Sundowning, also known as “late-day confusion,” is a symptom of dementias such as Alzheimer’s disease. Nearly 66% of seniors with mid- to late-stage dementia experience this phenomenon, which features symptoms such as wandering, increased confusion and disrupted sleep patterns. If you’re a caregiver to someone with dementia, you may have noticed their agitation and confusing getting worse in the late afternoon and evening. This can be frustrating and distressing, especially as you deal with the many other symptoms associated with dementia.
“We’re not sure why sundowning manifests, much like we don’t completely understand why dementia occurs,” says Barbara Harrison, Executive Director of Bridges® at Pembroke, a memory care assisted living community in Pembroke, MA. “However, since we’re exclusively designed to be a memory care assisted living community, we’ve had a lot of experience dealing with sundowning. Our community has been designed to meet the unique needs of individuals with dementia, including ways to reduce the symptoms of sundowning and other concerning behaviors. Many of the things we do in our community can be done by in-home caregivers as well.”
The Symptoms of Sundowning
Confusion, agitation and distress are fairly common behaviors for individuals with dementia. It’s fairly easy to tell, however, if what your loved one is experiencing is “normal” or if it’s actually sundowning. If your loved one is experiencing increased symptoms during the afternoon and evening and maybe even late into the night, it’s more than likely sundowning. Common symptoms include:
- Delusional thinking
- Visual and auditory hallucinations
- Pronounced mood swings
- Fear
- Aggressive behavior
- Pacing, wandering and disorientation
- Anxiety and agitation
There’s no need to make an “official” diagnosis of sundowning because, much like dementia itself, there are currently no treatments available to target this specific group of symptoms. However, if you’d like to determine if your loved one is, in fact, experiencing sundowning, document the symptoms and behaviors you’re seeing as well as when they occur.
Tips for Reducing Sundowning Symptoms
There are many different ways to reduce sundowning symptoms. It will be up to you, the caregiver, to determine what solutions work best for you and your loved one. “Everybody’s needs are unique and they can change fairly frequently, so we encourage at-home caregivers to try different things to see what works best,” says Barbara.
Here are some of the top ways Bridges® by EPOCH at Pembroke helps reduce sundowning symptoms in our residents.
Keep a regular routine. Routines are incredibly important to individuals with dementia because unfamiliar events or other things can cause anger, stress and confusion. If your loved one’s routine is being switched up, this can play a role in sundowning. As much as possible, stick to the same everyday schedule so your loved one feels calm and confident. If changes need to be made, it’s best to take small steps and adjust the routine gradually in order to better help it stick.
Light it up. Research has suggested that the circadian rhythm – our body’s sleep-wake cycle – can play a role in sundowning. If your loved one’s circadian rhythm is off (say, because of time changes or because they haven’t been outside in a while), you may want to adjust the light in your home. Consider light therapy with a full-spectrum fluorescent light, or be sure your loved one gets plenty of natural light on a regular basis. If your loved one is becoming increasingly agitated or confused, you can also brighten the lights to see if that helps.
Keep them active. If your loved one with sundowning symptoms has trouble sleeping at night, they will be fatigued during the day. While napping is okay here and there, too much snoozing during the daytime will make it more difficult for them to stick to a regular sleep schedule, which turns into a vicious cycle. To help your loved one get a good night’s sleep, find ways for them to stay active in the daytime. Take a walk around the neighborhood or hold a dance party in the kitchen. Do chores together or start a little exercise routine. Being active will help wear them out, making them sleepier in the evening.
Make lunch the main meal. Take a look at your loved one’s eating patterns and see if adjusting them may help reduce sundowning symptoms. Larger meals, alcohol and caffeine can increase agitation and sleep problems. Feed your loved one a healthy meal and encourage “treats” during the day or at lunchtime instead of in the evening. By eating a heartier meal during the day and sticking to light meals at night, your loved one may feel more comfortable and be able to sleep more easily.
Minimize stress. Find ways to keep your loved one calm and relaxed during the evening hours. Stick to activities that are soothing and not too challenging. Watch a nature program, turn on soothing music or simply snuggle with the family pet.
Reassure, comfort and validate. Even though it can be frustrating to see sundowning happening night after night, remember that your loved one’s concerns are very real. If they are getting agitated, reassure them that they are safe, loved and in a familiar place. If there are familiar items that give them comfort, make sure those are on hand. You can even redirect with family photos or cherished memories. The world can be a scary place for someone with dementia, and familiarity and comfort can help them cope during this difficult time.
Watch for triggers. Sundowning can be triggered by different things. In order to find out what’s causing your loved one’s symptoms, take notes and see what patterns are making their symptoms worse. Once you understand what may be causing the sundowning, it will be easier for you to avoid situations that cause confusion and agitation.
“Sundowning can be incredibly exhausting, not just for your loved one with dementia but also for yourself,” says Barbara. “It’s essential for you to take care of yourself as you’re caring for your loved one. By focusing on yourself and giving yourself what you need to stay healthy, you’ll be better equipped to care for your loved one and enjoy your times together.”
Compassionate Care for All Stages of Memory Loss
Bridges® by EPOCH at Pembroke provides assisted living memory care that is comfortable, positive, safe and engaging. Exclusively dedicated to caring for those with Alzheimer’s disease and other forms of dementia or memory impairment, we’ve created a wellness-focused lifestyle that promotes dignity and individual preferences. Our memory care professionals receive specialized and ongoing training designed to help residents maximize their independence in a secure, calm environment – making a truly positive impact on the lives of our residents each and every day.
Dedicated Memory Care
The team of compassionate dementia-care experts at Bridges® by EPOCH at Pembroke delivers 24-hour assistance and inspiring programs that exercise physical and cognitive abilities – all in a supportive, purposefully designed environment. For added peace of mind, we offer simple, all-inclusive pricing options that help make the process a little easier for families.
Community Amenities
Characterized by a beautiful residential design, Bridges® by EPOCH at Pembroke provides everything residents with memory loss need to enjoy comfort, familiarity and security. Soft colors, directional cues, aromatherapy and interactive life stations create a peaceful and secure environment where residents feel at home.
Contact us today to learn more.