Coping With Sundown Syndrome

Sundown syndrome—also called sundowning or sunsetting—is a behavior common in people with Alzheimer’s disease. It describes the episodes of confusion, anxiety, agitation, or disorientation that often occur at dusk and into the evening hours. The episodes may last a few hours or throughout the night.

Suggestions for Helping a Loved One With Sundown Syndrome

Sundown syndrome can be draining for the person with Alzheimer’s disease and his or her caregivers. Some suggestions include:

• Schedule the day so that the more difficult tasks are done early in the day, when the person is less likely to become agitated.
• Watch the person’s diet and eating habits. Restrict sweets and drinks with caffeine to the morning hours. Try serving the person a late afternoon snack or an early dinner.
• To help the person relax, try decaffeinated herbal tea or warm milk.
• Keep the house or room well lit. Close the drapes before the sun goes down, so the person doesn’t watch it become dark outside.
• Try distracting the person with activities he or she enjoys. Soothing music or a favorite video may help, as well.
• Plan more active days. A person who rests most of the day is likely to be awake at night. Discourage afternoon napping and plan activities, such as taking a walk, throughout the day.
• Seek medical advice. Physical ailments, such as bladder or incontinence problems, could be making it difficult to sleep. The doctor may also be able to prescribe medication to help the person relax at night.
• Change sleeping arrangements. Allow the person to sleep in a different bedroom, in a favorite chair or wherever it’s most comfortable. Also, keep the room partially lit to reduce agitation that occurs when surroundings are dark or unfamiliar.

Nighttime restlessness doesn’t last forever. It typically peaks in the middle stage of the disease, then diminishes as the disease progresses. In the meantime, caregivers should make sure the home is safe and secure, especially if the person with Alzheimer’s wanders. Restrict access to certain rooms or levels by closing and locking doors, and install tall safety gates between rooms. Door sensors and motion detectors can be used to alert family members when a person is wandering.

Contributing Factors

While the exact cause of sundown syndrome is not known, experts believe there are several contributing factors:

• Physical and mental exhaustion (after a long day)
• An upset in the internal body clock causing a biological mix-up between day and night
• Medication that can cause agitation or confusion
• Disorientation due to the inability to separate dreams from reality when sleeping
• Less need for sleep, which is common among older adults

Once the person is awake and upset, experts suggest that caregivers:

• Approach their loved one in a calm manner
• Find out if there is something he or she needs
• Gently remind him or her of the time
• Avoid arguing or asking for explanations
• Offer reassurance that everything is all right and everyone is safe

When some extra care is needed, you can trust CareWorks Health Services to provide the experience and training to help a family caregiver understand the behaviors of someone with Alzheimer’s. Let us work the night hours so a family caregiver can get a solid night of rest in order to be refreshed and ready for a new day of care.

Tips courtesy of WebMD and The Alzheimer’s Association

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