A Caregiver’s Guide To Managing Sundowning Symptoms

Have you noticed your loved one with Alzheimer’s disease or another form of dementia tends to act differently later in the day? There might just be a reason for that. Many people with dementia experience sundowning, a syndrome that, according to the Mayo Clinic, is a state of confusion that occurs later in the afternoon and often lasts into the night.

During sundowning, a person with dementia may face a group of symptoms at a specific time of day. What causes sundowning behaviors? While the exact cause is unknown, the Mayo Clinic shares that a person with sundowning symptoms may experience side effects as a result of:

  • Disruptions to routine or their circadian rhythm
  • Fatigue, boredom or depression
  • Having unmet needs such as hunger and thirst
  • Untreated pain or infections
  • Low lighting, increased shadows, and problems separating reality from dreams
  • Spending an increased amount of time in an unfamiliar environment
  • Medication side effects

Symptoms of Sundowning

While they can vary from person to person, according to the Mayo Clinic, some of the most common sundowning symptoms include:

  • Confusion
  • Ignoring directions
  • Anxiety
  • Aggression
  • Pacing and wandering

Managing Sundowning in a Loved One with Memory Loss

The above behaviors and symptoms can be troublesome, but fortunately, there are some ways families and caregivers can help to manage the symptoms while better caring for their loved one in the process. Try these techniques for your loved one with Alzheimer’s or dementia.

Create a daily routine.

Maintaining a routine can establish predictability. Wake up with the sun, as exposing your loved one to natural light in the early morning can help regulate their circadian rhythm. It can also reduce agitation and relieve anxiety.

Try to eat around the same time each day, get outside, if possible, and participate in enriching activities. Be careful to not make days too busy, as this can be tiring and cause overstimulation. It can also help to limit napping later in the afternoon.

Spend time in the sunshine.

Whether you and your loved one go for walks or your loved one simply sits by the window, being exposed to sunshine can boost mood and, as we shared above, promote a more regulated circadian rhythm. You’ll want to make sure exercise occurs no later than four hours before bedtime, however.

Actively avoid situations and things that make your loved one’s sundowning more prevalent.

The National Institute on Aging shares that items with sugar or caffeine, like coffee, soda and other beverages, can make sundowning worse. Try to limit these to morning hours. Cigarettes and alcohol should be avoided as well.

Set yourself up for nighttime success.

As the day comes to a close, prepare for nighttime by creating a calm environment.

  • Close curtains and blinds
  • Turn on the lights
  • Reduce background noise
  • Play calming music instead of a TV show
  • Distract your loved one with an activity or snack they love

Enhance safety.

If your loved one wakes and is upset at night, approach them in a calm manner and evaluate if there is something they need. Avoid arguing, and offer reassurance that everything is OK if they are distraught. If they need to pace, allow them to safely, under your supervision.

If you’re afraid your loved one will not be safe at night or that they may wander, consider purchasing night lights, gates to block stairways, locks for windows and doors, video cameras, motion detectors, and door sensors. Also be sure to put away any potentially dangerous items.

A Note About Medication

If those techniques don’t work, medications may help alleviate symptoms or manage sleep problems. Before considering this, you should speak to your loved one’s doctor to determine what may be best for them.

Remember to never make changes to your loved one’s medications without first speaking to their doctor. This is because:

  • Certain medications can interact negatively with each other
  • Removing, adding or altering medications may cause additional symptoms
  • They may make sundowning or other health conditions worse

While the intentions behind altering medications may be good, your loved one’s doctor can help to ensure their continued health and safety by evaluating interactions and other health conditions they are dealing with.

Supporting Caregivers in Managing Sundowning Symptoms

It’s important to remember that your loved one may be sensing your frustration, even without you saying anything. By managing your emotions, you can help reduce your loved one’s symptoms while making a difference in your own health. What are some ways to do this?

  • Ask friends or family for help, allowing them to fill in or give you a short break
  • Rest as much as you can and take breaks during the day when your loved one is at their best
  • Consider looking for outside help
  • Look into a memory care community
  • Join a support group

No matter where your loved one is in the process, Bridges® by EPOCH is here to help. With support groups and care, we can provide you with the support you need.

To learn more about managing sundowning symptoms, contact our team. We’d be happy to chat with you about some of our techniques and share more about our lifestyle during a visit. Simply contact the community nearest you to get started.

Enhancing Quality of Life

Bridges® by EPOCH memory care communities have been developed from the ground up to anticipate, meet and exceed the needs of our residents and their families. Our team of remarkable people, the exceptional care and services we offer, and the purposeful design of our buildings all combine to create the most rewarding, secure and nurturing lifestyle possible for our residents.

Bridges® by EPOCH communities are located in Connecticut, Massachusetts and New Hampshire, in the following towns: Norwalk, CT; Stamford, CT; Trumbull, CT; Andover, MA; Hingham, MA; Lexington, MA; Mashpee, MA; Pembroke, MA; Sudbury, MA; Westford, MA; Westwood, MA; and Nashua, NH.