While the causes of sundowning syndrome aren’t fully understood, it can bring a lot of added stress and challenges to caregivers concerned about the safety and wellbeing of their elderly parents.
If you are a caregiver for someone with dementia or Alzheimer’s disease, you might have experienced this behavior in various ways in the form of confusion, anxiety, or aggression that occurs in the late afternoon and into the night.
Here are some information and tips about sundowning syndrome and how you can create a comfortable and safe environment.
Potential causes of sundowning syndrome
According to the Alzheimer’s Association, research shows that around 20% of people with Alzheimer’s experience this syndrome. As the name suggests, when sundown approaches, it can trigger sudden behaviors, from mood swings and anxiety, to hallucinations and increased energy.
As a result, those behaviors can turn into more stressful situations, such as pacing, crying, anger, or aggression. Understanding what factors may be causing these behaviors can help you find ways to alleviate them.
One theory is that the fading light of sundown can trigger a sense that it’s a time to change activities. Another theory is that the brain changes associated with their memory loss create confused sleep-wake cycles. Many feel like they need to be somewhere, but can’t explain why.
The reduced light also can increase shadows and make it harder to see, creating agitation. The person may also be able to pick up on any nonverbal stress or frustration from those around them and feel upset.
Sundowning also can be caused by physical needs or symptoms that aren’t being met, such as fatigue, hunger or thirst, pain, depression, or boredom. They could be exhausted from trying to keep up with an environment that feels confusing to them.
Tips for managing symptoms
Watch and listen
Observe carefully when signs of sundowning occur, and try to identify possible causes. Make notes if necessary to track behaviors. Is there a flurry of activity around sundown, with family coming and going from work or school? Is your loved one getting tired or confused? Do they need a snack or water?
If your loved one is expressing frustration or becomes upset, listen to their concerns calmly and validate them, even if you don’t understand. Reassure them that everything is okay, and try to find an activity they enjoy to help them.
Soothe and distract
Once you listen and validate your loved one, you can attempt to redirect them to something that will comfort or distract them. Play music, put on their favorite TV show, give them a snack, go on a walk with them, or give them a beloved pet to comfort them. Simple tasks such as folding or sorting laundry can be a helpful distraction, or have a family member call around the same time every day.
Using candles or essential oils can provide familiar or calming scents to soothe. Consider providing them with a foot or hand massage to relax them, or have a professional come regularly to offer this service.
Using relaxation tools or triggering familiarity with songs or TV can provide comfort to your loved one struggling with memory loss and be an effective tool in giving them relief.
Tips to prevent sundowning syndrome
Structure and routine
A consistent daily routine could help your loved one immensely, as well as organizing the day in ways that will benefit them.
For example, keep the most activity during the morning or early afternoon. This includes bathing, doctor’s appointments, trips, or exercise. Physical activity and exposure to daylight are important for helping to reset the body clock. In the winter months consider using a light box.
If your parents need to nap, keep them short and earlier in the day so that they won’t interfere with sleeping through the night.
Keep things simple
During sundowning hours, keep their environment calm and simple. Reduce activity and noise, and keep their room free of clutter and anything stimulating. Plan a larger meal for lunch and a lighter one for dinner, and keep things well lit to reduce shadows and confusion.
Don’t serve caffeine or sugar too late in the day, and reduce liquid intake to avoid increased bathroom needs.
Also make sure you are tending to your own needs to reduce your parent picking up on any nonverbal stress or frustration you may have.
Talk to your doctor
If symptoms persist, talk to their doctor about medications, herbs, or supplements that can help with your loved one’s anxiety during this time of day. Have your loved one evaluated to identify if they are experiencing any pain or have a condition such as sleep apnea that could be contributing to their symptoms.
Make sure you ask about any medication side effects that also could affect how they are feeling.
If symptoms progress
As memory loss progresses, you might find that it becomes more and more difficult to help your loved one find relief, or to keep them safe. It may be time to consider moving your loved one to an assisted living community for around-the-clock professional care where they will be safe and supported.
The Kensington Falls Church offers state-of-the-art memory care for seniors experiencing any level of Alzheimer’s or dementia. Your loved one will be fully supported by dedicated staff who will create a structured, comforting environment where they can thrive.
Contact us today to hear more about our memory care community and programs. We want to support you and provide relief so that you can do what is best for your loved one.