Dementia: A Guide to Sundowning

Sunrise  |  October 24, 2019
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Sundowning is a symptom of many forms of dementia, including Alzheimer’s. It refers to the changes of behaviour that can occur in the evening for people living with dementia, i.e. just when the sun is going down. This can particularly affect people with mid-stage to advanced dementia and is often known as “late-day confusion.”

The late afternoon or early evening can be a really tricky time for sufferers. It’s common for an individual to experience sundowning, which can include confusion, agitation, irritability and restlessness. The particularly difficult thing is that this comes at just the time caregivers may need to take a break.

Sundowning can even continue past dusk and into the night, affecting the sleeping patterns of both an individual and their carer. This can cause a myriad of knock-on effects, affecting mood, activity levels and general health.

This is a pattern of behaviour that can unfortunately continue for several months.

Causes

There are lots of reasons why sundowning might occur. One possibility that has often been raised is that the brain changes associated with dementia can affect a person’s “biological clock” which tells them when to sleep. Sundowning can also be caused by the wearing off of prescribed medication later on in the day, boredom, too much noise and light, or other pre-existing medical conditions including hearing or sight loss, pain and depression.

Quality of life

A person living with dementia may benefit from doing things they find relaxing and enjoyable at this time of day, in order to take their mind off of sundowning-associated issues. These distraction techniques can include making a snack or a drink, enjoying time with a pet, watching a calming television programme, listening to soothing music or going out for a short walk.

If you are caring for a loved one with dementia, it’s important to take the time to speak to the person when their mood changes. Talk in short sentences in a calm and soothing way and ask them what’s wrong and how you can help – show them you are there to listen.

Throughout the day, it can also be helpful to limit the amount of naps a person takes to encourage them to sleep better once night-time hits. Natural daylight is also helpful, so think about the physical environment by keeping curtains open and using rooms with natural light. This can support a natural body-clock and subsequent sleeping pattern.

Once the transition to night-time begins, it may also be helpful to turn lights off in the household, close the curtains and cover up any potentially confusing reflections from glass surfaces. Keep an evening routine going to make that transition as easy as possible.

Whilst sundowning can be a difficult reality for so many people affected by dementia, there are things that can be done to manage it as it happens. To find out more about dementia care at Sunrise Senior Living UK, please visit our website on www.sunrise-care.co.uk or visit your local Sunrise community.