Sundowning syndrome

The term “sundowning syndrome” is used to describe certain changes in behaviour that occur in the evening, around dusk. Sundowning syndrome isn’t a disease. Rather it’s a group of symptoms that occur at a specific time of the day, causing some people who have dementia to experience a growing sense of agitation or anxiety at this time.

Sundowning often makes the person with dementia feel very strongly that they are in the wrong place. They might talk about needing to pick the children up from school, even if their children are adults. They may also say that they need to go home, even if they are home, or run errands that don’t exist. 

Other symptoms might include pacing, shouting, arguing, or becoming confused about who people are or what’s going on around them.

Why does sundowning happen?

Sundowning has several causes. Thirst, hunger, illness and physical pain can all play a part. As can spending a day in an unfamiliar place and any disruption to routine and the body’s internal-clock. But mainly, as the day goes on, the person with dementia becomes more tired, and this can lead to their dementia symptoms worsening. 

As darkness falls, streetlights come on and the roads become less busy as people settle in for the evening. These changes can make the person increasingly concerned that they are in the wrong place, or have forgotten to do something vital during the day. 

Tips for managing sundowning

  • Hold the person’s hand, sit close to them or hold their arm.
  • Speak in short sentences and give simple instructions to try and avoid confusion.
  • Talk in a slow and soothing way.
  • Ask them what the matter is. Listen carefully to their response and if possible, see if you can deal with the reason for their distress.
  • Use distraction techniques: take them into a different room, make the person a drink or snack, turn some music on, go out for a walk.

Tips for preventing sundowning

Design and follow a daytime routine containing activities the person enjoys, like going for a gentle walk or visiting the shops. Consider:

  • Limiting napping in the daytime to encourage them to sleep well at night.
  • Avoiding large meals in the evenings as this can disrupt sleep patterns.
  • Trying to limit their intake of caffeinated and alcoholic drinks. Instead, offer them herbal teas, decaffienated coffee or cola, or alcohol-free beer and wine. You may want to suggest they consider stopping drinking alcohol altogether

Introduce an evening routine with activities the person enjoys, such as watching a favourite program, listening to music, stroking a pet etc. However, try to keep the television and radio stations set to something quiet and calming – sudden loud noises like shouting can be distressing to people with dementia.

Also try:

  • Closing the curtains and turning the lights on before dusk to ease the transitions into night-time.
  • If possible cover windows, mirrors and glass doors with some fabric, towel, sheet or curtain. Reflections can be confusing for people with dementia.

If your loved one will be in a strange or unfamiliar setting, bring familiar items – such as photographs – to create a more relaxed, comforting setting.

Contact us

At Choice Care we have experienced and highly qualified professionals ready to help. So if you would like to talk to someone about sundowning syndrome or have further questions about other aspects of dementia, then please get in touch on 01254 504905. We look forward to hearing from you.