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Understanding Sundowning

Sundowning is the term for daily symptomatic personality changes that dementia patients experience. Sundowning occurs around the same time every day; usually at dusk. You may notice your patient or loved one experiencing some or all of these symptoms in the evening.

• Intensified confusion
• Agitation
• Pacing and wandering
• Restlessness
• Sleeplessness
• Combative behavior

Since our clocks shifted ahead an hour and the days are getting longer, your family member or patient may experience sundowning symptoms a bit later in the day, which could require a change to their caregiver’s schedule or adjustments to the patient’s evening routine.

The most important thing is that you understand that Sundowning is real, and you should treat it as you do other dementia symptoms. It’s helpful to know that there are things you can do to help minimize the patient’s symptoms.

Some theories state that mental and physical fatigue brings on sundowning symptoms. However, if a fatigued patient is treated with a familiar evening routine in peaceful and calm surroundings, they will wind down with minimum stress and be prepared for a good night sleep. To reduce sleep disturbances, encourage daytime activity and exercise, and discourage excessive daytime napping.

The right eating habits can also help reduce sundowning symptoms. Be sure to limit late day caffeine and sugar.You may even shift your patient’s eating habits by serving a larger meal earlier in the day, and prepare a lighter fare for dinner. This will make them more feel more comfortable and will help provide a more restful sleep.

As the day comes to an end, the darkness itself can cause problems for dementia patients. Increased shadows can make them unsure of what they see. This could cause agitation and fear. Be sure to turn on indoor lights as soon as daylight begins to fade. Keep a nightlight on when your patient goes to bed. If they awake during the night, they will not feel as frightened or confused if there is light in the room.

For more information on sundowning and sleep disturbances, visit the Alzheimer’s’ Association website.