Sundowner syndrome (or sundowning) is a term used to describe why some people with Alzheimer’s disease become more restless, agitated, or combative once the sun goes down.
They may wander more, and become more distressed at this time of day and have difficulty sleeping. Often this is a characteristic of the middle stages of Alzheimer’s, and can settle down as the disease progresses. Many people are mobile and wander day or night throughout their illness anyway, but if it is a new phenomenon and only occurs after dark, it may be related to sundowning.
It is thought that perhaps the part of the brain which controls the biological clock is affected. Concepts of day and night can become blurred and time is less important to them. If you can keep routines of meal times, walks, activities and rest times going as long as possible this helps. Like children they like routines.
If none of these things help, it is a good idea to consult the doctor in case a change in medication or timing of medication may help. The doctor can also rule out infections, pain, or drug interactions as the cause of the distress.
Sadly, aimless wandering and other distressing behaviours can become part of dementia in the middle stages, but there are lots of little hiccoughs along the way that can be resolved if the problems are just that the person with Alzheimer's cannot express their needs adequately.
Carers need to be able to know what their loved one is trying to tell them, the same as a new mum with her baby gets to know the differences of meaning in each cry.
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