Sundown syndrome, also known as sundowning, is a neurological state that causes increased memory loss, agitation, and confusion when the natural light outside begins to fade. Although one in five Alzheimer’s patients experiences the syndrome, it can also occur in older adults without any form of dementia. 

When a loved one starts sundowning, they may cycle through rapid mood changes, become restless, pace, rock back and forth, cry, become suspicious or demanding, and experience visual or auditory hallucinations. This is understandably hard on both sufferers and caregivers. 

How To Minimize Symptoms

Every adult that experiences sundowning syndrome has their own triggers. However, the most common triggers include a lot of end-of-day activity, excess fatigue, low light conditions, urinary tract infections, and internal clock disruptions. Observe and make note of your loved one’s specific triggers so they can be avoided in the future. 

To help minimize sundowning symptoms, incorporate the following into your nightly routine:

• Stick to the same routine everyday to help your loved one feel safe and secure. They should get up, eat, bathe, do an activity, and get ready for bed at the same time each day. 
• Limit strenuous activities and visitors to the morning hours.
• Avoid excessively sugary foods or anything with caffeine late in the day.
• Minimize sensory stimulation towards the evening hours. Turn down TV’s, radios and everything else that creates background noise. 
• Turn on a sunlamp (or light box) when it starts to get dark outside. Sunlamps can help minimize the effect of sundowning as well as seasonal affective disorder. The boost in light will also eliminate shadows, making everything clearly visible. 
• Antidepressants and anti-anxiety medications can help mitigate the symptoms. Bear in mind that side effects can be challenging, so speak with a geriatric psychiatrist to find the best option. 
• See a doctor if you suspect an underlying medical condition. Urinary tract infections and sleep apnea are known to worsen sundowning behavior and must be treated with medication.
• Supplements like ginkgo biloba, St. John’s Wort, and Vitamin E can help ease symptoms of anxiety and improve cognitive function. A low dose of melatonin, a hormone that naturally induces sleep, can also alleviate sundowning symptoms. Speak to a physician to find out if natural supplements are an appropriate option for your loved one. 

What To Do When Sundowning Occurs

It’s difficult not to become exasperated when sundowning symptoms flare up, but the most important thing to do is remain calm. 

• Answers their questions.
• Remind them what day/time it is. 
• Don’t try to argue or reason.
• Reassure them everything will be alright.
• Validate their feelings.
• Distract them with an activity they enjoy doing. 
• Play familiar, relaxing music, or soothing white noise.
• Hold their hand or give them a gentle massage.
• Allow them to pace around the room or engage in repetitive behaviors, as long as they’re safe.  

Many adults that go through sundowning syndrome are prone to wandering off, so it’s important to make sure windows and doors are locked. Keep nightlights plugged in to ensure they can find their way around in the middle of the night. Baby monitors, door sensors and nanny cams are great ways to keep tabs on your loved one and make sure they don’t leave the home unsupervised. 

Gallagher Home Care is a Medicare-certified home health agency that serves across 8 Pennsylvania counties. Our dedicated employees are trained to provide exceptional, compassionate care to seniors in a variety of circumstances, including those living with dementia. We provide house-keeping, home safety monitoring, and companion care, and even provide free in-home evaluations for new families. Request an appointment online or call (412) 453-8082 to learn more.