Sundowning Symptoms in Dementia: What You Need to Know

Sundowning symptoms and dementia can be a difficult combination to navigate. Sundowning describes the behavior changes that occur when someone with dementia experiences increasing confusion, agitation, and restlessness as the day goes on. Sundowning symptoms can occur with any type of dementia, but seem to be particularly apparent with Lewy Body Dementia.

10 Things you Need to Know about Sundowning Symptoms

1. Sundowning usually begins in the late afternoon or early evening and may include wandering, increased confusion, irritability, aggression, hallucinations, and sleep disturbances.
2. Sundowners Syndrome can occur due to numerous triggers such as stress from too much stimulation in the environment, hunger or thirst caused by skipping meals or lack of hydration throughout the day, fatigue from physical activity earlier in the day, pain, or discomfort from an illness or infection.
3. Sundowning is not necessarily a sign of dementia, but if it persists and disrupts activities of daily living, it could be a symptom of the condition.
4. Sundowning can often be managed with simple changes in lifestyle, including scheduling more rest during the day, avoiding overstimulating environments, setting routine reminders for meals and snacks, providing plenty of fluids throughout the day to stay hydrated, and making sure medications are taken at regular intervals as prescribed by a doctor.
5. Sundowning can also benefit from calming activities such as music therapy or participating in gentle exercise like walking or swimming.
6. Caregivers should create an environment that is calming and comfortable with low lighting, minimal noise, and a consistent daily routine.
7. Sundowning can sometimes be managed through medications prescribed by a doctor such as anti-anxiety or antidepressant drugs.
8. Sundowning can sometimes (especially in the early stages of dementia) be prevented if the person is given adequate rest throughout the day and is kept engaged in meaningful activities that they find enjoyable.
9. Sundowning symptoms can be difficult to manage at times but it’s important to remember that many older adults can experience some degree of confusion during the evening hours and this does not necessarily mean dementia is present.
10. If sundowning persists and disrupts everyday life, it’s important to speak to your healthcare provider.

Sundowning symptoms can be difficult to manage, especially for caregivers of those with Lewy Body Dementia. Engaging in calming activities such as music therapy or gentle exercises like walking or swimming can help reduce sundowning symptoms. Caregivers should also ensure that their loved one gets adequate rest during the day and is kept engaged in meaningful activities they find enjoyable.

While the exact cause of sundowning is unknown, it is thought to be related to changes in the body’s circadian rhythm. The term was first used in the late 19th century to describe the worsening of symptoms in patients with dementia.

As the day progresses and the sun starts to go down, people with sundowning may become more agitated or even violent. Hallucinations and delusions might increase significantly. Sundowning can be a very frightening experience for both the person with dementia and their caregivers.

Ways that Sundowning Symptoms may Appear

• Crying relentlessly
• Screaming
• Violence
• Agitation
• Walking and pacing
• Shadowing their caregiver
• Delusions
• Restlessness
• Paranoia
• Hallucinations

What to Know about Sundowning Hallucinations

Hallucinations are visual or auditory illusions that are not based in reality. Visual hallucinations are when someone is seeing things that are not really there, such as animals or people. Auditory hallucinations may involve hearing voices or other sounds. People with dementia may also have delusions, which are false beliefs that are not based in reality. For example, a person with dementia may believe that their home is being burgled when there is no evidence of this.

Hallucinations and delusions can be caused by a number of factors, including changes in the brain, medications, sleep deprivation, and anxiety. Treatment for hallucinations and delusions typically involves addressing the underlying cause, such as adjusting medications or providing support for anxiety. In some cases, antipsychotic medications may also be prescribed.

If your loved one is experiencing sundowning, it’s important to speak to your healthcare provider for further advice and treatment options.

Conclusion. While Sundowning syndrome can be troubling for both patients and caregivers, there are a few ways to manage the condition. Sundowning syndrome is often treated with a combination of medications and behavioral therapies. In some cases, changes to the home environment, such as adding more light in the evening hours, can also help to reduce sundowning symptoms.

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Lewy Body Dementia Signs: Key Symptoms you Need to Know Dementia Distraction Techniques – How to Help People with Dementia Caring for a Mother with Dementia: The Reality of the Situation How to Make Traveling with Dementia Work: A Caregivers Guide