Understanding Sundowning: Tips to Redirect and Reassure Loved Ones

Sundowning is something that many people with Alzheimer’s or other forms of dementia experience. It refers to the confusion, anxiety, and agitation that often increase in the late afternoon and evening. By understanding and managing sundowning, we can help improve life for both those affected and their caregivers.

What is Sundowning?

Sundowning includes behaviors such as:

• - Increased confusion

• - Agitation or irritability

• - Restlessness or pacing

• - Mood swings

• - Hallucinations or delusions

Though the exact cause isn’t fully understood, it’s thought to be linked to changes in the brain that affect the internal body clock. Fatigue, low lighting, and shadows can also play a role in these symptoms.

Tips for Managing Sundowning

Managing sundowning is all about creating a calm environment and using strategies to gently redirect attention. Here’s how you can help:

• Keeping a consistent daily routine can lessen confusion and anxiety. Try to have meals, activities, and bedtime happen at the same time each day. Predictability can make a big difference.

• Reduce noise and distractions to set a peaceful tone. Soft lighting, comfortable seating, and calming music can all help. Avoid loud noises or stimulating activities that might increase agitation.

• As it gets darker, shadows can cause confusion. Keep rooms well-lit, and consider using nightlights in hallways and bathrooms to help prevent disorientation.

• Regular physical activity can help reduce restlessness and improve sleep. Simple exercises like walking or stretching can be very beneficial, but try to avoid vigorous activities close to bedtime.

• Caffeine, sugar, and certain other foods can make sundowning worse. Offer nutritious meals and snacks, and encourage regular hydration.

• During sundowning episodes, it’s important to provide reassurance. Speak in a calm, gentle tone, and use simple, clear language. A comforting touch, like holding hands or offering a hug, can also help.

Use Redirection Techniques

Redirection is about gently shifting focus away from distressing stimuli. Here are a few ideas:

• - Engage in a favorite activity, like looking through photos, listening to music, or working on a puzzle.

• - Offer a snack or drink; sometimes this can help soothe and distract.

• - Change the environment by moving to another room or going for a short walk.

• - Talk about positive memories or topics that the person enjoys.

Caring for a loved one with dementia can be tough, especially when dealing with sundowning, but understanding it and using these strategies can make a real difference. By sticking to a routine, creating a calming environment, and using redirection, you can help ease the anxiety and offer comfort during this challenging time of day.