Dementia Stages and Methods for Management During Sundowning
Sundowning, a common condition affecting people with dementia, causes an increase in agitation, confusion, or distress towards the end of the day. This article outlines effective strategies for managing and reducing sundowning in dementia patients.
Key strategies include:
- Establish a daily consistent routine: Providing predictability and reducing anxiety is crucial. Following a consistent routine for meals and sleep, as recommended by the Alzheimer's Association, can help manage sundowning symptoms [1][3].
- Minimize environmental triggers: Bright lights, strong smells, uncomfortable textures, loud noises, or excessive stimulation can exacerbate sundowning. Keeping rooms well-lit in the evening to reduce shadows or lighting changes may help reduce confusion. Encouraging a person with sundowning to get outside in sunlight every day or sit by a window can also be beneficial [1][3].
- Stay calm and communicate softly: Approaching a person with sundowning calmly, asking if they need anything, and reminding them of the time of day may help manage their agitation. Avoiding arguing with or physically restraining a person with sundowning is also recommended [1][5].
- Use music or familiar calming activities: Opting for relaxing activities in the evening, such as listening to calming music or looking at photographs, may help soothe distress and redirect attention positively [1][5].
- Create a relaxing environment: Reducing or avoiding alcohol, caffeine, and nicotine may help improve sleep for a person with sundowning. Limiting naps in the daytime if a person has difficulty sleeping at night may also help. Approaching a relaxing environment with appropriate lighting and reduced sensory overload can help avoid overstimulation that can escalate agitation [1][3].
- Plan rest and low-demand quiet times: Scheduling trips or appointments in the morning or early afternoon may be beneficial. Limiting too much stimulation in the afternoon or evening may help reduce sundowning symptoms [2].
- Look for and address unmet needs: Factors that may contribute to sundowning include changes in lighting, medication side effects, tiredness, hunger, changes in the brain that occur with dementia, and changes to the person's circadian rhythm. Identifying and addressing these needs can help manage sundowning [2][3].
- Track patterns of behavior: Discussing frequent agitation with a doctor may help identify potential treatment options. Tracking patterns of behavior can help anticipate and proactively manage periods of increased confusion or agitation [4].
- Consult a physician about possible medication options: If behaviors are severe or unmanageable, consulting a physician about possible medication options may be necessary [1].
In summary, combining environmental adjustments, empathetic communication, routine, and personalized soothing techniques—while monitoring for physical or emotional needs—forms an effective framework to manage sundowning in dementia patients [1][2][3][5].
Caregivers can minimize environmental triggers such as bright lights or loud noises to help reduce the symptoms of sundowning in dementia patients, as suggested by the health-and-wellness advice in this article. To create a relaxing environment, caregivers may consider reducing alcohol, caffeine, and nicotine intake for the patient, as recommended by science-based research. Additionally, incorporating mental-health practices like calming music or familiar activities into the daily routine of a dementia patient with sundowning can help improve their mental state and overall well-being.
