Sundowning or “sundowner’s syndrome” is a commonly used term among professionals working with patients who have Alzheimer’s disease or other dementias. This term describes a pattern of increased behavior problems in the late afternoon and early evening. Persons may exhibit increased confusion, agitation, wandering, hallucinations and general disorientation.
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While the cause is not definitive, there are likely several factors. Primarily, the person may be tired after daily activities and caregivers may suffer similar weariness which shows through to the care recipient. The change from light to dark and the “internal clock” may also play a role during this time which has traditionally been transitional (i.e. returning from work, or family time in evenings).
Here are some practical tips, compiled from our experience and advice from the Alzheimer’s Association website:
Anticipate this problem and schedule accordingly. Try to reduce activities and outings at this time. Plan some quiet, alone time in late afternoons.
Keep a routine (always important for a person with dementia). Naps or quiet activities may be helpful during this time (and you may want to avoid naps earlier that might interfere with later sleep).
Reassure the person and redirect them when agitated or restless. Do not attempt to argue with them or use “reality therapy”.
Examine causes of agitation. Noise or stimulation may increase these behaviors.
Identify causes of physical discomfort. If you notice a major change in behavior, a person may be feeling pain or have an underlying infection. Many times, our care managers will note a significant change and when a culture is done, the client has a UTI (urinary tract infection).
As a caregiver, get plenty of rest and recognize your need for a break. Your irritation or exhaustion may further exacerbate your care recipient’s behaviors.
Consult with a physician knowledgeable about dementia. With problem behaviors, it can be helpful to use the services of a geriatric psychiatrist. Medications may alleviate symptoms.
Aging Wisely’s care managers support many clients with dementia and their family members in this difficult journey. Whether it be for advice and caregiver consultations, referrals to professionals and programs, coordination and oversight, or a full assessment, we’re your resource—for solutions when you need them.
Contact us online or at 727-447-5845 for help or questions.