Overview
This note addresses the challenges of managing sundowning behaviors in a family member with dementia, describing symptoms, causes, and practical strategies to help during late afternoon and evening hours.
Sundowning Symptoms and Causes
- Sundowning is common in people with dementia, usually appearing at sunset or early evening.
- Symptoms include confusion, anxiety, aggression, agitation, ignoring directions, pacing, or wandering.
- It occurs as dementia affects brain areas regulating the internal clock, disrupting sleep and wake cycles.
- Reduced evening light and extra tiredness or anxiety can worsen sundowning symptoms.
Strategies to Manage Sundowning
- Ensure rooms are well-lit in the evening, reducing shadows and preventing confusion.
- Close drapes or blinds and adjust lighting as needed to create a consistent environment.
- Minimize loud noises and environmental disruptions in the evening.
- Engage your loved one in relaxing and enjoyable activities to distract from agitation.
- Be patient and gently redirect with reassuring and familiar routines.
- Encourage enough daytime activity to prevent restlessness, but avoid overexertion.
- Limit daytime napping to two hours or less to help maintain a healthy sleep cycle.
Recommendations / Advice
- Use environmental cues and calming activities in the evening to help manage sundowning behaviors.
- Maintain consistent routines and lighting to reduce confusion and agitation.
- Monitor for signs of fatigue or boredom during the day and adjust activities accordingly.