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Sundowners in Elderly and How to Decrease their Troubling Effects

Sundowners in elderly adults can occur when one has dementia of any type. It is estimated that 60% of seniors in long-term care communities have behavioral issues associated with dementia or Alzheimer’s disease.

Symptoms of Sundowners in Elderly Adults 

Typical symptoms of Sundowners in elderly adults include:

  • agitation
  • confusion
  • increased suspicion
  • irritability
  • disorientation
  • restlessness
  • hearing/seeing things that are not there
  • yelling
  • pacing
  • mood swings that are unpredictable

Unfortunately, the medications used to treat Alzheimer’s and dementia, depression, and anxiety can cause side effects, too, making it difficult to treat. Oftentimes, a person with dementia has trouble communicating when they have a need or a pain, leading to frustration and anxiety issues.

If you are a caregiver for a person with Sundowners, you probably are desiring some ideas for how to help minimize this difficult situation. Recent studies show that melatonin production may be decreased in these individuals due to the degeneration of the Suprachiasmatic nucleus of the hypothalamus. This causes a person’s internal clock to be thrown off and they have difficulty with sleep at normal hours. Dementia patients benefit most from a consistent, calm, and familiar routine.

Disruptions in routine can cause increased Sundown behavior.

  • Keeping your Senior busy throughout the day, getting some exercise, and limiting daytime naps will benefit their wake and sleep rhythm.
  • Sugar and caffeinated beverages should be consumed only in the mornings. Bright lighting in the home also helps with their internal clock.
  • In the evening, it is best to keep background noise to a minimum.
  • Maintain a consistent bedtime routine, starting well before you turn the lights off.
  • Fighting, confrontation, and arguing will cause more issues with Sundowning.
  • Patients also do not react well to you getting in their personal space, restraining them, or using exaggerated hand gestures.
  • Violent or emotional TV programs can increase behaviors as well. Using a gentle voice, clear but firm instructions, and not trying to reach the patient will aid in their trust.
  • If TV is part of the routine, simple and non-violent programming is best. The Home & Garden Channel or nostalgic shows that are familiar to them will help to keep them calm.
  • Most importantly, making sure their basic needs are met and that they are not in pain will decrease episodes of Sundowning.

When these behaviors are minimized there will be less stress on the caregivers and allow for more quality time spent with your loved one.