What is Sundowning? How Does it Affect Those with Alzheimer’s & Dementia?

Aging brings with it many physical and cognitive changes. Some cognitive decline, typically a slowing in processing speed, is normal. However, more extreme cognitive deficits are typically a sign of dementia or Alzheimer’s. Such conditions can be frightening. Individuals and their families may not know what to expect. People typically following a trajectory of worsening symptoms, but one that is not often talked about, is sundowning. This is a phenomenon where dementia symptoms seem to worsen in the evening.

Learn more about sundowning and how to address it, to help the aging adult in your life:

Symptoms of Sundowning

As noted, sundowning describes a phenomenon where dementia patients exhibit increased confusion in the evening. Often, these individuals will become anxious and agitated. They might convey a belief they are in the wrong place and need to go home. They may want to launch into the typical evening behaviors of their past—picking up children from school, running to the grocery store, and going home to start dinner. When not allowed to leave their location, they may become increasingly argumentative.

Causes of Sundowning 

The symptoms of sundowning seem to be the result of a few variables or components working together. For one, aging adults who have been awake all day, may find themselves becoming fatigued. This can affect their already diminished cognitive functioning. This factor can be further exacerbated if the individual is hungry or thirsty. Evening is also the time of day when the sun sets, and seniors may be accustomed to a certain routine. They become concerned they are not where they should be.

Another factor that can contribute to sundowning is stress. Of course, stress is a factor that can worsen the symptoms of many different mental and physical health disorders. For an individual with dementia, their ability to understand and manage stressful situations may be somewhat diminished. When they do face stress, they may become confused, and react quite differently than they would have in the past. Daytime and evening stress can contribute to and exacerbate the occurrence of sundowning symptoms.

Prevention of Sundowning 

Fortunately, to help an aging adult avoid the escalation of confusion, you can take steps to prevent the symptoms of sundowning. One way to prevent sundowning is to maintain a daily routine. Establishing a new routine can help an aging adult find some sense of stability. The routine should include activity. You may think a nap would be helpful to avoid fatigue, but it may actually be more prudent to avoid naps, so the senior will be tired enough to go to bed in the early evening and can sleep well through the night.

Limit the individual’s intake of caffeine, especially in the evening, and perhaps eliminate alcohol altogether. Both can affect sleep-wake cycles and add to confusion. Avoid large meals in the evening, as this may also disrupt regular sleep patterns. To ease the evening transition, turn on lights and close the blinds or curtains. Implement an evening routine that can help to induce calm and prepare the individual for bedtime. This might include watching a favorite television program or listening to relaxing music.

Management of Sundowning 

When symptoms of sundowning do occur, you can take steps to help manage the situation. Stay calm, ask the individual gentle questions, listen carefully, and respond in a soothing voice. Do what you can to reduce their distress by explaining the circumstances so they can understand. Use distraction techniques to shift their mind from their distress. Take them to a different room or engage them in a calming activity. Ensure they have food, water, prescribed medications, and help them prepare for bedtime.

Final Recommendations 

Many families want to help their seniors remain at home. This is admirable as many seniors do find great benefits in being with their families. However, dementia and Alzheimer’s can be challenging conditions. Some families find that they are unable to give their senior the full level of care that they need. This is especially true for families where the adults all work and there are small children in the home. Ultimately, this environment may not be ideal for the aging adult either. They may find it chaotic and unsettling, and it may exacerbate their dementia symptoms, including occurrences of sundowning.

Families may decide that it is in their seniors’ best interest to move into a memory care setting. These locations are ideal for the population because they have specialized services and staff trained to provide dementia care. The calm environment, routine, and stability can help an aging adult with dementia to feel at their best. This can help to prevent symptoms of sundowning and at least contain the symptoms when they do occur. If you are looking for a dementia care setting for your senior, consider Quail Park Memory Care Residences. Their services focus on providing for quality of life while maintaining dignity.