Sundowning is an Alzheimer’s symptom. It is also known as late-day confusion. If you have Alzheimer’s or another form of dementia, you may find that your confusion and agitation gets worse late in the afternoon and into the evening. In comparison, your symptoms may be less obvious earlier in the day. this is known as sundowners dementia.
You are most likely to experience sundowning if you have mid-stage to advanced dementia. There are steps you can take to help reduce sundowning, so it is important to learn about these in the early stages of Alzheimer's and get some good habits in place.
Tips for Alzheimer's Patients
1. Stay Active
Many people have trouble sleeping at night when they experience sundowning. Fatigue is also a common trigger of sundowning. This can create a vicious circle. Too much daytime napping and inactivity can make it harder for you to fall asleep at night time. To promote a good night’s sleep, stay as active as you can during the day. For example, take walks in the park with loved ones or clear some space to have a dance. This might help improve your quality of sleep and reduce your sundowning symptoms. It can also help to improve your physical health.
2. Minimize Your Stress Levels
Try to stay calm in the evening hours. Stick to simple activities that aren’t too challenging or frightening. Frustration and stress can add to your irritability and confusion.
If you have mid-stage or advanced dementia, even watching television or reading a book might be too challenging for you. Instead, consider playing soft music to create a calm and quiet atmosphere. Or if you have a beloved pet, the evening hours might be a good time for a cuddle.
3. Have a Schedule
Alzheimer’s can make it hard for you to develop and remember new routines. You might react to unfamiliar places and things with feelings of stress, confusion and anger. These feelings can play a large role in sundowning.
Sticking to the same schedule every day will help you feel more calm and collected. Try to avoid making changes to routines that work for you and those that care for you. If it is necessary to make changes, try to adjust your routine gradually and as little as possible.
4. Adjust Your Eating Patterns
Adjusting your eating patterns may also help reduce your sundowning symptoms. Large meals can increase your agitation and may keep you up at night.
Try to avoid caffeine or alcohol or enjoy them at lunch instead of dinner. Limiting your evening food intake to a hearty snack or light meal might help you feel more comfortable and rest easier at night.
5. Light Up Your Life
You might experience sundowning as the result of changes in your circadian rhythms — your sleep-wake cycles. Adjusting the light in your home might help to reduce your symptoms.
According to research published in Psychiatric Investigation, some studies suggest light therapy can reduce agitation and confusion in people with dementia.
Try placing a full-spectrum fluorescent light about one meter away from you for a couple of hours each morning. The Alzheimer’s Association also suggests brightening the lights when you feel confused or agitated.
Tips for Caregivers
As your disease progresses, you will more than likely need help to care for yourself, whether that be from family members, friends or paid professionals. The tips below aim to assist these people to help you.
6. Provide Familiarity and Comfort
When people are ill, they usually want to be surrounded by comforting thoughts, things and people. For someone with Alzheimer’s, the world can become a frightening place. Comfort and familiarity can help them cope with this difficult time in life.
If you care for someone with Alzheimer’s, fill their life and home with things they find comforting. If they move into a hospital or assisted living facility, furnish the space around them with cherished items.
For example, bring their favorite blanket or family photos to their new home. This may help to ease the transition and curb their sundowning symptoms.
7. Monitor Behavior
Each individual has different triggers for sundowning. To help identify the triggers of the person you care for it can be helpful to monitor their behavior.
Try using a journal or smartphone app to track their daily activities, environments and behaviors. Look for patterns to learn which activities or environments seem to make their symptoms worse.
Once you know what their triggers are, it will be easier to avoid situations that make them agitated or confused.
8. Remember to Care for Yourself
Sundowning syndrome can be exhausting, not just for those that experience it, but for the people who care for them too. As a caregiver, it is essential to take good care of yourself. You’ll be in a better position to offer the patience and support when you are rested and healthy.
Take regular breaks, eat a well-balanced diet, exercise regularly and try to get enough sleep at night. If you are a family member or friend, you can also speak to your doctor about respite care and other professional support services, which can help you take time out.