Sundown Syndrome – Coping Strategies

As sunset looms over the horizon, elders with dementia may be affected by this shift in their environment. The early evening can be a challenging time for people with Alzheimer’s Disease as they may experience sundown syndrome. Sundowning can manifest as confusion, agitation, and restlessness which worsens as daylight begins to fade. This can be difficult because if sundowning affects your elder’s ability to sleep well, then it will subsequently affect their functioning the next day.

Sundown Syndrome manifests during sunset and being tired or worn out can increase restlessness. To help support a more balanced routine try to include these healthy habits into your daily routine.

  • Bright light exposure during the day can maintain a proper circadian rhythm.
  • Daily physical exercise each day can decrease restlessness.
  • Daytime naps should be kept short and earlier in the day.
  • Decrease caffeine intake, and do not serve it late in the day.
  • Do not serve alcoholic drinks as they increase confusion.
  • Ensure you plan a balanced schedule without over-tiring your elderly loved one.

These habits will help support your elderly loved one in restful night sleep and less agitation during the day.

Coping with Sundown Syndrome

Signs of sundowning include confusion and distress which can manifest as behaviors such as emotional outbursts, yelling, crying, pacing, or wandering. If a person with Alzheimer’s becomes agitated due to sundown syndrome, stay calm, patient, and listen to their concerns. Reassure them that their feelings are valid, they are safe, and everything is okay.

Another option is trying to help them cope by offering a more enjoyable alternative or a pleasant distraction. You can offer them their favorite snack, drink, or fun activity. Another helpful distraction could be involving them in a simple care task such as washing dishes, folding towels, or sweeping the floors. Be mindful of using TV as a distraction, calming shows that they like may be helpful, but the news may be upsetting and is not advised. A better routine is to make this time a soothing part of the day, with calming music or quiet activities such as reading or going for a nature walk. A community connection may also be a supportive option, if your elder often is affected around the same time, try, and schedule a phone call with a friend to keep them present and involved.

If scheduled activities are not assisting your elder in coping with sundown syndrome, try adjusting their environment to suit their needs. A busy and messy area can contribute to your elder’s anxiety, so try and reduce background noise and material clutter in the room. As well, too many people can confuse and distress your elderly loved one, so during sunset, it is valuable to only have a few family members around to keep them company. In addition, the shadows cast by the setting sun may cause further confusion, so before the sunset, try and close the curtains and turn on the lights to minimize shadows and confusion.

If sundowning persists as an issue despite these preventatives and coping measures, it is valuable to seek medical advice from your family doctor. It is important to connect with your physician in case your elders’ sundowning is being affected by medication or a sleep disorder.

We also recommend you check these related posts on family caregivers in our Home Care Services blog: