With the changes in weather and shorter days during the fall and winter months, people living with Alzheimer’s disease can experience behavior and mood changes. One of these changes is called “sundowning.” According to the Alzheimer’s Association, studies have shown up to 20 percent of older individuals with Alzheimer’s disease experience sundown syndrome or “sundowning,” which is a change in behavior that happens in the late afternoon.
Causes and Symptoms of Sundowning
Seniors with memory loss conditions are more prone to experience sundowning symptoms that start around early evening and continue into the late evening. When there is an interruption in Circadian rhythms—the cycles that tell the body when to eat, sleep, and wake up—moods and behaviors tend to shift significantly. Direct links have not been discovered yet; however, there are some possible causes of sundowning you may have noticed with a senior in your care.
Factors that may influence sundowning can include:
- Overtiredness at the end of the day
- Biological clock mix-up between day and night
- Visual misinterpretation due to reduced light and increased shadows
- Caregivers’ possible nonverbal cues of frustration
- Inability to separate dreams and reality, resulting in disorientation
While this phenomenon’s causes may be relatively unknown, there are some signs you can watch for that may indicate sundowning is in effect. If you notice seniors with behavioral, emotional, and cognitive changes, including anxiety, sadness, confusion, and delusions, you may need to conduct further investigation to rule out or confirm sundowning.
How Can Caregivers Support Seniors with Sundown Syndrome?
For seniors diagnosed with sundowning, symptom length can vary because every person is unique in how it affects them. You may notice that some of the seniors you’re caring for are experiencing sundowning for several hours around the same time every evening. Then again, other seniors may be prompted by an unexpected change in routine. In this case, symptoms usually go away without intervention once the shift is corrected.
Regardless of the symptom or length of occurrence, there are several ways you can support a senior through sundowning and provide care that helps them continue thriving.
- Reduce Clutter and Loud Noises in the Evening
Sundowning symptoms can be further exacerbated by loud noises and disorganization, making them more challenging to address. You can help reduce sundowning symptoms for the seniors in your care by designating times for quiet activities starting in the afternoon in preparation for the evening—when symptoms usually occur.
Some quiet activities you can suggest to seniors in your care can include:
- Playing soothing ambient sounds or music
- Reading poetry or a light-hearted book
- Going for a relaxing walk
- Playing an easy-to-follow card game or board game
Along with engaging in quiet activities, creating an atmosphere of organization can greatly reduce sundowning symptoms. You can help seniors by reorganizing furniture in a way that reduces clutter and anxiousness.
- Regulate light exposure
Exposure to light is believed to affect everyone’s internal clock in some way, shape, or form. For the seniors in your care, sundowning symptoms may come on during specific times of the year when sunlight depletes, or the sun rises earlier in the day. You may suggest a lighting system to the families of the seniors you support. A lighting system can automatically and gradually increase or decrease light depending on the time of day. This can help ease seniors experiencing sundowning symptoms into light changes.
- Introduce ways to distract and redirect
Since seniors experiencing sundowning can become distracted, disoriented, or agitated, you should try to distract them with things they enjoy. It’s never a good idea to argue or reason with a senior living with Alzheimer’s and in the midst of sundowning symptoms. Better alternatives to maintain a sense of calm include:
- Offering them their favorite snacks or drinks
- Having a family member or friend call them
- Turning on a favorite TV show (Try to avoid potentially upsetting programming such as the news.)
- Maintain a structured routine
For seniors living with Alzheimer’s disease, developing a routine is essential to continued sundowning intervention. Just as important, sundowning symptoms can significantly decrease when a structured routine (for both day and night) is established. The benefits of creating a routine for seniors experiencing sundowning include a sense of stability during the day and familiarity of surroundings.