Alzheimer's Foundation of America

Coping with… Sundowning

Sundowning is a dementia-related symptom that refers to increased agitation, confusion and hyperactivity that begins in the late afternoon and builds throughout the evening. Most sundowning emerges in mid-stage dementia and slowly worsens as the disease progresses. What causes it? Dementia may damage the body's internal clock, causing a disruption of sleep-wake cycles. Secondly, individuals with dementia become fatigued by their inability to process information; the more hours spent on this process, the more exhausted—and irritable—they may become.

Tips:

  • Plan activities or outings in the morning.
  • Do only simple, calming activities in the afternoon.
  • Keep individuals awake during the day.
  • Increase indoor lighting before dusk.
  • Ensure that the individual is not suffering from hunger, thirst, pain or fear.
  • Correct potential causes with basic interventions such as hydration and snacks.
  • Remove excess stimuli and clutter.
  • Watch for sundowning in early-stage dementia or rapidly worsening symptoms, both of which may suggest delirium.
  • Consult your doctor to see if medications may help.
  • Be twice as patient and kind during these hours.

For more information, please go to the Alzheimer's Foundation of America website.

Q: My 78-year-old father is experiencing the early stages of dementia. What can I do to minimize his frustration?

A: First, be sure that your father has been thoroughly assessed by a physician and that he is properly diagnosed. In some cases, dementia symptoms are caused by a treatable medical condition. If your father has been diagnosed with a progressive (irreversible) dementia, continue to pay close attention to his behavior and his complaints—and report any changes to his doctor. The doctor may propose treatments that will have the effect of reducing feelings of frustration.

As a family caregiver, you will have many opportunities to manage his experience to help reduce frustration. It helps to stick to a daily schedule. Program...

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