As a caregiver, you may notice that a person with dementia (or Alzheimer’s disease) is consistently "not himself” or “not herself” as the day goes on, and especially into the evening when the sun goes down. This is common and it is actually called sundowning, although you may have heard this referred to as “Sundowner’s Syndrome” or “Sundowning Syndrome.” The Alzheimer Society of Canada describes that a person may become more “confused, anxious, aggressive, agitated, or restless” during a period of sundowning. The Alzheimer Society of Canada also states that up to 66% of people living with dementia may experience sundowning. This means that there are many caregivers just like you who are caring for people who experience sundowning.
Although the person in your care may not appear to be himself/herself during an episode of sundowning, it is important to treat them as the person you have always known them to be.
If you suspect that the person in your care is experiencing sundowning they should be assessed by a health care professional. It is important to determine if the behaviour is in fact the result of sundowning or if it is due to another health concern such as an infection or pain.
The Alzheimer Society of Canada has many suggestions for dealing with sundowning. First, they recommend determining whether the person is experiencing pain, is hungry, or needs to use the washroom. Other suggestions include providing adequate lighting to minimize shadows when it starts to get dark in the evening and minimizing over-stimulation from the television or radio. You can also keep the person busy and distracted during the time that sundowning usually takes place (for example, by having them assist with preparing dinner or setting the table). It is also recommended to maintain an evening routine that is familiar to the person and avoid stressful activities like medical appointments during this time. Another suggestion is to take notes about each episode of sundowning and the behaviours of the person in your care. Any additional details including daily events or changes to the person’s routine such as the amount of rest or activity may also be helpful. Keeping a journal can assist with uncovering patterns in the sundowning behaviour including strategies that reduce the sundowning behaviour. These notes can also provide details about the sundowning to the person's health care provider(s) as it can be especially difficult to recall these details during office visits or appointments.
It is important you keep yourself on the agenda by taking care of your own health needs and finding strategies to cope with the sundowning behaviour. Coping strategies that could be used include:
- Sharing the caregiving duties (with family, friends, or health care professionals)
- Maintaining a healthy diet
- Getting enough physical activity
- Obtaining a restful sleep at night
- Reaching out for support or resources in your community
- Educating yourself further on sundowning and coping strategies by consulting reputable and reliable sources such as a health care professional or the Alzheimer Society of Canada
Please note that this article is not intended to be a substitute for medical advice.
For more information on sundowning please visit the Alzheimer Society of Canada’s Website.