What is Dementia Sundowning and Can it Be Managed?

Patients diagnosed with Alzheimer’s disease or other forms of dementia may suddenly exhibit a change in behavior later in the afternoon or early evening. While these changes may only last a few hours for some, for others they can last through the night. These sudden behavioral changes for individuals with dementia is known as sundowning or sundown syndrome, and can often be referred to as late-day confusion. The behavioral changes that occur with sundowning not only confuse and stress the dementia patient, but can also cause a great deal of anxiety and stress for loved ones and are givers.

Sundown syndrome is a symptom of all forms of dementia, and according to the Alzheimer’s Association, research shows that about 20% of patients with Alzheimer’s experience sundowning. Sundowning can trigger sudden emotional, cognitive, and behavioral changes including:

Increased confusion
Delusions
Hallucinations
Restlessness
Anxiety
Energy surges
Mood swings
Sadness

These sudden changes brought on by sundowning can result in hostile, aggressive, or difficult behaviors like disorientation, rocking, pacing, screaming, crying, anger, or resistance. It can also unfortunately result in violence. When an individual is experiencing sundowning, they may suddenly feel the desperate need to go somewhere or do something but they really have no idea why they are feeling these things.

The longer sundowning symptoms last, the more likely the sleep schedule for the dementia patient will be disrupted, resulting in a person staying awake all night and sleeping most of the day.

Although the exact cause of sundowning remains unknown, the widespread thought is that dementia wreaks havoc on the body’s circadian clock. Because of this disruption and the stress that comes with living with dementia on a daily basis, patients often have low energy reserves by the end of the day and become very tired and irritable.

Can Sundown Syndrome Symptoms Be Managed?

As research continues to search for the answers to what the causes of sundowning are, loved ones and caregivers of patients with dementia can continue to be observant about what triggers these symptoms. Empathy, creativity, flexibility and strong observation skills are needed to find ways to address symptoms when they occur. It’s important to keep in mind that every individual is different, and an approach that works for one patient may not work for another. Even the most minor success can greatly help to relieve the stress and anxiety you or your loved one feel when sundowning occurs.

– Be alert for and try to minimize triggers.

One of the most important ways to manage sundown syndrome symptoms is by observing what triggers the symptoms to begin with. This could be caused by a noisier environment when family members visit in the evening, loud conversations in the shared assisted living dining area, or the hour during a care staff shift change. It’s important to be aware of signs that your loved one is becoming fatigued or agitated when their environment becomes more crowded.

– Keep activities and routines structured.

Familiarity provides security for patients suffering with dementia. One of the best ways to help them cope is by ensuring they have a regular daily routine. Try to reduce napping as much as possible by making the most of any available activities offered by their assisted living community during the day. You can have them sit in the same place during meals in the shared dining room, or make sure they are getting ready for bed at around the same time every night. It’s best to avoid visits from multiple family members or stressful tasks as the sun starts to go down.

– Stimulate a regular sleep-wake cycle.
Natural sunlight is the most important cue for a dementia patient as to when it is time to go to sleep and when it is time to wake up. Ensuring their environment is well lit during the day can help them stay oriented. On the same hand, a darker environment will help them know it’s time to go to sleep.

It’s important that the tv, radio, or other forms of sensory stimulation are turned off at night. Leaving these items on not only disrupts the sleep cycle, it can cause sensory stimulation overload that results in anxiety and confusion.

– Make sure they are socializing.
It is often the case that loved ones or caregivers avoid exposing dementia patients to social situations for fear of an embarrassing situation occurring for the individual. While this is done with the best of intentions, it is not necessarily the right approach.

Studies have shown that patients with dementia who are socially isolated tend to deteriorate quicker than those who are able to engage regularly with others. Try to schedule regular social activities to keep your loved one engaged, but always be aware of signs that they are becoming tired, overwhelmed, agitated, or confused.

Conclusion

When your loved one is diagnosed with dementia it can be a stressful time for all involved. It can be an even more stressful time when your senior loved one exhibits symptoms of sundown syndrome. Addressing these issues requires patience, love, and understanding. Terrace Ridge Assisted Living is here to help. We offer a discerning residential environment for those who, for whatever reason, should not live alone, but do not require skilled nursing care. Here, residents have the calm assurance that help is always available, should they require assistance with their activities of daily living. Residents may range from being very independent to being physically and/or memory challenged. Contact us today to learn more.