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Sundowning in Dementia Care

What is Sundowning?

Sundowning is a symptom commonly associated with individuals diagnosed with dementia, impacting as many as two-thirds of seniors. A set of symptoms characterized by increased behavioral changes, this is commonly observed in individuals during the late afternoon and evening hours. 

Symptoms to Watch Out For

The intensity and presentation of sundowning vary. People with Alzheimer’s and other types of dementia may experience the following: 

  • Confusion and disorientation 
  • Aggressive behaviour 
  • Wandering
  • Difficulty sleeping 
  • Increased anxiety 
  • Hallucination 
  • Refusal to receive assistance or engage in activities

These sundowning presentations may be influenced by factors such as mental and physical exhaustion, changes in routine, increased stress, and being in unfamiliar, confusing, or high-stimulus environments. 

Reducing and Managing Sundowning

Individuals experiencing sundowning benefit from a supportive and structured environment. This includes close monitoring, kindness, and understanding from carers and the people around them.

As appropriate, the following best practices have been shown effective in caring for someone experiencing sundowning:

  1. Establish a consistent morning and bedtime routine.
  2. Schedule activities in the mornings or early afternoons, such as doctor appointments, outings, and baths. 
  3. Encourage more outdoor activities including walks, mild exercise, or socialization.
  4. Keep a diary of events that leads to sundowning episodes to identify and reduce potential triggers. 
  5. Reduce or avoid activities that trigger sundowning in late afternoon or evenings. 
  6. Keep evening meals light and small while offering a bigger meal during lunch, as appropriate.
  7. Limit daytime naps to allow for more sleep at night.

Best Practices for Carers

When a person is experiencing sundowning, it is crucial for caregivers to: 

  • Remain calm and caring 
  • Alleviate their or remove stressors
  • Provide and attend to their needs
  • Gently remind them of the time, as appropriate
  • Do not argue and avoid the use of physical restraint

The best approach is to allow them to pace back and forth while keeping them safe, providing them with distraction activities according to their preference, and being truly present with them throughout.[1],[2]

Your AllCare team is trained and skilled at providing personalized and safe care to persons with Alzheimer’s and other forms of dementia. Customizing care, ensuring safety, and providing personalized comfort and assurance are essential when sundowning occurs. 


[1] https://www.alz.org/help-support/caregiving/stages-behaviors/sleep-issues-sundowning

[2] https://www.msn.com/en-ca/health/medical/sundowning-syndrome-recognizing-the-signs-and-symptoms/ar-AA17AeSW?ocid=msedgntp&pc=ACTS&cvid=43f025a0ccd947a7b06b30a6b199b7eb&ei=8

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