Sundowning – Late Day Confusion in Dementia and Alzheimer’s

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If you are a caregiver for a loved one with Alzheimer’s disease or dementia, you may be familiar with the challenges that happen in the late afternoon and early evening. If your loved one becomes agitated, restless, irritable or confused, they are probably experiencing ‘Sundowning’, also known as late day confusion. Sundowning can also continue into the night, making it hard for people with Alzheimer’s and dementia to fall asleep. This leads to sleep deprivation and difficulty functioning during the day, both for your loved one and you.

Why do some Alzheimer’s and dementia patients experience Sundowning? The reasons aren’t clear. However, according to the National Institute on Aging, one possible cause is that Alzheimer’s related brain changes can affect a person’s “biological clock”, leading to sleep and wake cycle confusion. Other issues that can bring about Sundowning include: tiredness, depression, pain, boredom or unmet needs such as hunger and thirst.

If your loved one is experiencing sundowning, here are a few tips to help:

  • Maintain a consistent, predictable routine for waking, eating, bathing and activities.
  • Plan activities that expose your loved one to light during the day to encourage nighttime sleepiness.
  • Limit caffeine and sugar in the afternoon. Do not serve alcoholic drinks.
  • Play gentle, relaxing music in the evening.
  • Limit daytime naps and keep them short and not too late in the day.
  • Close curtains or blinds at dusk to minimize shadows, which may cause confusion. Turn on lights to reduce the agitation that can happen when surroundings are too dark.
  • Try to reduce stimulating activities and noise levels in the evening.
  • Offer familiar items, such as family photos and favorite books, to create a more relaxed atmosphere.

If sundowning continues to be a problem, it’s best to seek medical advice. Sometimes another illness, a medication side effect or sleep disorder can increase the likelihood of sundowning, particularly if it has developed quickly.

Sundowning can be challenging and exhausting for everyone involved. Since it happens at the end of the day, it can be particularly difficult for caregivers who are already tired. It’s essential that caregivers take care of themselves, so they can provide support and patience when challenging situations arise. That’s where Assisting Hands can help.  We offer professional in-home personal care services in Bethesda and surrounding areas. Our caregivers keep your loved one safe and secure when you can’t be with them. Call us at 301-363-2580 and let’s discuss how we can help.