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Caregiver Tip Sheet – Sundowning

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Caregiver Tips for Sundowning

“Sundowning” is a term used for individuals living with dementia who may show behaviors in the late afternoon or evening. Sundowning is seen more in the middle to late stages of dementia.

Most individuals begin to relax and unwind as the day comes to an end. Sundowning causes the individual to become more active and could present with episodes of agitation, anxiety, confusion and aggressiveness.

As the caregiver, you can’t control memory loss or the effect it has on the individual living with dementia. However, you can control how you cope and react to it.

What are Factors that Cause Sundowning?

  • Tiredness or fatigue.
  • Underlying medical conditions such as UTI’s.
  • Too little or too much lighting.
  • The inability to tell the difference between reality and delusions.
  • Interruption of routines.
  • Disturbance of 24 hour “body clock”. This typically tells our bodies when we are tired.
  • Being in an unfamiliar place. This could happen after a hospitalization or after moving to a new place as well.
  • Medications that may be wearing off towards the end of the day.
  • Increase in shadows causing confusion and fear.
  • Reaction to a tired or stressed caregiver.

How You Can Help

Tips to reduce Sundowning

  • Limit items like caffeine and sugar in the morning and eliminate them completely in the evening.
  • Limit napping during the day.
  • Open curtains or blinds during the day to allow more exposure to light.
  • Develop a routine for bedtime. Shut the television off at the same time every night, play familiar music that they enjoy, etc.
  • Activities should be done during the day to help keep the individual awake and to encourage sleepiness during the evening.
  • Install nightlights in areas that are dimly lit to help reduce confusion and agitation caused by shadows.
  • Talk with the PCP to ensure there are no underlying conditions such as UTI’s. Underlying conditions could cause sundowning to develop rapidly or worsen.

Tips to reduce Sundowning as it Happens

  • Listen to what the individual has to say. This could help identify what is causing the behavior. Are they fearful of the room because there is not enough light?
  • Redirect their attention. Often times this can help decrease anxiety and fear, especially if they are redirected to something they enjoy.
  • Use a gentle touch. This can be extremely soothing and help them to feel safe and comfortable.

For more information about caregiver tips or program availability through Living Well with Dementia, please contact Easterseals Homemakers & Health Services at 603.335.1770.