Sundowning is the name for a group of behaviors, feelings, and thoughts people who have Alzheimer's or dementia can experience as the sun sets. It is not a disease, but instead is a group of symptoms that occur at a specific time of day. The behaviors often start or get worse around sunset; however, they can occur at any time of day. Around 20% of people diagnosed with Alzheimer’s disease experience sundowning at some point.
Characteristic behaviors of Sundowning include:
Restlessness, agitation, irritability, or confusion that can begin or worsen as daylight begins to fade.
Pacing, wandering, or yelling.
Difficulty with falling asleep and staying in bed.
The causes of sundowning are not well understood. However, factors that may contribute to Sundowning include:
Alzheimer’s-related brain changes that affect one’s “biological clock,” leading to confused sleep-wake cycles.
Being overly tired or bored.
Unmet needs such as hunger or thirst.
Depression and pain.
How to help a person experiencing sundowning:
Approach them in a calm manner and find out if there is something they need.
Gently remind him or her of the time and offer reassurance that everything is alright.
Avoid arguing and reduce noise, clutter, and the number of people in the room.
Try to distract the person with a favorite snack, object, or activity. For example, offer a drink, suggest a simple task like folding towels, or turn on a familiar TV show (but not the news or any shows that could be upsetting).
Do not use physical restraint. Allow the person to pace back and forth, as needed, with supervision.
Make early evening a quiet time of day through playing soothing music, reading, going for a walk, or having a family member/friend call during the time.
Adjust lighting, letting in natural light during the day, if possible, and try softer room lighting in the evening.
The Amity Program's mission is to increase social engagement between older adults and the younger generation. By doing so, we hope to raise awareness about and reduce social isolation among older adults, a risk factor for dementia and, accordingly, Sundowning.
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