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Sundowners Syndrome: What it is and How to Cope

July 02, 2015

If you are caring for a loved one with Alzheimer’s or dementia, you may be familiar with Sundowners Syndrome. Sundowners syndrome is characterized by memory loss, confusion, agitation, or wandering during the evening hours when the sun is setting. It affects up to 20% of individuals with Alzheimers. Sundowners can also be seen in those with dementia and in otherwise healthy individuals who are experiencing a protracted hospital stay. Symptoms of Sundowners include rapid mood changes, anger or agitation, crying or fear, depression, restlessness, and stubbornness.

The cause of Sundowners is unknown, however, Sundowners may be triggered by a variety factors. If your loved one is in an assisted care facility, Sundowners may be triggered by end-of-day activity. During late afternoon shift changes, there tends to be more activity and this activity has been linked to the anxiety or confusion many with Sundowners experience.

At home care providers should be on the lookout for a variety of factors that can contribute to Sundowners including fatigue, low light and the change of seasons. Sundowners can be triggered by fatigue at the end of the day and lack of activity after dinner. Others with Sundowners are triggered by the low light during the evening hours. This period of low light, before interior lights are fully turned on, can increase shadows making even a familiar room seem suddenly unfamiliar. The onset of winter has been shown to increase agitation in those with Sundowners.

How can you help your loved one cope with Sundowners? Because the causes are unknown, treatments are not well established. There is no pill to take to make Sundowners more manageable. There are, however, things you can do to help your loved one cope.

Try establishing a regular routine. “Routines help the elderly feel safe by minimizing surprises and establishing relied upon activities,” says Larry Meigs, President and CEO of Visiting Angels, one of the nation’s leading at home care providers. According to Meigs, “A regular routine can help to reduce anxiety and confusion.”

Plan your day carefully. In addition to having a regular routine, those with Sundowners benefit from participating in more vigorous activities in the morning. It is also important to avoid loading up the day with too many activities. Experts recommend no more than two activities in a day.

Keep an eye on your loved one’s diet. There may be a correlation between the foods your loved one eats and the symptoms they exhibit. Avoiding caffeine and sugary foods in the later part of the day can help to keep Sundowners under control. Keeping a food diary can help to identify the foods that trigger symptoms.

Minimizing noise from the television, radio and other devices in the evening hours can help as well. It is often advised that evening visits from individuals outside the household be avoided to minimize your loved one’s stress and anxiety.

Keeping your home well lit is an easy way to help your loved one cope with Sundowners. “Our caregivers watch the daylight closely. We try to turn on lights early so as the daylight fades interior lighting can take over without a dip into darkness,” says Meigs. Keeping rooms well lit can help your loved one to feel more secure as they move around their home.

If you are concerned your loved one may have Sundowners Syndrome, please contact your health care provider. Working closely with your health care provider, you can diagnosis and develop strategies for successfully coping with the symptoms of Sundowners Syndrome.

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