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Sundowning and Alzheimer's Patients

How to Cope with Sundowning in People with Alzheimer's

Apr 14, 2009 JoAnn Sardo

Sundowning in people with Alzheimer's is a condition in which the person exhibits increased confusion, anxiety and agitation, usually in late afternoon or early evening.

While this phenomenon is fairly common, it presents a significant challenge to the family member or health care professional who is the caregiver to that person. Below are some common reasons for sundowning along with strategies to assist in alleviating some of the more pronounced symptoms. Remember that each Alzheimer's patient is different and therefore may react differently to these strategies.

When Sundowning Occurs and Why

Sundowning typically occurs in late afternoon or early evening. Many researchers believe that there are several reasons for this. First, things look different at night compared to how they look in the daytime. It is darker and there are more shadows. Older patients with Alzheimer's are more tired later in the day into early evening, making them more susceptible to the things that look different. Since their brains are already misfiring, the onset of darkness can cause increased anxiety, confusion, agitation and restlessness.

Another theory is that Alzheimer's may disrupt that part of the brain that controls the circadian rhythms of the body. The circadian rhythms are responsible for regulating the body clock and the sleep-wake cycle. This disruption causes increased confusion which can manifest itself in late afternoon or early evening. Some research has shown that if the person with Alzheimer's is uncomfortable, in pain, or hungry, he can become agitated because despite these problems, he is unable to communicate these problems to the loved one or caregiver.

Identify Sundowning Triggers

Things that trigger sundowning will vary from patient to patient. As a caregiver, try to identify some of the triggers affecting your loved one. As they are identified, they can be eliminated. For example, if the trigger is loud noises, allow the person with Alzheimer's to spend time in a quiet place during the time when sundowning normally occurs. Spend that time with him, talking quietly about familiar things such as family and friends.

How to Help when Sundowning Strikes

Keeping rooms well-lit and eliminating shadows can help alleviate the symptoms of sundowning. Limiting outings and visits from friends or family during sundowning periods may help. Alzheimer's patients are more relaxed and able to accomplish more tasks during the morning hours.

Enjoy quiet activities during the sundowning hours. Reading together or listening to soft music can help. Figure out if napping during the day helps or hinders the sundowning. For example, too many daytime naps can make an Alzheimer's patient irritable, as can not enough sleep or nap time. Each person is different and it is a caregiver's responsibility to determine what works best for the individual.

Always keep familiar items nearby, such as photographs, favorite books or knickknacks. Avoid spending time in loud places or where there is too much activity during the sundowning hours. Spend time talking quietly with him, provide a caring touch and plenty of reassurances that everything is okay. Visit the Alzheimer's Association web site for more detailed information regarding sundowning.

Sundowning is a serious side-effect of Alzheimer's and presents a significant challenge to caregivers and family members caring for a loved one. Knowing the symptoms, understanding the triggers and providing constant reinforcement to your loved one can make the challenge of sundowning more manageable.

The copyright of the article Sundowning and Alzheimer's Patients in General Medicine is owned by JoAnn Sardo. Permission to republish Sundowning and Alzheimer's Patients in print or online must be granted by the author in writing.

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