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What is Sundowning and why does it occur?

Posted by Kathy Stewart
Date:

Vegas Sundowning

Do you notice a significant change in your dad’s behavior close to dinnertime?   Does your mom’s mood darken in the evening most nights?  If you are the caregiver for a parent with Alzheimer’s or another form of dementia, you may see behavior changes in the evening that seem unfamiliar or out of character for your parent.   This is known as Sundowning.  It is a group of symptoms that commonly occur in someone with dementia in the late afternoon and can persist into the night.  It’s a noticeable change in behavior or a state of confusion that is triggered by the fading light outside as the sun sets. Although the exact science of why this happens is unknown, many researchers believe a symptom of Alzheimer’s or dementia is a disruption in a person’s circadian rhythms.  In other words, it disrupts a person’s natural body clock and the signals of when to wake or when to sleep.  This disruption can cause irritation that is acted out through their behavior in the evening.

The behaviors that your parent may display associated with sundowning are as unique as the individual.  Negative behaviors are often compounded if your parent has a hard time hearing, or their eyesight is fading. Many behaviors can be presented, but some of the most common examples are:

  • Anxiety
  • Agitation or irritation
  • Suspicion about your actions or who you are
  • Confusion about where they are or who you might be or what year it is.
  • Can’t seem to get comfortable, pace back and forth due to restlessness, or even wander from the home
  • Express anger, yelling, swearing, or an overall bad mood and temper
  • Hallucinations where they may see or hear things that are not there
  • Unable to follow directions or completely ignore your help or guidance
  • Demanding behavior

The symptoms of Sundowning can stop abruptly, fade, or continue over time.  There is no clear way to predict this behavior.  The best way to address Sundowning is to implement ways to manage the behavior.  In our Aegis Living communities, we have integrated light therapy programs for our dementia residents.  A dawn simulator placed in our resident’s apartment can help to reset their circadian rhythms naturally.  It is a simple way to start their day and a signal at the end of the day.

A dawn simulator exposes your parent to a slowly increasing intensity of light for 30 minutes before waking up in the morning.  And at night, the light will decrease gradually for 30 minutes before their set bedtime.  Dawn and sunset simulators are easily found online because they have gained a lot of popularity in recent years to help those with seasonal affective disorder (SAD), some types of depression, sleeping disorders, and even jet lag. These types of devices continued to advance and improve to be very user-friendly and come in a range of prices.

With over 20 years of experience caring for seniors with memory loss and the behavior changes that often accompany dementia, we have a few tips for caregivers to help alleviate the effects of Sundowning.

  • We understand that your life is busy and the additional stress of caring for your loved one can make schedule planning more difficult. But it is essential that you keep your parent on a regular schedule every day.  It is important to also include a bedtime routine to help them wind down at the end of the day and signal that it is night time.  In the evening, we suggest that you reduce background noises like the television and radio that can cause agitation. And avoid stimulants like alcohol, caffeine, and nicotine that can affect sleep patterns.
  • Fatigue can sometimes worsen the behaviors associated with sundowning, so getting a good night’s sleep is critical for their health and happiness. And this may mean you need to curb long naps during the daytime and keep them more engaged in activities throughout the day.
  • To keep their internal clock set, exposure to sunshine during the day is very helpful. Since we have many communities in the Pacific Northwest, Aegis Living provides clear umbrellas to our residents, so they are able to walk a short distance outside comfortably but still get a healthy dose of vitamin D in their day. Along with this idea, keep the house well-lit in the evening and night before bedtime.  For some, adequate lightening can decrease agitation.
  • When your parent is tucked in for the night, make sure their hearing aid or eyeglasses are within an arm’s reach of their bed. This will help them stay oriented if they need to get up during the night. It may sound simple and obvious, but it can have a positive effect.
  • And don’t forget to consult with your parent’s doctor, especially if sundowning behavior has happened quickly. You want to make sure this is a normal part of the progression of their dementia, and there isn’t another underlying issue.  Something as simple as dehydration or a UTI can significantly impact the behavior of a parent suffering from Alzheimer’s or another form of dementia.
  • Aegis Living has over 20 years of experience in the field of memory care. Keep an eye out for local speaking engagements or, ‘Ask the Expert’ events at a local Aegis Living community to learn additional insights or tips for dealing with behaviors associated with dementia, such as sundowning.

If you are interested in moving your parent to a memory care community, contact your local Aegis Living community to schedule a tour and see all that we can offer your parent.