Sundowning behaviour

Sundowning is a term used to describe the confusion, restlessness or agitation some people with dementia may experience late in the day (afternoon or early evening) or “as the sun goes down”. Persons with Alzheimer’s or dementia experience a decline in their abilities to function and cope.  These symptoms can be distressing to the person and overwhelming for the caregiver to manage.

Factors that may contribute to sundowning:

1. The person you are caring for is mentally and physically tired by the end of the day.
2. They’re up during the night and sleeping during the day.
3. Low lighting and shadows can cause confusion and create hallucinations.
4. Not enough or too much stimulation.
5. Physical issues like hunger, dehydration constipation, pain, or infection.
6. When someone is restless or confused, they may try to leave their home.
7. If you’re feeling stressed at the end of the day, the person you’re caring for may pick up on that and it can increase their restlessness.

Tips that have helped others in a similar situation:

• Keep track of activities, environments or behaviours to learn patterns that may worsen the sundowning.
• Closing the curtains, relaxing in a favourite chair, playing soft music, or turning on a night light may help with a better night sleep.
• Provide more lighting to reduce shadows when it begins to get dark.
• Stick to a regular routine; schedule activities during the earlier part of the day and encourage rest in the afternoon.
• Ask the person if they are hungry, need to use the bathroom, or are in pain.
• Plan larger meals earlier in the day and a light snack at bedtime. Limit caffeine and alcohol intake.
• If restless, both you and someone the person trusts can go for a walk or a drive.
• Breathing together will lighten things up. Slowly inhale through the nose and exhale through the mouth; try it a few times.
• Talk to the person’s health care provider about the symptoms and sleep issues. Medications may be prescribed.
• Consider an Adult Day Program to provide you with a much needed break.

Remember, during the course of your day, it is perfectly OK to step out of your caregiver role to enjoy a hot ‘cuppa’ tea or coffee.

For more tips and strategies on sundowning visit:

http://alzheimer.ca/en/Home/Living-with-dementia/Understanding-behaviour/Sundowning

https://www.alz.org/help-support/caregiving/stages-behaviors/sleep-issues-sundowning

What has worked best for you “as the sun goes down”.