Is your elderly loved one exhibiting behavioral changes? Do these changes become more prominent as the day progresses? If the answer is yes, they may be suffering from sundowners syndrome. But what is sundowners syndrome?

Also known as sundown syndrome or late-day confusion, it refers to feelings and symptoms that occur during the late afternoon or early evening. Typically, the condition affects patients with Alzheimer’s disease and dementia. Let’s take a closer look at what sundowners syndrome in seniors entails, potential causes and how to help someone with the condition.

What Are Common Sundowning Behaviors?

Sundowners syndrome affects everything from mood and behavior to memory and thoughts. Generally, these symptoms kick in when the sun starts to set and continue throughout the night. Here are some of the most common symptoms.

Senior woman having difficulty sleeping because of sundowners syndrome.

Sleep Problems

A major side effect of sundowning is restlessness and agitation. Rather than become relaxed as the day ends, patients get more tense, leading to difficulty sleeping. When left unaddressed, sleep disturbances can cause other health problems such as hypertension, cardiovascular issues and mental and physical exhaustion.

Behavioral Changes

Most people with sundowners syndrome will exhibit the following behavioral symptoms:

  • Wandering
  • Shadowing
  • Increased aggression

Sundowning usually increases confusion, which may cause patients to wander randomly. They might also start shadowing (or following) someone they trust, like a loved one or caregiver. In some cases, this confusion leads to frustration that triggers aggressive, violent behavior.

Mood Changes

In addition to behavioral signs, people with sundowners syndrome often experience mood changes. It’s common for patients to exhibit the following emotions:

  • Irritability
  • Anxiety
  • Sadness
  • Confusion

Some sundowning patients will experience increased irritability and frustration, while others will be more anxious or sad. Many patients also go through confusion and paranoia, which may lead to hallucinations and delusions.

What Causes Sundown Syndrome?

The exact cause of sundowners syndrome in the elderly is unknown. However, some studies suggest it’s connected to the internal body clock. When someone develops dementia or Alzheimer’s disease, their brain may struggle to distinguish between being awake and sleeping, leading to increased confusion, trouble sleeping and other sundowning symptoms.

Although sundowning can affect anyone, you’re more at risk if you experience the following:

  • Fatigue
  • Depression
  • Boredom
  • Insomnia

These factors increase the likelihood of sundowners syndrome and worsen symptoms.

Senior man suffering from depression.

How Can You Help Someone With Sundowning Symptoms?

Now that you know what sundowning is, you might be wondering: How do you treat it? Unfortunately, because the syndrome is typically linked to dementia, there’s no way to resolve it entirely — it continues as dementia or Alzheimer’s disease progresses. However, you can minimize symptoms. Here are a few key things that may help manage the syndrome.

Avoid Triggers

According to Cleveland Clinic, about 20% of Alzheimer’s patients experience sundowning. While each individual has their own unique experience with the condition, there are some general things that make sundowning worse, such as:

  • Sleep disorders
  • Dehydration
  • Fatigue
  • Poor lighting
  • Overstimulation
  • Caffeine
  • Alcohol

Staying hydrated, relaxed and well-rested can go a long way in reducing sundown syndrome symptoms. It’s also helpful to avoid substances that prevent good sleep, such as caffeinated beverages and alcohol.

Use Medications

Certain medications, such as antidepressants, antianxiety drugs and antipsychotics, have proven effective in reducing sundowning symptoms. Furthermore, some medications can help foster a good night’s sleep, like melatonin.

Of course, medications don’t work for everyone, and some may cause adverse effects. Speak to your doctor to learn more about your options and their respective pros and cons.

Change the Environment

It’s important that patients with dementia and Alzheimer’s disease feel at ease in their environment. Creating a comfortable, peaceful atmosphere can reduce some of the most prominent symptoms, including agitation and irritability. If you haven’t done so already, consider making the following environmental changes:

  • Turn off lights at night. Keeping lights on during the day and turning them off at night might help reset a person’s body clock.
  • Reduce noise during bedtime. To reduce the risk of sleep issues, try lowering noise levels at night.
  • Hang up family photos. Keeping family photos around can help jog memories and lower the risk of confusion or paranoia.

The happier a patient is with their environment, the less likely they are to become frustrated, restless and stressed.

Remain Calm

When a loved one is exhibiting unwanted symptoms, it’s normal to feel worried or overwhelmed. However, it’s important to try to remain calm.

Patients sometimes model the behavior of their family, friends and loved ones — if they notice you’re anxious or worried, it can worsen their own symptoms. On the other hand, if you seem relaxed, they might become less stressed. You can promote calm feelings by:

  • Avoiding arguments
  • Asking if you can help
  • Providing reassurance

Try not to argue or yell, as this will make the patient even more agitated. Instead, calmly ask if they need something or if there’s anything you can do to help. You should also try to offer reassurance by reminding the patient where they are and telling them they’re safe.

Care giver having a conversation with senior woman.

Seek Professional Assistance

In the early stages, you may be able to handle sundowners syndrome at home. However, as dementia progresses, the symptoms tend to worsen, making it exceedingly difficult to cater to the patient’s needs. To ensure their loved ones receive the help they need, many people turn to the assistance of memory care professionals, such as the Catered Living at Ocean Pines team that provides the best senior living community.

Our memory care home, located in Worcester County, Maryland, helps patients — and their families — navigate the challenges associated with memory loss. In addition to a cozy, safe environment, we offer a team of passionate caregivers who are experienced in handling sundowners syndrome. Ultimately, we aim to help reduce symptoms, improve well-being and make residents happy.

Interested in learning more about our home? Feel free to call us at (410) 208-1000 or schedule a tour online.