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Sundowning and Alzheimer’s Disease: What it is and How to Deal With it

sundowning and Alzheimer's disease

Sundowning syndrome is a common Alzheimer’s and dementia disease, most often affecting people who have mid- to late-stage dementia. It is also often referred to as “late-day confusion.” Sundowning relates to a state of confusion that occurs in the late afternoon or nighttime. Some symptoms that come from sundowning are confusion, aggression, or anxiety.

Many behaviors of Sundowning can be mental or physical. They can occur very suddenly or for no apparent reason. Or it could result from a frustrating situation. While this may be hard to deal with, you have to remember that the person who has Alzheimer’s or Dementia is not doing it on purpose.

Factors that can Agitate Sundowning

  • Fatigue at the end of the day, both mentally and physically
  • A biological mix-up between day and night in their “internal body clock.”
  • Low lighting and shadows which Alzheimer’s disease patients to misinterpret what they see, so they become confused and scared
  • Difficulty in differentiating reality from dreams
  • Change in their daily routine
  • Signs of any infection, such as a urinary tract infection


Ways to Manage Sundowning symptoms

  • Provide them with maximum comfort.  When you are sick, you want to be surrounded by comfortable things and people. For loved ones with Alzheimer’s disease, the world can be a scary place. Try to surround them with things that put them at ease. Comfortable pillows, fluffy blankets, family photos, and other familiar objects can help your loved one feel cozy.
  • Light up the home in the evening. Inadequate lighting may increase agitation that occurs when surroundings are dark or unfamiliar. Adjusting the lighting in homes may be helpful to regulate their sleep schedule and put them at ease. Nightlights are useful to keep a room well lit at night.
  • Make a comfortable sleeping environment. Keep a warm room temperature. Provide window locks and nightlights to help promote safe surroundings. Door sensors or motion detectors are also helpful in alerting the family that the person is wandering.
  • Maintain a predictable daily schedule. Try to encourage your loved one to stick to a regular schedule that helps them feel at ease. The plan could include bedtimes and meal times.
  • Plan more active days. Plan activities for the morning or early afternoon to discourage afternoon napping. Fit daily exercising into your loved one’s routine, but not less than four hours before they go to bed.
  • Minimize stress as much as possible. Help your loved one remain calm in the evening hours by sticking to simple activities that aren’t too challenging or fearful. Snuggling with a loved pet could be a very comforting and straightforward action. Playing soft and quiet music may contribute to creating a peaceful environment as well.  In the later stages of Alzheimer’s disease, watching TV or reading a book could be hard to follow which could ultimately frustrate your loved one.
  • Identify what triggers them and take note of it. Avoid distractions during evening hours such as loud noises or coming and going throughout the house. Compose a journal of activities that agitate your loved one. By doing this, you will avoid agitation for your loved one in the future.
  • Be mindful of your condition as well. If you are feeling stressed or tired in the middle of the day, your loved one may sense it and become agitated. Help yourself by making sure you get plenty sleep at night.

Need Help?

Sundowning syndrome can be exhausting for seniors who have Alzheimer’s Disease and other forms of Dementia. It can also be very challenging for their families. Here at Comfort Keepers, we not only understand all of the challenges that come along with the disease, but we also offer many different care services that will help your loved one that is suffering from Alzheimer’s disease. For more information or to talk to one of our caregivers, contact us at (877) 698-9394