As the sun sets, some seniors with Alzheimer’s disease may display marked shifts in mood and behavior. States of irritability, agitation, restlessness and confusion flare up as daylight decreases. Caregivers and medical professionals refer to this sudden change in the elderly as sundown syndrome.
The terms “sundowning” and “late-day confusion” are interchangeable. Confusion and agitation are common in seniors living with dementia. However, when episodes of sundowning strike, these dementia symptoms intensify. During bright daylight hours, in comparison, sundown symptoms in seniors with Alzheimer’s are less pronounced.
What causes sundowning?
Experts have yet to pinpoint the cause for sundown syndrome. Medical specialists, however, link sundowning with the brain changes caused by Alzheimer’s disease. As a result, an elderly individual’s innate biological clock blurs the line between the cycles of sleeping and waking.
Sundowning may also be experienced as a consequence of external factors. Alzheimer’s patients who undergo physical pain or boredom may show symptoms. Unsatisfied hunger or thirst also contribute to the symptoms. Tiredness, boredom and depression are known to be triggers.
Additionally, seniors with dementia may undergo greater confusion as shadows increase during evening hours. Elderly individuals in the dream state may have difficulty distinguishing images in dreams from reality, leading to an exacerbation of sundowning symptoms. Low lighting also contributes to the syndrome.
Most instances of sundowning occur in seniors suffering from mid- to late-stage Alzheimer’s disease. Sundown syndrome itself is not considered a disease but a cluster of symptoms that manifest during a specific time of day—which is during late afternoon and extending into the night.
What are signs of sundowning?
Sundown syndrome displays as increased confusion and agitation once darkness starts to settle. Anxiety, pacing, uncharacteristic outbursts and wandering are all common signs of sundowning in elderly people living with dementia. These seniors become atypically upset or stressed late in the day.
What reduces symptoms of sundown syndrome?
When sundowning symptoms appear, caregivers may take steps to reduce their severity. Symptoms may be mitigated by simple adjustments to the senior’s schedule and minor alterations to the individual’s home environment. Some researchers suggest that small doses of melatonin are also effective.
Tip 1: Establish Routine
Seniors with dementia thrive when routines are prescribed. Avoid sundowning symptoms by maintaining a predictable waking, bedtime, meal and daytime activity schedule daily. Fill each day with appropriate activities as well as adequate exposure to daylight to encourage nighttime sleepiness.
Tip 2: Encourage Rest
Improve the chances of quality sleep by limiting caffeine and sugar to morning hours. Refrain from serving alcoholic drinks, which only augment elderly individuals’ anxiety and confusion. Discourage daytime napping; if napping during the day is necessary, keep the naps short and early in the day.
Tip 3: Promote Exercise
A senior who experiences a day of light-to-moderate exercise will sleep restfully at night. Outlets through which the senior has opportunities to exercise include walks, whether at the park or around the home, and exercise classes at the local senior center.
While an optimum amount of exercise is important to a senior’s physical health and ability to get a good night’s rest, be careful to avoid planning too much activity during the day. A schedule filled with excessive activities tires a senior. Fatigue only increases sundown symptoms.
Tip 4: Enhance Lighting
At night, turn on a nightlight to reduce the agitation that stems from being in dark, unfamiliar surroundings. Light therapy also works to comfort a confused senior. Light a full-spectrum fluorescent light near the senior for two hours each morning. Consider brightening the lights when the individual experiences increased agitation.
Tip 5: Reduce Stress
A calm evening environment helps a senior with dementia relax, which in turn reduces symptoms of sundown syndrome. During evening hours, reduce background noise. Limit television watching, which is a stimulating activity that can sometimes be upsetting for individuals suffering from dementia.
Playing gentle music or familiar sounds that mimic nature enhances a senior’s ability to wind down for the evening. Create a familiar, relaxed setting (especially if the senior stays within a residential facility) by displaying recognizable photographs of beloved people and places.
Tip 6: Provide Distractions
When the senior resides in a nursing facility, the daily staff shift changes can prompt agitation in the individual with Alzheimer’s. Distract the senior when the burst of activity puts them in a mode for engaging in activities (like checking on the kids) that were once appropriate for the afternoon.
Tip 7: Consult a Physician
A visit to a physician may be warranted if the symptoms of sundowning persist. The senior’s doctor may be able to pinpoint an underlying issue, such as pain, medication side effect, sleep disorder or other illness, that causes the sundown symptoms to continue.
The senior’s physician may prescribe medications that promote better nighttime rest, but oftentimes sleep medicines are only intended for the short-term. Plus, medications that enhance sleep may come with unwanted side effects or increase the chances of falls or dizziness.
Seniors who display symptoms of sundown syndrome can be comforted by skilled caregiving professionals, such as those from Assisting Hands Home Care. Our team of dedicated memory care providers are experienced in identifying the symptoms of Alzheimer’s and dementia and compassionately responding to them.
If your aging loved one wanders due to sundown syndrome, Assisting Hands Home Care caregivers will gently guide them throughout the home, ensuring trip hazards are out of the way. We understand that exercise is important to a restful sleep, so we’ll accompany care recipients on walks or transport them to senior exercise classes.
In addition to these aforementioned services, Assisting Hands Home Care service providers offer a range of non-medical services to optimize your loved one’s well-being each day. Our caregivers are instrumental in assisting with the activities of daily living, such as bathing, meal preparation and medication reminders.
Families in Hinsdale, Downers Grove, La Grange and the surrounding communities of Cook and DuPage Counties, Illinois, place full trust in the skilled home care services provided by Assisting Hands Home Care. Consult our representatives for a free memory care assessment.