Sundowning is a common symptom of different forms of dementia, sundowning involves an increase in symptoms of agitation and confusion, which occur during the early evening hours or late afternoon hours. The time between sunset and twilight can be especially disturbing for people who have dementia and sundowning symptoms.
Symptoms can include:
Worsening of behaviors in the late afternoon is a clue that sundowning may be starting. Fading light appears to be a trigger and sundowning symptoms get worse as the sun goes down. Usually symptoms begin to improve by the early morning hours.
Sundowning can put major stress on caregivers, as well as anyone else who spends the evening or nighttime hours with a person who has sundowning. The goal should be to help maintain a sense of calmness and keep them oriented to place and time.
A person with dementia is likely to react to unfamiliar places and faces they don’t recognize. Maintaining a regular schedule involving the same time for their daily ritual in the same location will help the person who is reacting negatively with confusion and anger. Avoid making changes if you can. If you must change their daily schedule, do it gradually.
Avoid giving large meals late in the evening, this can lessen the symptoms of sundowning. Avoid giving them alcohol and caffeine particularly late in the day. Offer light snacks in place of large meal towards the end of the day.
Administer their medicine timely as prescribed by their healthcare provider. Always consult their physician before giving any supplement.
Keep them active during the daytime hours — encourage walks, listening to music, light exercise if possible, etc. — This will help improve their sleep at night, while reducing seasonal sundowning symptoms.
Write down the factors that contribute to agitation, confusion and other sundowning symptoms. Share this with other caregivers, it will help them to manage and take care of your loved one.
Give them simple tasks to do to eliminate their frustration, particularly later in the day. Frustration can often add or increase symptoms of seasonal sundowning. Reading or watching television, may be too difficult for a person with late-stage dementia. Keep everything around them calm and quiet as you can.
Recent study found that light therapy can decrease agitation and confusion in an individual with dementia. Keep the room well-lit and bright as the sun goes down.
Learn about common ways to manage their symptoms. Log what works and what doesn’t. It’s an ongoing process. Pain, urinary tract infections (UTIs) or vitamin deficiencies, can mimic sundowning. Consult with their physician if you suspect any of these.
Most of all, your patience will help them remain calm.