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What Is Sundowning and How Does It Impact Seniors with Dementia?

Wednesday, May 20, 2020

If you have a loved one with dementia, you may have noticed that, during the evening hours, their behavior changes – sometimes drastically. As the sun goes down, your loved one may be acting out in ways that are out of character. This behavioral change is commonly referred to as “sundowning.”

Sundowning is a group of symptoms that occur in individuals with Alzheimer’s disease and other forms of dementia. Generally, these changes appear to be triggered by fading sunlight, although sundowning can occur at any point of the day. Sundowning is often characterized by increased confusion and agitation, as well as other changes like hallucinations, anger, suspicion and other unwanted behaviors.

Although the reason sundowning occurs is not known exactly, it’s believed to be caused by a disruption in circadian rhythms – the natural sleep-wake cycle of our bodies. Our circadian rhythms are affected by sunlight, so when the natural flow gets disrupted, it can be frustrating, irritating and scary for someone with dementia. Think about how tired we can get when we have to ‘spring forward’ or ‘fall back’ – that goes double for people with memory issues, and it can happen at any time.

Sundowning generally occurs in mid- to late-stage dementia, but even those who are in the early stages may experience sundowning. Besides the setting sun, sundowning can be triggered by a wide variety of things, like medication, disturbed sleep, a loss of routine during the day, physical changes to the brain and many, many other reasons.

Dealing with sundowning can be challenging, frustrating and overwhelming for caregivers who are already balancing a full schedule of care with their daily lives. It’s important to remember that you are not alone in this struggle. Sundowning isn’t simple, but it is a common occurrence, and there are resources and tools to help. At Bridges by EPOCH, we hear from many caregivers who are dealing with this issue, and it’s something we manage for our residents at our memory care community. Understanding why these symptoms may be occurring, and remembering that they are symptoms of a disease and not a reflection on your loved one, can help you navigate the behaviors and find ways to calm, soothe and care for your loved one with Alzheimer’s disease or another form of dementia.

Tips for Managing Sundowning In Your Loved One

Follow a daily schedule.

Routine is incredibly important for individuals with dementia – as a caregiver, that’s something you know very well. Any changes to a daily routine, no matter how small, can result in frustration, stress, confusion and anger for your loved one. These feelings and emotions play a big role in sundowning. As much as possible, stick to the same schedule every day, which will help your loved one feel calmer and more secure. If changes are necessary, do your best to adjust their routine gradually with as little disruption as possible. Having a set “bedtime routine” will also help ensure your loved one is confident and secure at the end of the day.

Ramp up the vitamin D.

Since sundowning may be caused by changes in your loved one’s circadian rhythms, be sure that he or she is getting enough natural sunlight during the day. Avoid “blue-light” devices at night (including TVs, cell phones, tablets and the like), which can disrupt the body’s natural sleep-wake cycles. If getting sunlight proves to be difficult, look into light-therapy boxes. Finally, you can always brighten the lights in a room if your loved one is feeling agitated or confused – the Alzheimer’s Association® suggests that this can be beneficial.

Get enough exercise.

Sundowning can be triggered when your loved one is having difficulty sleeping at night. Too much inactivity and daytime naps can make it harder for seniors to fall asleep at night, which causes a vicious cycle of sundowning – exhaustion – daytime drowsiness – sundowning – rise and repeat. In order to promote a good night’s sleep, make sure your loved one is getting enough activity during the day. Getting enough physical activity will help wear them out, improve their sleep quality and help them have better physical health as well as reduced sundowning symptoms.

Adjust eating patterns.

Eating too much too late in the day can cause digestive issues, which can increase agitation and keep your loved one up at night. Too much caffeine or alcohol can have the same effect. Consider serving your “large” meal at lunch and choose a lighter meal in the evening. Try to avoid too much snacking after dinner in order to help your loved one feel more comfortable and sleep easier at night.

Reduce stress.

Research shows that the changes caused by Alzheimer’s disease and other forms of dementia make it physically more difficult for seniors to process and deal with stress – which can be a huge trigger for sundowning. Create an atmosphere of calm for your loved one in the evening to help them stay happy and serene. Encourage simple activities in the evening to reduce frustration. Snuggle with a pet or a favorite toy, and play soft music to create a calm, quiet atmosphere. Reading a favorite book out loud, watching a happy TV show or movie or even a light hand or shoulder massage can be very soothing.

Monitor their behavior to see what might be triggering them.

Every person is unique, and everyone has different triggers for sundowning. In order to help you identify your loved one’s triggers – and avoid them in the future – watch them and make observations when you see symptoms arising. Once you identify a pattern and can determine what environments, activities and actions seem to be causing their symptoms to worsen, it will be easier to avoid those situations in the future.

Caring for a loved one with dementia is an all-encompassing and tiring job, and sundowning syndrome can make it even more difficult. Don’t forget that it’s just as important to care for yourself as for your loved one. By taking the time to eat right, get regular exercise, get enough sleep and do nice things for yourself, you’ll be in a better position to give your loved one the care and support they need.

Exceptional Care & Fulfilling Lifestyle

Bridges® by EPOCH provides memory care assisted living that is comfortable, positive, safe and engaging. Exclusively dedicated to caring for those with Alzheimer’s disease and other forms of dementia, our communities offer 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 – enriching the lives of our residents every day.

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No matter what level of care or service is needed, residents and families can rest assured that our care and life enrichment programs address the various stages of memory decline, allowing residents the opportunity to age in place.

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At Bridges® by EPOCH, our services are designed to recognize and adapt to the unique challenges and individuality of each resident, while ensuring comfort and safety. We believe in a full-service approach to care and provide a high level of personalized attention for residents in various stages of memory loss.

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