What Is Sundowning and How to Deal With It


Sundowning is a challenging phenomenon often experienced by individuals with Alzheimer's disease and other forms of dementia. It's characterized by increased confusion, agitation, and anxiety during late afternoon and evening hours. Understanding what sundowning is and how to deal with it is crucial for caregivers and loved ones. In this article, we'll explore the causes of sundowning and provide strategies to manage and alleviate its effects.

Symptoms & Behaviors of Sundowning:

Sundowning, also known as "late-day confusion", is a term used to describe a range of behaviors and symptoms that tend to worsen as the day progresses. These behaviors may include:

  • Agitation: Restlessness, pacing, and wandering.
  • Confusion: Difficulty recognizing familiar people or places.
  • Anxiety: Increased fear or paranoia.
  • Irritability: Easily becoming frustrated or upset.
  • Hallucinations: Seeing or hearing things that aren't there.
  • Mood Swings: Rapid changes in mood, often from calm to upset.

Causes of Sundowning:

While the exact cause of sundowning is not fully understood, several factors may contribute to its occurrence:

  • Circadian Rhythm Disruption: Disruptions in the body's internal clock can affect sleep-wake cycles, leading to increased symptoms in the evening.
  • Fatigue: Mental and physical exhaustion throughout the day can worsen symptoms as the day goes on.
  • Sensory Overload: Overstimulation from noise, bright lights, or too much activity can increase confusion and anxiety.
  • Hunger or Thirst: Individuals may have difficulty expressing their basic needs, leading to discomfort.

How to Deal With Sundowning:

  • Establish a Routine: Consistency in daily routines, including meal and sleep times, can help manage sundowning. Keep the individual engaged during the day to reduce restlessness.
  • Create a Calm Environment: Minimize noise, clutter, and excessive stimulation in the late afternoon and evening. Use soft lighting to create a relaxing atmosphere.
  • Proper Nutrition: Ensure the individual is well-fed and hydrated, addressing any hunger or thirst that may be contributing to their discomfort.
  • Engage in Relaxation Techniques: Encourage calming activities such as gentle music, aromatherapy, or a warm bath to soothe anxiety.
  • Medication Management: Consult with a healthcare professional about medication options to manage sundowning symptoms. Medications should be used as a last resort due to potential side effects.
  • Caregiver Support: Caregivers should seek support and respite when dealing with sundowning. Managing these behaviors can be emotionally draining, so seeking help is vital.

Sundowning is a challenging aspect of dementia care, but with understanding and the right strategies, its impact can be minimized. It's crucial to remember that each person's experience with sundowning is unique, and caregivers should adapt their approach to meet individual needs. Consult with healthcare professionals, support groups, and dementia specialists for guidance in managing sundowning effectively while providing the best possible care and support to your loved one.