Sundowner Syndrome Treatment - How to Cope
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
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.
Minimising Sundowner Syndrome Symptoms
cause of the agitation, caregivers can try checking several things:
- Do they need the toilet? Sometimes they
know something is wrong but may have forgotten what to do or where the toilet
is. Having regular toileting times or reminding
them to go can help.
- Are they
constipated? This too can cause some agitation
- Have they
eaten much today?
- Could they be
thirsty? Always have mugs of water
available for them to help themselves to drinks. Dehydration can cause agitation and they
cannot understand why. Monitor how much fluid intake they have in a
- Are they
sleeping too long during the day time? An
afternoon nap is good but not too long or the night sleep is disrupted and evening
wandering becomes more likely.
- Limit caffeine
and sugar to the morning hours.
- Are they
bored? Simply wondering what to do? Try giving them a tray of activities cards to look at and old
magazines. A doll to dress or a cuddly toy. See our ideas for activities.
- Taking them
for a walk sometimes calms and settles them. It’s good to make sure they get
plenty of day light during the day as this helps the brain to adjust to the
Sundowner syndrome treatment may require medication
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.
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
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.
need a medal for coping each day with the many challenges they face. Many carers
feel isolated and are scared to discuss problems in case they are seen as
inadequate. This is far from true. We all need to pool ideas on care giving. Good Luck!
For my complete guide to Alzheimer's Caregiving: click on the book to see what's included. . . .
Read about coping with the grief of living with or caring for someone with Alzheimer's
For help caring for someone at home, click here
A powerful article about sundowning written by a person with Alzheimer's
ARE YOU A BEREAVED MOTHER OR FATHER?
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For more details, you can contact the Principal Investigator:
Kailey Roberts, PhD, Assistant Professor of Clinical Psychology, Ferkauf Graduate School of Psychology, Yeshiva University.
Thank you for your consideration --
Judith Kottick, LCSW and Jean Singer, PhD
IRB Approved at the Study Level, May 10, 2021. #30499052.0
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