Sundowning (changes in behaviour at dusk)
What is sundowning?
Sundowning is a term used for the changes in behaviour that occur in the evening, around dusk. Some people who have been diagnosed with dementia experience a growing sense of agitation or anxiety at this time.
Sundowning symptoms might include a compelling sense that they are in the wrong place. The person with dementia might say they need to go home, even if they are home; or that they need to pick the children up, even if that is not the case. Other symptoms might include shouting or arguing, pacing, or becoming confused about who people are or what’s going on.
Why does sundowning happen?
There are lots of reasons why sundowning occurs. As the day goes on, the person with dementia becomes more tired, and this can lead to their symptoms worsening. Hunger, thirst and physical pain can also play a part. As darkness falls, street lights come on and people settle in for the evening and some people with dementia become increasingly concerned that they are in the wrong place.
Tips for managing sundowning as it happens
- Use distraction techniques: go into a different room, make a drink, have a snack, turn some music on, or go out for a walk
- Ask the person what is the matter. Listen carefully to the response and if possible, see if you can deal with the source of their distress
- Talk in a slow, soothing way
- Hold the person’s hand or sit close to them and stroke their arm.
Practical tips on preventing sundowning
- Follow a routine during the day that contains activities the person
- Going outside for a walk or visiting some shops is good exercise
- Limit the person’s intake of caffeinated drinks. Consider stopping the person from drinking alcohol altogether. Caffeine-free tea, coffee and cola are available, as is alcohol-free beer and wine
- Try and limit the person’s naps during the day to encourage them to sleep well at night instead
- Close the curtains and turn the lights on before dusk begins, to ease the transition into nighttime
- If possible, cover mirrors or glass doors. Reflections can be confusing for someone with dementia
- Once you are in for the evening, speak in short sentences and give simple instructions to the person, to try and limit their confusion
- Avoid large meals in the evening as this can disrupt sleep patterns
- Introduce an evening routine with activities the person enjoys, such as: watching a favourite programme, listening to music, stroking a pet etc. However, try to keep television or radio stations set to something calming and relatively quiet—sudden loud noises or people shouting can be distressing for a person with dementia.