Sundowning is associated with behavioural changes of people suffering with Alzheimer’s. Some people suffering with the disease, may find late afternoon and early evening to be difficult and start showing signs of sundowning. The signs include restlessness, agitation, irritability or confusion.
Sundowning often happens in the middle and later stages of Alzheimer’s. The problems can mean that people find it difficult to fall asleep and stay in bed, often when caregivers need a break themselves.
What Are the Causes?
The causes of sundowning are not well understood. However, it is acknowledged that it could be down to Alzheimer’s-related brain changes that can affect a person’s “biological clock,” leading to confused sleep-wake cycles.
Other possible causes include:
- Being overly tired – too little or disturbed sleep.
- Too little or too much light.
- Loss of routine.
- Unmet needs such as hunger and thirst.
- Conditions such as sight or hearing loss.
- Medication wearing off.
- Medication that worsens confusion and agitation.
- Difficulty separating reality from dreams.
Sometimes sundowning can be confused with someone actually trying to meet a need. People suffering with dementia may be acting in a certain way as they are trying to communicate, not just because it is late afternoon.
How to Spot the Traits
To spot the traits of sundowning, look for signs in the late afternoon and early evening. These may include increased confusion or anxiety and behaviours such as pacing, wandering, or yelling.
How to Manage It
When looking at how to manage those suffering with sundowning, it is important to note that it is different for every individual. The most effective way to deal with it is to find the root cause of the person’s behaviour. Then, it may be possible to deal with the issue and reassure the person that everything is OK.
However, if this is not possible, there are a few tips that carers can consider when faced with this issue.
- Reduce noise, clutter or number of people in the room.
- Distract the person with favourite snack, object or activity.
- Make early evening a quiet time of the day.
- Close the curtains or blinds at dusk to minimise shadows and the confusion they may cause.
- Try to support the person to do things they find relaxing and enjoyable.
Being too tired can cause restlessness, particularly in the late-afternoon and early evenings. Preventing sundowning might be the most effective way to deal with the issue before it arises, for both the carer and the person who is suffering with it.
Tips to prevent sundowning:
- Going outside or sitting by the window – exposure to bright light can reset a person’s body clock.
- Physical activity or exercise each day.
- Daytime rest if needed.
- Getting enough rest at night.
What could make it worse:
- Coffee, cola or other caffeinated drinks.
- Alcoholic drinks – may add to the confusion and anxiety.
- Planning too many activities during the day – a full schedule can be tiring.
- Strange or unfamiliar settings.
If Problems Persist
If sundowning continues to be a problem, seek medical advice.
A medical exam may get to the root cause of sundowning such as pain, a sleep disorder or other illness. Additionally, some medication may be contributing to the cause and can increase the chances of dizziness, falls and confusion.
At Minster Home Care, our staff are fully trained to deal with the issues relating to sundowning. We get to know the people we care for and ensure we are fully aware of what may be causing the issue and how we can best deal with it. For more information, contact us today.