Best Practices to Cope With Sundowning

Dementia and Sundowning: What is it?

Sundowning, also known as “sundown syndrome” or “late-day confusion,” is a common behavioral phenomenon observed in individuals with dementia, particularly Alzheimer’s disease.

What Causes Sundowning?

Some of the potential causes of sundowning include:

• Biological clock disruptions
• Sensory overload
• Dehydration or hunger
• Urinary or bowel issues
• Medication effects
• Pain or discomfort
• Environmental changes
• Emotional stress
• Lack of meaningful activity
• Lack of exposure to natural light
• Underlying medical conditions
• Alcohol or caffeine consumption

Tips for Coping With Sundowning

Below are some tips to help caregivers cope with sundowning:

Establish a Routine

Consistency is key when dealing with sundowning. A regular daily routine can help reduce anxiety and confusion. Ensure that meals, medication, and activities co-occur daily, providing structure and predictability.

Limit Stimulants

Avoid caffeine and sugar in the late afternoon and evening can help prevent exacerbating symptoms of sundowning. Opt for calming herbal teas or decaffeinated beverages instead.

Encourage Daytime Activity

Engage the individual in physical and mental activities during the day to promote better sleep at night. Gentle exercise, such as walking or gardening, can help reduce agitation and restlessness.

Expose to Natural Light

Exposure to natural light during the day can help regulate the body’s internal clock and improve sleep-wake cycles. Encourage outdoor activities or open curtains to let in sunlight indoors.

Create a Calm Environment

Designate a quiet and soothing space for relaxation during the evening hours. Dim the lights, play soft music, and minimize noise and distractions to create a calming atmosphere.

Limit Evening Naps

While short naps during the day can be beneficial, excessive daytime napping can disrupt nighttime sleep patterns. Limiting evening naps can help promote better sleep at night.

Provide Comforting Activities

Engage the individual in calming activities such as reading, listening to music, or gentle stretching before bedtime. These activities can help relax the mind and body, making it easier to transition to sleep.

Monitor Medications

Some medications may contribute to symptoms of sundowning or interfere with sleep patterns. Consult a healthcare professional to review the individual’s medications and discuss potential adjustments.

Practice Relaxation Techniques

Teach relaxation techniques such as deep breathing exercises, progressive muscle relaxation, or mindfulness meditation to help reduce anxiety and promote relaxation.

Stay Calm and Reassuring

Individuals experiencing sundowning may exhibit agitation, confusion, or distress, and caregivers must respond with patience and empathy. Staying calm can help caregivers de-escalate the situation and provide a sense of security for the individual. Validating the individual’s feelings and acknowledging their emotions can help them feel understood and supported. Offering comfort through touch, soothing words, or familiar gestures can also help the individual and alleviate their distress. Making sure your loved one feels safe and understood is super important for helping them through sundowning and keeping them feeling good overall.

Maintain a Sleep-Friendly Environment

Ensure the bedroom is conducive to sleep by keeping it cool, dark, and quiet. Invest in comfortable bedding and use white noise machines or earplugs to block out disruptive sounds.

Limit Evening Stimulation

Avoid activities or tasks that may overstimulate the individual in the evening hours. Limit screen time, loud noises, or emotionally charged conversations to prevent agitation and promote relaxation. Exposure to screens, such as television, computers, or smartphones, in the evening can disrupt sleep patterns and increase agitation in individuals with dementia. Caregivers should limit screen time and choose calming activities that promote relaxation instead.

Seek Support

Caring for someone experiencing sundowning can be emotionally and physically draining for caregivers. It’s important to recognize when support is needed and to reach out for assistance. Friends, family members, and support groups can offer valuable emotional support, practical advice, and a listening ear during challenging times. Sharing experiences with others who understand the struggles of caregiving can provide a sense of validation and connection.

Additionally, considering respite care options can provide much-needed relief for primary caregivers, allowing them to take breaks, rest, and recharge. Respite care services offer temporary assistance with caregiving responsibilities, allowing caregivers to attend to their needs and maintain their overall well-being. Seeking support benefits caregivers and enhances the quality of care provided to individuals experiencing sundowning.

Consult with Healthcare Professionals

If sundowning symptoms persist or worsen despite implementing coping strategies, consult with healthcare professionals, including physicians, neurologists, or senior specialists. They can provide further evaluation and recommend additional interventions or treatments.
Be Patient and Understanding
Above all, be patient and understanding when coping with sundowning. Remember that the individual is not deliberately behaving this way and may struggle with their symptoms. Approach each situation with empathy and compassion.

By implementing these tips and strategies, caregivers can help manage symptoms effectively and improve the overall quality of life for individuals with dementia and themselves.