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Geisinger becomes the first member of Risant Health

Sundowning, also known as “late-day confusion,” is a common condition affecting those with Alzheimer’s disease or other types of dementia.

If you care for a loved one with Alzheimer’s dementia or another type of dementia, thoughts like this may have crossed your mind: “I’ve been noticing that Mom gets a little grumpy before bed.” Or, “It seems like Dad has trouble remembering things around dinner time.”

What is sundowning?

The tern “sundowning” refers to a specific group of symptoms that occur in the evening in people with dementias such as Alzheimer’s dementia. Symptoms of this common condition most often strike late in the day (typically when the sun goes down) and can include:

  • Mood swings
  • Confusion
  • Wandering
  • Aggression
  • Acting fearful or suspicious
  • Hallucinations

“People who experience sundowning can have a variety of symptoms. They may yell or have outbursts, cry, wander off or display personality changes in the evening. While these symptoms can last through the night, they usually disappear by morning,” explains Glen Finney, MD, a behavioral neurologist and director of the Memory and Cognition Program at Geisinger.

What causes sundowning?

Although the exact cause of sundowning is unknown, the following situations are believed to cause symptoms to flare up:

  • Changes in daylight
  • Too much activity
  • Being overtired 

Changes in weather and increases or decreases in levels of daylight can also disrupt the body’s internal clock. 

“It can be challenging to find a single reason for sundowning behavior. Causes can range from simple fatigue to an underlying health issue, such as having a urinary tract infection, or UTI. If you need help managing your loved one’s symptoms, it’s important to talk with their doctor,” Dr. Finney says.

How to reduce sundowning symptoms

Although sundowning can’t be prevented, symptoms can be managed in several ways: 

  • Keep your loved one on a routine: A change in routine can trigger or worsen sundowning behaviors. Keep things predictable with regular meal times, bed times and activities.

  • Turn up the lights: When it begins to get dark outside, turn on the lights to keep your home well-lit and put a nightlight in the bedroom. Since it’s believed that decreased light exposure can trigger some sundowning behaviors, having extra light may help prevent behavior changes. One study found using LED bright blue-white light during the day and dimmer yellow-white light at night helped.

  • Limit caffeine and alcohol (especially in the evening): Both can overstimulate the body and make it difficult to fall or stay asleep.

  • Redirect their attention: If your loved one is agitated or confused, try to redirect their attention. Offering them a puzzle, engaging them in a favorite activity, making a snack or snuggling with a pet may help them calm down.

  • Encourage them to stay active: Physical activity can not only help your loved one stay healthy, it can help them get a good night’s rest. Start small — accompany them on a short walk or assist them with lifting light hand weights. Understand their limitations to avoid pushing them too hard and pay attention to body language or cues that they’ve had enough.

  • Offer wind-down time in the evening: Help your loved one unwind in the evening before bed. Keep noise levels down and read or listen to their favorite music. By promoting a soothing environment, you’ll help them relax, which can make it easier for them to fall asleep.

“Sundowning behaviors can be challenging, but by understanding what triggers your loved one’s symptoms and keeping them on a good routine, you can help reduce their recurrence,” Dr. Finney advises.

D-CARE study at Geisinger

Are you caring for someone with dementia or struggling with dementia yourself? We invite those affected by dementia and their caregiver to be part of our national research study that will compare three different models of dementia care over the course of 18 months. Participation in this study is voluntary.

If you’re interested in participating or for more information, call 570-808-7215.

Learn more about our voluntary dementia care study

Call us at 570-808-7215
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