Sundowning, or “late-day confusion,” is a challenging experience for individuals with dementia and their caregivers. This phenomenon, occurring in the late afternoon or evening, brings about increased confusion, anxiety, and agitation. Caregivers need to comprehend sundowning and offer compassionate care to ensure the well-being of their loved ones. This article delves into effective pharmacological and non-pharmacological strategies to manage sundowning and create a safe environment.
What is Sundowning?
Sundowning is a problem that some people with dementia have. Dementia is a condition that affects the brain and makes it hard to remember things, think clearly, or do everyday tasks. Alzheimer's disease is the most common type of dementia. Sundowning means that the person with dementia feels more confused, restless, or upset in the late afternoon or evening. They may pace around, wander away, or get angry. This can be scary or stressful for them and their family or caregivers. Sundowning happens because the person's body clock is not working well. They may also be tired, hungry, thirsty, or overstimulated by noise or light.
What Causes Sundowning?
We don't know exactly what causes sundowning, but some things may make it more likely to happen. These include:
- A problem with their body clock. The body clock is a system in the brain that tells us when to sleep and when to wake up. It is affected by light and darkness. A person with dementia may have a problem with their body clock, making them feel more awake or alert at night and sleepy or dull during the day.
- Being tired or sleepy. A person with dementia may have trouble sleeping at night or napping too much during the day, making them feel more confused or restless when the sun goes down.
- Low Light or shadows. A person with dementia may not see well in the dark or get confused by the changing light, making them feel more anxious or afraid.
- Having an infection or another illness. People with dementia may have a fever, pain, or other symptoms that make them feel more uncomfortable or unwell. This can make them more irritable or agitated.
- Taking certain medicines. Some medicines can have side effects that affect the mood, memory, or behavior of the person with dementia. They may also interact with other drugs or change how the body works.
Sundowning can be different for each person with dementia. Some people may have it more often or more severely than others. Some people may have it only for a brief time or only in certain situations. Pay attention to what triggers or worsens sundowning for your loved one and try to avoid or reduce those factors.
How to Manage Sundowning?
Sundowning is when the person with dementia feels more confused or upset in the late afternoon or evening. They may pace around, wander away, or get angry. This can be scary or stressful for them and you. Here are some tips on how to reduce sundowning:
- Keep a predictable routine. Try to do the same things at the same time every day, like eating, sleeping, and having fun. This can help the person with dementia feel more secure and comfortable.
- Limit caffeine and sugar. Avoid giving the person with dementia coffee, tea, soda, or sweets in the afternoon or evening. These can make them more alert or restless and affect their sleep.
- Make the home well-lit. Use lamps, candles, or nightlights to make the rooms bright and cozy. This can help the person with dementia see better and not get scared or confused by the dark or shadows.
- Do some calming activities. You can help people with dementia relax and enjoy themselves by doing things they like, such as listening to music, looking at photos, walking, or cuddling. This can also distract them from any worries or fears they may have.
- Talk to the doctor. If sundowning persists or worsens, it may be a sign of another problem, such as an infection, pain, or a side effect of a medicine. You should consult the person's doctor and see if they need any tests or treatments. The doctor may also suggest some medicines that can help with sundowning, but use them carefully and follow the instructions.
Creating a Safe Environment
Sometimes, people with dementia may feel more confused or upset when the sun goes down. This is called sundowning. It can make them do things that are not safe, like wandering away or getting angry. You can help your loved one feel safer and calmer by following these tips:
- Try to keep the same routine every day. This means doing the same things simultaneously, like eating, sleeping, and having fun. This can help your loved one know what to expect and feel more secure.
- Ensure there is enough light in the house, especially in the evening. You can use lamps, candles, or nightlights to brighten the rooms. This can help your loved one see better without getting lost or scared in the dark.
- Avoid loud noises and too much activity that can make your loved one nervous or overwhelmed. You can play soft music or turn on a fan to create soothing sounds. This can help your loved one relax and focus.
- Listen to your loved one and try to understand how they feel. Don't argue with them or correct them if they say something wrong. Instead, show them that you care and are there for them. You can talk about things that make them happy or remind them of good memories. This can help your loved one feel more connected and valued.
