Dementia and Sundowner’s Syndrome: Terminology and Tips

Dementia and Sundowner’s Syndrome: Terminology and Tips

time icon 4 min read update icon Sept. 26, 2019

Continuing with our series on Dementia awareness, this week we bring you a great guest post on Sundowner’s Syndrome by Shannon Martin…

Dementia is a general term used to describe a group of symptoms related to cognition, such as memory loss, personality changes and more. Different diseases cause dementia, such as Alzheimer’s disease, Pick’s disease, Parkinson’s, vascular dementia, frontotemporal lobe dementia, and Lewy Body disease. Alzheimer’s disease is thought to be the most common form of dementia, though many people may suffer from a combination.

A good diagnostic workup is important when someone exhibits signs of dementia, to ensure symptoms are not a result of something reversible like a vitamin deficiency or medication side effect.  A diagnostic workup will typically include a thorough history and physical, along with blood work and other screenings to rule out alternative causes.  Families may wish to consider visiting a memory clinic or specialist (such as a geriatric psychiatrist or neurologist) for this process.  Cognitive symptoms that affect functioning are NOT a normal part of aging.

Another term related to dementia that you may have heard is Sundowner’s Syndrome or sundowning behavior.  This term describes a pattern of increased behavior problems in people with dementia in the late afternoon and early evening.  Persons may exhibit increased confusion, agitation, wandering, hallucinations and general disorientation.

While the cause of Sundowner’s Syndrome is not definitive, there are several hypotheses (and likely a combination of several contributing factors).  The person may be tired after daily activities and caregivers may suffer similar weariness which shows through to the care recipient.  The change from light to dark and the “internal clock” may also play a role, especially as light therapy has been shown to help.  The expected patterns of the day and how we are socialized may also play in to this—as the early evening brings expectations of change, i.e. going home from work, kids or a spouse returning from work and other changes that take place in routine going from day in to evening.

If you have a loved one with dementia who suffers from sundowning behaviors, it can be a real challenge to cope.  It may be hard to keep the person calm or redirect him/her from repetitive behaviors or attempts to wander away. 

Here are a few tips to help:
  • Anticipate this problem and schedule accordingly.  Try to reduce activities and outings at this time if those may be difficult to manage.  Plan some quiet, alone time in late afternoons or get the person involved with something that distracts or calms.
  • Keep a routine (always important for a person with dementia).  Naps or quiet activities may be helpful during this time (and you may want to avoid naps earlier that might interfere with later sleep).
  • Reassure the person and redirect when agitated or restless.  Do not attempt to argue with them or use “reality therapy”.  You may want to use “Yes, and…” language, which validates the person’s feelings while then attempting to move on to another issue or activity.
  • Examine causes of agitation such as noise or other disturbing stimuli.
  • Identify causes of physical discomfort.  If you notice a major change in behavior, a person may be feeling pain or have an underlying infection.
  • As a caregiver, get plenty of rest and recognize your need for a break.  Your irritation or exhaustion may further exacerbate your care recipient’s behaviors or make it hard for you to cope.
  • Consult with your medical providers or seek out a specialist.  With problem behaviors, it can be helpful to use the services of a geriatric psychiatrist.  Medications may alleviate symptoms.

As a dementia caregiver, you will often be able to best identify solutions that work best for your care recipient.  You may need to seek respite care or additional assistance as symptoms increase or safety needs become a concern.  Some resources you might want to check out include a Dementia Terminology Fact Sheet and an Alzheimer’s Specialty Care Guide.  You can seek information and resources on the Alzheimer’s Association website, as well as through your local chapter.

Sharp Seniors - Editorial Staff

This guide was originally published on Sharp Seniors. Grandfolk acquired in 2017 and restored it's content for readers.