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Understanding and Helping Seniors Through Sundowner’s Syndrome

What is Sundowner’s Syndrome?

 

Alzheimer’s and dementia in its many forms includes confusing behavior and mood changes. When those suffering from Alzheimer’s and dementia approach the middle to latter stages of the disease, frequent changes occur which are especially evident as nighttime approaches. The condition, known as Sundowner’s Syndrome, and sometimes called sundowning, causes agitation, sadness, fear, delusions, and hallucinations. With an increased level of confusion during the twilight hours, it can be difficult for patients and their caregivers.

Though doctors and researchers continue to research the cause behind Sundowner’s Syndrome, the prevailing theory in the symptoms along with the timing is not coincidental. The syndrome may result from the sensory stimulation which builds up over the course of the day, causing the patient to be overwhelmed and act out. Others believe the cause is anxiety due to the darkness which can be very disorienting.

 

Signs and Symptoms of Sundowner’s Syndrome

 

As twilight approaches, those with Sundowner’s Syndrome often follow their caregivers closely, observing them and mimicking their movements and actions. They also interrupt ongoing conversations, asking the same questions over and over. Often patients who are sundowning lose their ability to communicate clearly, and theoretical concepts become extremely difficult for them to understand.

In the worst cases, patients with Sundowner’s Syndrome become restless, roaming aimlessly throughout their home, trying to go outside to escape the space, go to a location important to them, or make it on time to a non-existent appointment.

Other signs and symptoms of those with Sundowner’s Syndrome are:

  • Unexplained anger
  • Exaggerated agitation
  • Anxiety
  • Delusions
  • Hallucinations
  • Fear
  • Crying
  • Pacing
  • Insomnia
  • Stubbornness
  • Emotional outbursts
  • Restlessness
  • Depression
  • Paranoia
  • Violent behavior

These behaviors typically manifest in the late afternoon and go on into the night, though the timing varies from patient to patient. As a result, sundowning often means patients and their caregivers fail to get sufficient sleep, which in turn causes the symptoms to increase.

 

Tips for Managing Sundowner’s Syndrome


Those suffering with Alzheimer’s and dementia can be difficult, even impossible to reason with, which makes it important for caregivers to be especially patient when the symptoms of Sundowner’s Syndrome manifest themselves.

Understanding the patient’s routines and moods, can help caregivers minimize symptoms. When caregivers react to behaviors, those behaviors tend to worsen. Even unexpressed frustration by a caregiver can result in increased sundowning symptoms.

Here are some tips to help caregivers manage Sundowner’s Syndrome in their patients or loved ones:

  • Always remain calm when approaching your patient or loved one. There should be no raised voices, no yelling, and no surprise touches.
  • Don’t argue, ask for explanations, or attempt rationalizing when patients or loved ones who are sundowning make statements that don’t make sense.
  • Always provide a peaceful setting, guiding your patient or loved one away for loud noise, including family activities and other gatherings. It is important to prevent chaotic activities or commotion during times when sundowning episodes occur.
  • As late afternoon approaches, close blinds or draw curtains, so your patient or loved one doesn’t see the change from afternoon light to nighttime darkness. After, turn on the lights to keep the room well-lit for better visibility.
  • Maintain a routine. A daily routine (getting ready for a meal, putting on pajamas, etc.) can help decrease the anxiety your patient or loved one feels as evening approaches.
  • Increase daily activities. More daily activities – walks, crafts, visits, games, etc. – can help your patient or loved one rest better at night. Add simple, soothing activities at bedtime like a happy TV show or movie, some beloved music, or even some time with pets. Whenever your patient or loved one doesn’t want to join in, allow them the choice, and don’t argue.
  • If your loved one or patient wants to sleep in a different room or in a comfortable chair, allow them to sleep where they are most calm and comfortable. Use a nightlight wherever they chose to sleep, keeping the room partially lit to help reduce fear, anxiety, and disorientation.
  • Maintain a safe space by removing potentially dangerous items and using safety devices and locks that can allow you, as the caregiver to rest, even if your loved one or patient is awake or wandering.
  • Monitor your patient or loved one’s diet, restricting sweets and caffeine consumption in the late afternoon evening.
  • Always seek medical advice if there seems to be a physical problem. The doctor can not only prescribe medications for infections and discomfort, but also a possible medication to help them sleep better.
  • Remain flexible as you care for your patient or loved one.

 

Need Additional Help?

If you need additional guidance or help in caring for your loved one with Alzheimer’s or dementia who is experiencing Sundowner’s Syndrome, please contact us to learn how he compassionate and experienced caregivers at Jewish Family Home Care can help you or your loved one.