Shining the Light on Sundowner Syndrome

What is sundowner syndrome?

There is no clear definition of sundowner syndrome, but it’s typically a spectrum of unusual behaviors that often include confusion, agitation, and restlessness that occur late in the afternoon into the evening.

Sundowners Syndrome primarily affects the elderly who have Alzheimer’s disease or other forms of dementia. According to the Alzheimer’s Association, as many as 1 out of 5 people with Alzheimer’s exhibit symptoms.

However, it can also happen temporarily to older people when recovering from surgery and anesthesia. Stays in hospitals or other unfamiliar environments can also trigger symptoms.

Consistency in these late-day behavioral patterns generally signals that a syndrome may be developing. Although the behavior passes, as it occurs during a particular time of day, it can be very distressing to the loved one and caregiver.

Typical symptoms and behaviors of Sundowner Syndrome:

• Rapid mood changes
• Confusion
• Extreme agitation
• Anxiety
• Depression
• Fear
• Stubbornness
• Restlessness
• Emotional outbursts
• Crying
• Trouble sleeping
• Pacing

More severe symptoms may include:

• Hallucinating
• Wandering
• Hiding things
• Paranoia
• Acts of violence

Five Triggers of Sundowner Syndrome:

1. Fatigue – Disturbed sleep during the night can result in fatigue the next afternoon.
2. Low light – Natural light diminishes, and shadows increase as the sun goes down.
3. Internal imbalance – A culprit might be hormonal imbalances or disruptions of the internal biological clock regulating waking and sleeping hours.
4. Late day activity – Too much stimulation and activity toward the end of the day.
5. Change in seasons – Shorter hours of daylight associated with fall and winter.

Six Ways to Manage Sundowners

1. Establish a routine – Establishing a routine, minimizing surprises, and limiting daily activities and events helps loved ones feel safe instead of fearful and confused.
2. Provide familiarity – Surround loved ones with precious and comforting items such as family photos and favorite things.
3. Monitor diet – Avoid food or drinks with caffeine and large amounts of sugar, especially later in the day. Provide a light meal in the evening and a larger meal at lunchtime.
4. Regulate noise – Keep noise, loud TVs, or late-day visitors to a minimum. Instead, play calming music or engage in quiet activities.
5. Lighting – Keep rooms well-lit, adding more light as the sun goes down. Use nightlights to reduce the stress of getting up during the night. Also, lightboxes show that the effects of sundowning and depression can help.
6. Keep a record – Track activities, situations, and environments that appear to trigger sundowning behavior and cause symptoms to worsen.

Two important things to remember:

• Your loved one is not responsible for their actions; they are not purposefully acting out.
• Don’t be afraid to ask for help – Sundowners can be draining for the caregiver. You can’t care for a loved one if you aren’t healthy–physically, mentally, and emotionally. Reach out to healthcare or homecare professionals and give yourself a break from time to time.

Community Care of the Northeast

CCNE homecare allows elderly loved ones to age safely in their own homes while providing assistance when needed. If you are a caregiver and need a break during the most stressful times, call us for a consultation. We can set up a schedule to go over your needs and discuss how and when we can help.

Contact us today for support at 215-335-4416.