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Sundowning: what is it?

When I first started working with older adults with Dementia, I learned very quickly what Sundowning is and how to soothe those experiencing this daily state of confusion.

So, What is Sundowning?

Sundowning is term to describe the change in behavior at end of day, or when the light begins to fade as the sun sets. It usually impacts those with Dementia, but can happen to older adults without that diagnoses. It is not a disease, but symptoms, specifically behaviors, from unknown causes.

What are the behaviors of Sundowning?

  • Agression
  • Confusion
  • Distraction
  • Anxiety
  • Depression

Although the exact cause is not known, there can be some contributing factors that once discovered can be addressed and helped.

These factors could be:

  • Fatigue
  • Spending a day in an unfamiliar place
  • Low lighting
  • Increased shadows
  • Disruption of the body’s “internal clock”
  • Difficulty separating reality from dreams
  • Being hungry or thirsty
  • Presence of an infection such as an urinary tract infection (UTI)
  • Boredom
  • In pain
  • Depression

How does one cope with the behaviors of Sundowning?

Until you have an understanding of what may be causing the Sundowning, here are some helpful tips to ease the symptoms or behaviors.

  • Adjust lighting throughout the day, but always maintain enough for safety
  • In the evening turn off tv and play music they enjoy that has a softer sound (classical, light jazz, hymns, etc.)
  • Use touch for those that respond positively to it (holding hands, hand gently resting on forearm, arm around the shoulder)
  • Aromatherapy for those that don’t have a sensitivity to different scents
  • A light walk outdoors
  • Sitting outdoors and watching nature
  • A weighted blanket
  • Holding a baby doll
Caregiver sitting outside with older adult

What if you could prevent the negative symptoms?

How amazing and life altering for the older adult, but also the caregiver/partner! Although, it may not be curable, anticipating this behavior can make a difference.

Start by observing the “bewitching” hours for about a week. Notice what time, when, where it happens, how the lighting is, and maybe who is near by. Take detailed notes to see if there is a trend or pattern.

Sundowning can also be prevented by taking a few extra steps:

  • Set a daily routine
  • Limit daytime napping
  • Limit caffeine and sugar to morning hours
  • Provide small nutritious afternoon snacks
  • Use a night light to reduce agitation that may occur in surroundings that are dark or unfamiliar.
  • In a strange or unfamiliar setting, bring familiar items — such as photographs, knick knacks, keepsakes — to create a relaxed, familiar setting.

In all, try to stay calm and understanding, getting aggravated with the one you are caring for will only make things worse.

Most importantly, be sure to mention the symptoms to their primary care physician .

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