What is Sundowing?
The term "sundowning" refers to a
state of confusion occurring in the late afternoon and spanning into
the night. Sundowning can cause a variety of behaviors, such as
confusion, anxiety, aggression or ignoring directions. Sundowning
can also lead to pacing or wandering.
Sundowning isn't a disease, but a group of symptoms that occur at a specific time of the day that may affect people with dementia, such as Alzheimer's disease. The exact cause of this behavior is unknown.
When sundowning occurs in a
it may be related to the flurry of activity during staff shift
changes or the lack of structured activities in the late afternoon
and evening. Staff arriving and leaving may cue some people with
Alzheimer's to want to go home or to check on their children ó or
other behaviors that were appropriate in the late afternoon in their
past. It may help to occupy their time with another activity during
Sundowning Causes and Triggers
Doctors arenít sure why sundowning happens, although it appears to be related to the changes Alzheimerís 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 patientís environment if
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 personís anxiety.
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 nightís 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.
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.
your doctor about what meds your loved one is taking and the
behavior you are seeing. Chronic pain can add to an Alzheimerís
patientís 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 oneís 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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