What is Sundowners Syndrome?

Sundowners describes the phenomena of irritability and other symptoms that occur in the late afternoon and evening in people with Alzheimer’s disease and other forms of dementia. The symptoms a person “sundowning” may experience include restlessness and wandering, agitation, delusions, increased confusion and more.

Many dementia symptoms are simply exacerbated during this period of the day, or your loved one may almost seem like a whole different person when the evening hours hit.

Scientists aren’t sure what causes Sundowners Syndrome. It is likely related to the fading light and perhaps the disturbed sleep cycles and body rythyms caused by dementia. I have always thought that our circadian rythyms and lifelong patterns may play a big role (i.e. this is the time of day when we usually expect transition…leaving work, family arriving home from school/work, preparing for dinner, relaxation, bed). Many times the people sundowning seem to be anticipating that something is supposed to happen, that they should be going somewhere or want to “go home”.

Sundowning can indicate that the person is worn out, in some discomfort, or feeling hungry or thirsty at this point in the day. The person may also be sensing the caregiver’s own frustration or exhaustion at the end of a long day.

How can I manage my loved one’s Sundowners?

• Plan. Anticipate that this can be a tough time of day and schedule accordingly. Don’t plan outings or other activities which might be difficult during this period. Be prepared to provide closer attention and learn ways to redirect your loved one (enlist extra help if needed).
• Prevent. Try to ensure your loved one gets plenty of rest, food and drink. Watch for subtle signs of pain or discomfort. Regularly help him/her to the bathroom. Make sure the temperature is comfortable.
• Soothe. Use soothing music or other activities to create a sense of calm. Find out what works best for your loved one.
• Adjust lighting. Turn on good quality lighting as daylight fades. Consider closing curtains to reduce shadows.
• Provide a safe environment/outlet for pacing and wandering. If your loved one is prone to pacing, you may want to plan walks in a safe area during this time or create a space where he/she can walk around without wandering away.
• Check out our Dementia Symptoms slide show, with practical suggestions for help with wandering and other behavioral symptoms.
• Talk to your doctor about the sundowners symptoms your loved one is experiencing. Sometimes medications can help, or the doctor may need to adjust current medications or address sleep issues.

Contact our eldercare team about dementia caregiver support and resources, dementia home care or respite care and more. For more sundowners, dementia and eldercare resources, sign up to get our free monthly tips.

Alzheimer’s disease and other forms of dementia can be isolating, for the person and the caregiver:

• A study in the U.K. found that about 1/3 of people reported losing friends after an Alzheimer’s diagnosis. Also, almost 40% of people living with dementia reported being lonely (increasing to 2/3 of those who lived alone).
• Social engagement, on the other hand, can have a protective effect against dementia symptoms.
• Many studies indicate that social isolation and withdrawal from activities are common among caregivers.
• And, on the other side, dementia caregivers who are satisfied with their social relationships show fewer negative psychological symptoms.

Why is social isolation common for those with dementia?

• Many times, people don’t understand the disease or how to interact with the person. They may be afraid of the disease (or even irritated by symptoms they don’t understand) and withdraw from contact.
• The individual may feel ashamed and embarrassed by mistakes and therefore stop participating in activities.
• Practical concerns may get in the way. The person may not be able to get to activities after he/she stops driving and have difficulty remembering appointments and trouble taking initiative.
• Dementia caregiving is often a 24/7 job, meaning that most caregivers reduce activities and social time. Dementia caregivers may also feel emotionally isolated from friends who aren’t in the same situation.

Tips for overcoming social isolation for dementia patients and caregivers

• Help friends and family understand the disease and encourage them to ask questions or express their concerns. Here’s a list of great books to help children understand dementia and you might want to share some basic resources with friends as well as being honest about your experiences and feelings.
• Encourage humor! Laughter can be a lifesaver for dealing with uncomfortable feelings and awkward moments in dementia.
• Facilitate visits and continued activities. This might require a little logistical planning and modifications, but it’s worth the effort. We offer suggestions for senior-friendly activities and ways to modify activities on our EasyLiving blog, as well as concierge support for attending outings.
• Caregivers often benefit from support groups and/or professional counseling. This is an outlet for dealing with feelings and challenges of caregiving, which can help you maintain healthy relationships with friends, colleagues and spouses.
• Respite care should be incorporated into dementia care early in the process (get a free respite care checklist!).

What can friends or community members do?

• Keep an open dialogue. Don’t be afraid to ask “stupid questions”.
• Offer concrete assistance, as well as emotional support, to the caregiver. Understand if they turn down your invitations, but also ask if there are ways you might help or what they need to be able to attend. Keep reaching out and don’t be offended when a caregiver does not reciprocate.
• Educate yourself to reduce fear and misunderstanding. Check out some tips about communicating with people with dementia and how to connect.
• Increase Alzheimer’s awareness and help debunk myths and fears.

Are you facing the challenges of dementia care? Get help from a care manager, your partner in caregiving!

Today, we share with you our Slideshare presentation about dealing with dementia symptoms such as Sundowners Syndrome and wandering. Our experts have put together the best practical tips for dementia care and pointers for managing common dementia symptoms.

Some of the common dementia symptoms you may encounter over the course of the disease include:

• Difficulty carrying out day-to-day tasks and self care due to poor memory and inability to manage multiple steps in a task (for example, it becomes difficult to shop, plan and prepare meals)
• Early dementia symptoms often show up in the form of problems with more complex tasks: financial problems, leaving bills unpaid, being scammed or mismanaging appointments or medications
• Language difficulties/communication problems
• Mood swings
• Fear, which results in anger or lashing out and/or refusing care or activities
• Withdrawal from socialization or activities
• Sundowners syndrome, also known as sundowning: late afternoon/evening worsening of dementia symptoms
• Wandering and restlessness; difficulty focusing on tasks
• Anxiety and paranoia
• Memory issues causing the person to forget whether they have done tasks, thus repeating or ignoring things like personal hygiene or meals

With some basic tips, you will find that dealing with dementia symptoms becomes easier. Dementia caregivers get creative with managing various behaviors and day-to-day challenges, and you may find a support group or caregiver forum to be helpful in sharing ideas and dealing with your feelings. Also, consider the value of respite care from experienced dementia caregivers, so that you can take an occasional break. Another benefit of professional respite care is having a prepared back-up care team that knows your loved one.

If you need help with dementia symptoms, obtaining a diagnosis and good medical/care team and or managing dementia care, call us any time at 727-447-5845. Our comprehensive care management assessment provides vital information about dementia symptoms, resources and a plan of care so you can be prepared.