What is Sundowning and why does it occur?

What Is Sundowning And Why Does It Occur? |

If you are the caregiver for a loved one with dementia, you may experience a noticeable change in your parent’s behavior in the evening hours.   As the sun begins to set, your parent may act in ways that are out of character for them.  This change in behavior is referred to commonly as sundowning. 

Sundowning is a group of symptoms that occur in someone with memory loss that can start around dinnertime and continue into the night.  These changes seem to be triggered by the fading sunlight. Although the exact reason why sundowning happens is not known, researchers believe it’s a disruption in circadian rhythms— in other words, a disruption to a person’s natural body clock.  Circadian rhythms signal when to wake and to sleep.  When this is disrupted, it can be both irritating and frustrating, which is acted out through their behaviors. 

As unique as the individuals themselves, behaviors can range.  However, some of the most common examples include: 

  • Agitation
  • Extreme anxiety
  • Discomfort
  • Suspicion
  • Hallucinations
  • Confusion
  • Bad mood, anger, temper
  • Ignoring
  • Can’t follow directions
  • Demanding

Often, if a person has poor eyesight or difficulty hearing, these behaviors are compounded. The duration of these symptoms can stop abruptly, fade over time, or change.  There are no clear predictors to the sundowning behavior.   But as a caregiver, you are not alone.  Sundowning is not a simple condition, but it is a common occurrence that many caregiver struggle with during their course of caring for a loved one.

How can you best manage these behaviors?

Light Therapy

We suggest using a dawn simulator in your home as an easy and natural way to help reset a person’s circadian rhythms by signaling the start and end to their day with light. These helpful devices are very user-friendly and affordable.  The dawn simulator increases light intensity 30 minutes before waking up in the morning and decreases brightness gradually 30 minutes before their bedtime. 

Regular Schedule During the Day and Evening

Life is busy.  A life juggling family, work, and caregiving can be more stressful and demanding than most.  But it’s essential to establish a regular and habitual routine every day.  Those with memory loss find comfort in a daily routine.  So wake up at the same time every morning and set up a bedtime ritual at night that includes time to wind down from the day. The daily routine will help to start the day and, more importantly, signal when it is nighttime.

Get Outside

Get your daily dose of vitamin D by getting outside every day.  If the weather is less than cooperative, a transparent umbrella in the rain will allow you to get outside and breathe the fresh air in the drizzle.  Exposure to sunlight, whether it is shining bright or overcast, will help to set your internal clock as well as stretch your legs during a short walk.  Also, keep the curtains and window shades open during the day to let in natural sunlight.  And keep your home well-lit, especially in the evenings, because adequate lighting can help ease symptoms of sundowning.

A Good Night’s Sleep

Fatigue and lack of sleep can worsen the symptoms and challenging behaviors associated with sundowning.  Focus on getting your parent the best night’s sleep possible.   Reducing stimulants in the evening, like radio and television, can minimize agitation.   Avoiding caffeine, alcohol, and nicotine will help with better sleep patterns.  A bedtime ritual to help them wind down and relax in the evening is necessary, but also consider curbing their long naps in the afternoon.  If they need to rest, try a short 20-minute catnap. A little exercise and activities during the day can result in better sleep at night, so keep a full calendar to engage them.  

Talk to Their Doctor

Consult with your parent’s doctor about their evening sundowning issues, especially if these have come on quickly.   You want to rule out if there is an underlying issue causing these symptoms or if this is a normal progression of their dementia.  Many times, doctors have found that a patient is dehydrated or suffering from a UTI, and those issues can impact the behaviors of an older person with Alzheimer’s or another form of dementia. There are also medications on the market for sundowning.  Your doctor may be able to recommend an appropriate treatment.

Aegis Living has over two decades of experience in the field of memory care and caring for those with advanced dementia.   We offer expert advice through community events open to the public to learn from experts in various fields about understanding and managing behaviors, such as sundowning.   Contact your local Aegis Living community to find out if they are hosting an expert speaker event in your neighborhood. 

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