Dealing with Sundowners for Caregivers

SundowningYou either know what Sundowning is or you don’t. For those caregivers having to deal with it, they know all too well what this neurological behavior is like.  For those that don’t know what Sundowning or sundown syndrome is, let’s define it.

Wikipedia defines Sundowning as a neurological phenomenon associated with increased confusion and restlessness in patients with delirium or some form of dementia. Most commonly associated with Alzheimer’s disease, but also found in forms of dementia, the term “sundowning” was coined due to the timing of the patient’s confusion. For patients with sundowning syndrome, a multitude of behavioral problems begin to occur in the evening or while the sun is setting. Sundowning seems to occur more frequently during the middle stages of Alzheimer’s disease and mixed dementia. Patients are generally able to understand that this behavioral pattern is abnormal. Sundowning seems to subside with the progression of a patient’s dementia. Research shows that 20–45% of Alzheimer’s patients will experience some sort of sundowning confusion.

Now that we are all familiar with Sundowning, let’s take a look at how we can manage those with this behavior. There are various care tips on what caregivers can do to help alleviate the symptoms. Not all of these tips work for everyone, but numerous ones may work for different people.

  • Create a consistent sleep schedule and a daily routine. Make sure to create a space that allows natural light to filter into the room in the morning, yet blocks out light when it’s time to go to bed. If possible, don’t allow the person with Sundowning to sleep during the day or take cat naps as this will disturb their night time sleeping habits.
  • Make sure your loved one is able to choose where they are most comfortable sleeping. Also include a dim light or nightlight in case they need to use the restroom during the evening and include a glass of water by their nightstand to alleviate them having to get up more than once or twice during the night.
  • Caffeine in the morning should be okay, but limit caffeine intake to mornings only.
  • Take a walk or fit in some form of exercise in the late afternoon or early evening as this is the time when Sundowning generally starts to occur. Exercise is a wonderful habit to include every day for both mental and physical health benefits.
  • Consider adding a sound machine in their room to help calm them if they do wake up and can’t settle back down to sleep. The sound of ocean waves or singing birds are often soothing when trying to fall to sleep.
  • Make your loved one as comfortable as possible. You know what their favorite things are, so make them readily available to your loved one. If a certain blanket or song makes them less agitated when symptoms start to arise, then have them ready. If a neck massage or hand holding helps soothe them, then so be it.

Caregivers are not alone when caring for those with Sundowning. Talk to your loved one’s doctor about certain medication or supplements that may help them. Don’t be afraid or too proud to ask for help either. Everyone needs a break from time to time. You will return refreshed and better able to take care of your loved one.