How to cope with, reduce 'sundowning' syndrome

Karen Doughtie


How to cope with, reduce 'sundowning' syndrome

"Strength does not come from physical capacity. It comes from an indomitable will."

- Gandhi

I want to share information that was discussed in our recent support group. The subject was "Taking a Fresher Look at Sundowning."

This information was published by the Alzheimer's Association in their "Tips and Tools" publication. This article addresses the most current information on sundowning.

Sundowning is a syndrome characterized by cycles of increased confusion, anxiety, agitation, pacing and disorientation that affects people in moderate to late stages of dementia. Although it most frequently happens at the end of the day or in the evening, it does not appear to be at all related to the sun going down.

This can happen at 1 p.m. or 11 p.m. Studies indicate that the number of people with Alzheimer's who experience sundowning can be as high as 66 percent.

The causes of sundowning are not fully understood. Dementia causes a disruption on the circadian rhythm, or the internal clock. Professionals indicate that sundowning is more closely related to brain fatigue.

A brain depleted by dementia is constantly working extra hard to navigate the environment and maintain functioning levels throughout the day.

Typically people are more alert in the morning when the brain is most rested. As the day progresses the brain simply cannot cope anymore. This is when it is more difficult for a person to differentiate reality from dreams and past memories, causing agitation.

The number one thing a caregiver can do to lessen sundowning is to establish a routine and stick to it as much as possible. Some examples:

  • Take a regular nap in the afternoon, not all afternoon, but maybe an hour to recharge the brain.
  • Meals and bedtime should be on a routine schedule as much as possible.
  • Avoid stimulants and big dinners. No caffeine, nicotine or alcohol in the evening.
  • Keep your home well lit in the evening.
  • Reduce stimuli. Avoid loud noises, such as the TV. Try soft music.
  • Allow opportunity for pacing.
  • Avoid arguing and over-explaining. Offer reassurance instead.
  • When a loved one is agitated, try approaching them in a calm manner.

Being a caregiver for someone with dementia is a 24/7 commitment. Learning ways to keep your loved one calm is very important, not only to them, but also to you. If they are calmer, you are calmer.

Some caregivers can be resistant to trying new things, but please hear me when I say that there are two people on this journey. You, the caregiver, is the one with the healthy brain. You can decide to take the hard road or you can decide to listen to people who have experience in this field.

For more information and support call Memory Matters at 843-842-6688 or visit our website at www.memory-matters.org.

Karen Doughtie is assistant director of Memory Matters, serving Bluffton and Hilton Head. karen@memory-matters.org