If you’re caring for an older adult with Alzheimer’s disease, dementia or other related conditions, you might notice new behaviors popping up in the afternoons and evenings.
The aging adult in your life may become more restless or confused as the sun sets, even if they had a great day only hours before. This behavior is called sundowning, and it’s more common than many families realize.
Sundowning can feel overwhelming and leave family members seeking answers. In many ways, these symptoms seem to come out of nowhere. Feeling alarmed is reasonable, but the next step is to develop healthy ways to support your family member at home through these changes.
Understanding what sundowning is and what triggers it can help you provide better Alzheimer’s care and support in the moments that matter most.
What is sundowning?
Sundowning describes a set of behaviors and feelings that often appear or worsen in the late afternoon and evening. It’s not a disease but a group of symptoms that commonly affect people with Alzheimer’s disease and other types of dementia.
According to Cleveland Clinic, about 20% of individuals with Alzheimer’s disease experience sundowning at some point.
Common symptoms of sundowning
Symptoms of sundowning may include:
- Confusion and disorientation
- Anxiety, restlessness or agitation
- Wandering or pacing
- Hallucinations
- Mood swings, like irritability or sadness
Sundowning typically begins in the middle to later stages of Alzheimer’s disease and other types of dementia. No two people will have the same symptoms, so it’s important to observe your family member’s behavior to figure out how to help them when the sun goes down.
What triggers sundowning?
While researchers don’t know the exact cause of sundowning, several factors seem to intensify symptoms. According to the Alzheimer’s Association, common triggers include:
- Fatigue after a busy day
- A disrupted internal body clock, leading to daytime drowsiness and nighttime alertness
- Low lighting or shadows, which may cause confusion or hallucinations
- Unfamiliar environments
- Difficulty distinguishing between dreams and reality
- Stress or tension in the environment
Medical issues can also contribute to sundowning. Conditions like urinary tract infections, dehydration, sleep apnea or untreated pain can worsen symptoms, especially if they appear suddenly. Since your family member may not always communicate their discomfort during an episode, it’s important to discuss any changes with a doctor.
How to help during sundowning episodes
There’s no one-size-fits-all solution, but there are practical ways to reduce the frequency and intensity of sundowning episodes. For example, the Mayo Clinic recommends a low dose of melatonin to help ease an older individual back to sleep when other strategies aren’t as effective.
How to manage symptoms during the day:
- Maintain a consistent schedule for waking, meals and activities.
- Schedule outings or appointments for the morning or early afternoon when your loved one feels most alert.
- Encourage outdoor time in natural light.
- Limit caffeine after the morning.
- Keep naps short and earlier in the day.
How to manage symptoms during the evening:
- Turn on lights before sunset to minimize shadows and confusion.
- Reduce noise and avoid overstimulating activities or TV programs.
- Play calming, familiar music.
- Provide comforting items, like family photos or a favorite blanket.
- Offer a lighter dinner, followed by a relaxing activity.
If your loved one wakes up upset or disoriented, stay calm. Gently reassure them, check if they need support and remind them of the time. Avoid arguments and allow them to pace safely if necessary.
When to talk to a doctor
It’s always a good idea to involve a doctor sooner rather than later, especially when managing sundowning at home becomes more challenging. A trusted medical professional can rule out underlying issues such as infections, untreated pain or medication side effects, all of which may worsen sundowning symptoms.
If non-medication strategies don’t help, a doctor may discuss other treatment options to support your family member’s dementia or Alzheimer’s care. Remember, the older adult in your life may be just as concerned as you are about the emotions and behaviors brought on by sundowning, so being their advocate during medical visits is key.
You don’t have to navigate this alone
Caring for someone with Alzheimer’s disease or other forms of dementia requires patience, love and support. Due to the unexpected nature of the condition, sundowning is one of the more challenging aspects of Alzheimer’s care.
It’s not easy to watch a cherished family member experience extreme stress. Many adult children feel like there isn’t a lot to be done, but that’s not the case. The truth is that there is help available, and families don’t have to face this challenge alone. Memory care, when the time feels right for your family, might be the answer you’re looking for.
At Oxford Senior Living, we specialize in compassionate, secure memory care tailored to each resident’s unique needs. Our team builds personal connections with residents, so every aspect of the Alzheimer’s and dementia care we provide is thoughtful and steady.
We see families as crucial parts of the journey, not an afterthought. We love working with adult children, spouses or other relatives to develop a detailed care plan that brings out the best in an individual. With this approach, care becomes less scary and a lot more reassuring.
If you’d like to learn more about our comforting memory care services, we’re here to help. Contact your nearest Oxford Senior Living community today or reach out to our team to learn more about how we support residents through sundowning.
Key takeaways:
- Sundowning is a common set of symptoms linked to Alzheimer’s disease and other types of dementia. It often shows up in the late afternoon or evening and can include confusion, agitation, pacing and mood changes.
- Several factors can make sundowning worse. Things like fatigue or stressful changes in routine can all play a role.
- Simple daily habits can help reduce symptoms. A steady routine, daylight exposure, short naps and calmer evenings may lower the frequency or intensity of episodes.
- Caregivers should respond with calm reassurance. Gentle support in a quiet environment can help a loved one feel safer during difficult moments.
- A doctor should be part of the conversation. Sudden changes or worsening symptoms may point to an underlying health issue, and professional guidance can help families choose the right care approach.