Sundowner's Syndrome
What exactly is Sundowner’s Syndrome and is my loved one experiencing symptoms? Here are some ways you can help them manage it.
Ask for CareAs the sun slowly sets, you notice your father’s mood start to change. He’s seeming increasingly confused. You can sense he’s feeling a bit overwhelmed but you’re not sure quite why. You listen in on a phone conversation from his old friend and can tell it is difficult for him to track all the details of the discussion. After he hangs up, he looks in his drawer where he keeps his spare change. He tells you he thinks some money is missing. You try to tell him that you’re absolutely sure it’s all there but he quickly becomes agitated and is convinced someone stole it. As the skies begin to grow darker you notice he is becoming more and more disoriented. He begins pacing up and down the hallway and tells you he is going to go for a drive. You offer to accompany him on his evening errands but he stubbornly refuses your offer and says he’s just fine on his own.
This behavior is extremely out of character for your dad and you wonder how his mood seems to have changed so dramatically since this morning. You feel upset and wish there was something you could do to alleviate his anxiety. This isn’t the first time you’ve observed these changes happening throughout the day and they seem to be worse as soon as the sun goes down.
What you may be observing in your loved one’s behavior has become known in everyday vernacular as Sundowner’s Syndrome. As the name suggests, it’s a condition that causes symptoms such as confusion and agitation after “sundown” in people who suffer from Alzheimer’s disease.
It is believed that Sundowner’s Syndrome is caused by hormonal imbalances that occur in the evenings. Others theorise that the onset of symptoms in the evening hours is due to simple fatigue.
While Sundowner’s Syndrome has yet to be perfectly diagnosed and continues to remain somewhat of a mystery to those experiencing it and caregivers navigating it, we can equip ourselves with knowledge and medication to help alleviate and reduce its effects.
Sundowner’s Syndrome symptoms often reveal themselves more intensely as the day progresses. Your Mum/Dad may experience increased confusion, disorientation, wandering, and escape behaviors. At times, anxiety, paranoia, fear, and hallucinations may also occur.
According to Sundowner Facts.com, here’s a closer look at some things you can look out for to determine if your loved one may be suffering from Sundowner’s Syndrome:
1 Wandering: A person ‘sundowning’ might get disoriented and confused about where they are. He or she might wander in an effort to get centered again. Often times an individual might decide randomly to go for a drive in the evening and then might not remember their name or address. This is why it’s important to remain vigilant to Sundowner’s symptoms and ensure the proper round-the-clock is being provided.
2 Anxiety: Someone with Sundowner’s Syndrome may exhibit anxiety but be unable to articulate the reason for their feelings. This can then lead to frustration and disagreeableness.
3 Suspiciousness: Often times an individual appears to have a temporary personality change when the sun goes down. He or she may become suspicious and accusatory of family and friends.
4 Frustration: Agitation, frustration and at times extreme stubbornness are also common with the on-set of Sundowner’s Syndrome. They might not be receptive to helpful suggestions or steps to take care of them.
5 Inability to follow directions: When the sun starts to go down some people with Sundowner’s become confused and cannot process information as fluidly as they can during the daylight hours. This confusion can also lead to frustration and agitation.
In addition to ensuring your loved one gets the proper in-home care, there are some additional steps you can take to support your loved one who may be experiencing Sundowner’s Syndrome.
- Sleeping Schedule: Having a set time to wake up in the morning and time to get to bed every evening can allow the body to get used to routines and increase familiarity.
- Short Naps Only: 20 minute power naps provide short bursts of rest and relaxation, which can make a huge difference in alleviating Sundowner’s Syndrome symptoms.
- Routine Mealtimes: Just like sleeping, eating meals at the same time each day allows the body and mind to into a routine, which creates a sense of comfort. Alzheimer’s Association advises that it’s better to avoid food items that disturb sleep in the evenings, such as: nicotine, caffeine, alcohol, large meals or an excessive amount of sweets.
- Creating a Comfortable Living Space: Organising and decluttering the house and making it tidier and safer to live in. This can reduce the risk of falls. Keeping the home well-lit will distract the mind from realising it’s dark out, alleviating some of the symptoms of Sundowner’s especially in the night time.
- Staying Active Daily: Whether it’s planning daily walks, time in the garden or routine outings can stimulate one’s physical well-being and greatly diminish the effects of Sundowner’s Syndrome in the evening.
- Keep Your Loved One’s Mind Active & Fresh: A trip to the museum, tuning into a show on History Channel or reading a new book can encourage mental stimulation and engagement to ward off Sundowner’s Syndrome. Listening to favourite tunes can also elicit a sense of nostalgia and happiness!
- Consider Medication: If natural remedies do not appear to be having a helpful effect, there are specific medications on the market now for easing the condition of Sundowner’s Syndrome. Speak with your loved one, your caregiver and your doctor to see what medications might be suitable for your particular situation.
(Sources: Alzheimer’s Association, MedicalNewsToday, A Place for Mom, Sundowner Facts, Dementia Australia, Health Direct Australia)
Similar to other forms of dementia, the effects of Alzheimer’s, including the mysterious ways of Sundowner’s Syndrome, can cause anxiety for a loved one’s family as well. Not knowing precisely how to navigate it can also feel debilitating and like you’re sailing a ship without a rudder. This is why it’s helpful to educate yourself as much as possible as well as talking with our Care Team to better understand the most helpful approach you can take.
Nurse Next Door’s caregivers specialise in Alzheimer’s and dementia care. See how they can help Mum or Dad live happily, comfortably and safely at home here.
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