What is Sundowing?
Sundowning is a
symptom of Alzheimer's disease and other forms of dementia. It's
also known as “late-day confusion.” If someone you care for has
dementia, their confusion and agitation may get worse in the late
afternoon and evening. Sundowning is a symptom of Alzheimer's disease and other forms of
dementia. Confusion and agitation worsen in the late afternoon and
evening, or as the sun goes down. Symptoms are less pronounced
earlier in the day. Sundowning most often affects people who have
mid-stage and advanced dementia.
What Causes Sundowning
Taking care of a person with Alzheimer’s disease is rarely easy. It can get more difficult, however, in the evenings. As many as 20% of people with Alzheimer’s become particularly agitated, anxious, and restless as daylight fades; these symptoms can last throughout the night. This is called “Sundowning” and it can be very disruptive—both for the Alzheimer’s patient and the caretaker.
Sundowning is a symptom of Alzheimer's disease and other forms of dementia. Confusion and agitation worsen in the late afternoon and evening, or as the sun goes down. Symptoms are less pronounced earlier in the day. Sundowning most often affects people who have mid-stage and advanced dementia.
Doctors aren’t sure why sundowning happens, although it appears to be related to the changes Alzheimer’s disease causes in the brain.
A few of the possible
causes and triggers may include:
How to Tell if Your Loved One is Sundowning
Sundowning can occur as early as late afternoon, and may last all night; it usually gets better in the mornings.
The symptoms include:
What You Can
Fading light seems to be a pretty universal trigger for sundowning,
but your loved one might have other triggers that make sundowning
more likely. Try to observe and be aware of what seems to trip the
behavior, and try to minimize that in the patient’s environment if
Keep a steady routine.
Try to give the patient a
predictable schedule for waking, eating, sleeping, and other
activities. Routines can be comforting and a change in routine may
be contributing to the person’s anxiety.
Help your loved one get a good night’s sleep.
The elderly frequently need less sleep
than younger people, and insomnia at night can add to agitation. Try
to set the stage for a good night’s sleep for your loved one. Help
them stay away from alcohol or cigarettes; let them eat sugar or
drink caffeine-laden drinks only in the mornings. Make them a large
lunch and keep dinners smaller. Try not to let the person nap or
exercise fewer than four hours before bedtime; naps should be short
and only earlier in the day.
Create a comforting environment.
Darkness triggers the behavior, so make sure their
environment is well-lit. Close curtains and blinds. Turn on relaxing
music that you know they like. Ask other people staying in the house
to stay quiet, and be sure the temperature in the house is
comfortable; be aware that the elderly can feel cold and heat more
acutely than younger people.
Talk to your doctor.
your doctor about what meds your loved one is taking and the
behavior you are seeing. Chronic pain can add to an Alzheimer’s
patient’s stress and agitation, as can insomnia. It is possible that
the sundowning behavior could be helped by pain or sleep
medications. It is also possible that your loved one’s current
medications may be contributing to the problem, and it might be
worth it to try a different combination of medications.
In conclusion, Sundowning can be stressful for caregivers and difficult to deal with. In addition to the above, it may be helpful to join a caregiver support group to cope with the challenges. Hopefully, you can reduce the symptoms by creating a calming environment for the patient, reducing triggers, and talking to your doctor about possible treatment.
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