Caring for a loved one with dementia can be a challenging journey. Among the many difficulties that caregivers can face, one particular phenomenon is sundowning. Also known as “sundown syndrome,” sundowning refers to a cluster of symptoms that tend to heighten in the late afternoon and evening in people with dementia. Symptoms include increased confusion, agitation, and anxiety. Other unusual behaviors linked to sundowning include seeing or hearing things that are not there or accusing people of things that are not true.

While the exact cause of sundowning remains uncertain, several factors may contribute to its onset, including changes in the brain, disrupted circadian rhythms, tiredness, and sensory overstimulation.

“This late-day confusion often stems from changes in light caused by the setting sun. With the time change in the fall and the sun setting earlier, caregivers may see signs of sundowning,” said Cheryl Conley, MA, Social Services Director. “Fading outside light and increased indoor shadows can upset a person’s internal “clock,” which then leads to disorientation.”

Strategies to reduce late-day confusion and agitation

There are a number of strategies to help caregivers reduce the effects brought on by the loss of natural light in the late afternoon and evening.

“Create a calming environment at home by turning on lights early in the afternoon, playing soothing music, and setting the thermostat to a comfortable temperature,” Cheryl said.

Other ways to reduce the sundowning include:

  • Establishing a routine: Maintain a consistent daily routine to help regulate your loved one’s internal clock. Consistency can provide a sense of security and predictability, reducing anxiety and confusion.
  • Limiting stimulants: Minimize caffeine and sugar intake, especially in the afternoon. These substances can intensify restlessness and agitation.
  • Engaging in calming activities: Encourage gentle and relaxing activities like reading, listening to music, or practicing deep breathing exercises to help reduce agitation.
  • Monitoring diet: Ensure your loved one has a balanced diet and stays hydrated throughout the day. Hunger or dehydration can worsen sundowning symptoms.
  • Reviewing their medications: Consult your loved one’s physician to review their medications. Sometimes, adjusting the timing or type of medications can help alleviate sundowning symptoms.

“It’s important to stay patient and supportive,” Cheryl said. “Sundowning can be extremely challenging, but remaining patient and compassionate is crucial. Offer reassurance, and try to understand their perspective, even if their behavior is distracting or upsetting.”

Sundowning is a complex and distressing aspect of dementia caregiving, but with understanding, patience, and the right strategies, caregivers can help their loved ones navigate these challenging moments.

Remember that you are not alone on this journey. MemoryLane Care Services provides care coaching and counseling services for caregivers. The day program for adults living with short-term memory loss and dementia as well as older adults who cannot be left alone during the day offers activities that encourage socialization, provide cognitive enrichment, and reduce isolation and loneliness.

For more information, view our caregiver tip sheet, which is linked above, or call us at 419-720-4940.