Alzheimer’s and Sundowning

Sundowning and Alzheimer’s

Handling Behavioral Changes with Dementia: Sundowning

One of the most common and frustrating side effects of dementia is an issue known as sundowning. This term was developed to explain the increased agitation, confusion and sometimes even hyperactivity that take place with individuals with dementia during the later afternoon and the evening. Many times, sundowning will start to take place during the late afternoon and the evening and will include significant changes in the persons behavior. Typically sundowning begins to set in during the middle stages of dementia and typically worsens as the disease progresses.

Causes of Sundowning

Determining the exact causes of sundowning can be difficult, but many professionals believe that dementia may damage the bodys internal clock. This can disrupt the sleep-wake cycle in the body and cause the irritability and change in mood and behavior during this time in the evening. When individuals with dementia are tired from their disrupted sleep cycle and unable to process information, as they get more confused, they may become more exhausted and irritable in their confused state.

Tips for Dealing with Sundowning

Understanding sundowning and what it is, is an important first step in the process of handling sundowning with Alzheimers patients. Here are some other tips to consider when it comes to dealing with sundowning that can help you and your loved one:

  • Try to avoid activities or outing in the late afternoon and evening, when issues with sundowning tend to be worse. Try to plan most of the activities for the morning and only do simple activities or calming activities during the afternoon and evening times.
  • Attempt to get your loved one on a normal sleeping cycle. Set up a routine for your loved one and attempt to keep them awake during the day and limit the amount of naps they take. Try to get them in bed at the same time every night so that they get on a set sleep schedule.
  • Do not assume that every outburst is due only to sundowning. Make sure you are checking for other issues that may be causing or enhancing the irritability. Things like urinary tract infections, hunger, thirst or pain can all be at the root of the irritability so you will want to be sure you are checking for and treating these issues.
  • Make sure you are planning for sundowning by keeping your loved one in a set and comfortable routine near the end of the day. Always speak to them in a calm voice during this time, put them in a place that does not have excess stimuli and make sure that they have plenty of food and water. The more comfortable they are during this time the less likely they are to have outbursts or instances of intense irritability.


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