- Talk to a doctor before giving your loved one any medicine for sundowning. Some medicines can help with the symptoms but also have side effects or interactions. Only use them as directed and watch for changes in your loved one's behavior or health.
Conclusion
Sundowning is a problem that some people with dementia have. It means they feel more confused or upset when the sun goes down. This can be hard for them and you, but you are not alone. You can do many things to help your loved one feel safer and calmer, such as keeping a routine, keeping the home well-lit, doing some calming activities, and talking to the doctor. You are doing a wonderful job of caring for your loved one with dementia. Remember to take care of yourself too. You deserve some rest and support. Thank you for reading this article; I hope you found it helpful.
Resources
Sleep Issues and Sundowning
Fighting Alzheimer's From Sunrise to Sunset
Caregiver Training: Sundowning (video)
What is Sundowning? (video)
Sundowning: Late-day confusion
My Loved One with Dementia
Understanding Dementia (Alzheimer's & Vascular & Frontotemporal & Lewy Body Dementia) (Video)
How Do I Know Which Dementia I'm Looking At? (Video)
Dementia Training material (Free)
Promoting Meaningful Relationships with Dementia Patients through Validation Therapy
Unlocking the Power of Validation Therapy in Compassionate End-of-Life Care
Validation Therapy: A Valuable Tool for Families and Healthcare Teams
Best Practices for Approaching Combative Dementia Patients
The Validation Breakthrough: Simple Techniques for Communicating with People with Alzheimer's Disease and Other Dementias
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How Do I Know You? Dementia at the End of Life
The Dementia Caregiver: A Guide to Caring for Someone with Alzheimer's Disease and Other Neurocognitive Disorders (Guides to Caregiving)
Sundown Dementia, Vascular Dementia and Lewy Body Dementia Explained
The Caregiver's Guide to Dementia: Practical Advice for Caring for Yourself and Your Loved One (Caregiver's Guides)
Ahead of Dementia: A Real-World, Upfront, Straightforward, Step-by-Step Guide for Family Caregivers
The Dementia Caregiver's Survival Guide: An 11-Step Plan to Understand the Disease and How To Cope with Financial Challenges, Patient Aggression, and Depression Without Guilt, Overwhelm, or Burnout
Dementia Care Companion: The Complete Handbook of Practical Care from Early to Late Stage
As an Amazon Associate, I earn from qualifying purchases. The amount generated from these “qualifying purchases” helps to maintain this site.
The 36-Hour Day: A Family Guide to Caring for People Who Have Alzheimer's Disease and Other Dementias
Dementia Home Care: How to Prepare Before, During, and After
The Dementia Caregiver's Survival Guide: An 11-Step Plan to Understand the Disease and How To Cope with Financial Challenges, Patient Aggression, and Depression Without Guilt, Overwhelm, or Burnout
Dementia Caregiving: A Self Help Book for Dementia Caregivers Offering Practical Coping Strategies and Support to Overcome Burnout, Increase Awareness, and Build Mental & Emotional Resilience
Navigating the Dementia Journey: A Compassionate Guide to Understanding, Supporting, and Living With Dementia
Ahead of Dementia: A Real-World, Upfront, Straightforward, Step-by-Step Guide for Family Caregivers
Four Common Mistakes by Caregivers of Loved Ones with Dementia and what do differently (video)
Eldercare Locator: a nationwide service that connects older Americans and their caregivers with trustworthy local support resources
As an Amazon Associate, I earn from qualifying purchases. The amount generated from these “qualifying purchases” helps to maintain this site.
My Aging Parent Needs Help!: 7-Step Guide to Caregiving with No Regrets, More Compassion, and Going from Overwhelmed to Organized [Includes Tips for Caregiver Burnout]
Take Back Your Life: A Caregiver's Guide to Finding Freedom in the Midst of Overwhelm
The Conscious Caregiver: A Mindful Approach to Caring for Your Loved One Without Losing Yourself
Dear Caregiver, It's Your Life Too: 71 Self-Care Tips To Manage Stress, Avoid Burnout, And Find Joy Again While Caring For A Loved One
Everything Happens for a Reason: And Other Lies I've Loved
The Art of Dying
Final Gifts: Understanding the Special Awareness, Needs, and Communications of the Dying