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. One of the suggestions is taking 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 diet may be helpful. Keeping a journal can assist with uncovering patterns in the sundowning behaviour. These notes should be brought to each medical appointment as they can provide more details about the sundowning to the health care professional(s). It can be especially difficult to recall these details during office visits or appointments given the abundance of caregiving tasks that you may take on at any given time.
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. Refer to them as you always have in a calm voice, and gently re-orient them to their surroundings. Using simple terminology, you may want to describe where the person is, why they are there, who is with them, and what will take place over the next few minutes. For example, you may describe that they are in the washroom and you would like to help them wash their face as part of the evening routine before going to sleep. Consult with the person in your care and allow them to ask questions or make decisions about what you have described.
It is not easy caring for someone with dementia (or Alzheimer’s disease). It can be especially difficult to care for someone who appears to act themselves during the day but becomes unfamiliar, unpredictable, or even unrecognizable into the evening. You may feel uneasy, frustrated, and exhausted after the person in your care has experienced an episode of sundowning. These feelings are normal and it is important that you find ways to cope with the recurring episodes of sundowning. 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 by consulting reputable sources such as a health care professional or the Alzheimer Society of Canada
If you’re taking care of someone with dementia, an Elizz Caregiver Coach can help you navigate the complex challenges you face and work with you to establish a simple, personalized, and detailed caregiving plan.
At Elizz, we provide caregiver support for you and home care services for those who depend on you. Elizz is a Canadian company powered by Saint Elizabeth, a national not-for-profit health care organization that has been caring for Canadians since 1908.
For more information on sundowning please visit the Alzheimer Society of Canada’s Website.
You might also like our Elizz article entitled 6 Tips for Alzheimer’s and Dementia Care at Home.