensuring adequate rest at night may alleviate some symptoms of sundowning.
• Provide a calm and peaceful environment: Minimize clutter and noise to help lower their stress levels in the late afternoon or early evening.
• Exercise regularly: Physical activity can improve mood and encourage better nighttime sleep.
• Expose the patient to natural sunlight: This can help regulate their circadian rhythms and improve sleep quality.
• Identify and note down triggers: Prevention is better than cure! Keeping a journal can help you recognize patterns or activities that precede episodes of sundowning.
• Reduce stimulation at night: Dim the lights and minimize noise to create a soothing atmosphere that can help prevent overstimulation.

Learn More About Dementia Care

Sundowning can be a challenging aspect of dementia for both you and your loved ones. Understanding how and why sundowning happens will enable you to manage.

Try to incorporate these tips into daily life and you may see an improvement in your loved one’s evening experience. If you’re ever in doubt, seeking advice from healthcare professionals like Thoughtful Home Care, Inc. is always a wise decision. 

References: 

2006 Statistics about Alzheimer’s disease. Alzheimer’s Association. [Accessed November 2, 2006]. Available at: http://www.alz.org/AboutAD/statistics.asp.