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Sundowning: Support and Help for Those Affected by Common Dementia Side Effect

Sundowning: Support and Help for Those Affected by Common Dementia Side Effect

by Mary Beth TeSelle, Sponsored Content
Sundowning is a state of confusion in a person living with dementia, typically occurring in the late afternoon or evening. Experts says that increasing time spent outdoors in the light during the day can help to encourage nighttime sleepiness, reducing the effects of sundowning.

Living with, or caring for someone living with, dementia is incredibly difficult. Symptoms and behaviors may change every day or every hour and finding ways to cope can feel overwhelming.

One condition related to dementia that can be frustrating or even alarming is known as “sundowning.” The Alzheimer’s Association says as many as 25% of patients diagnosed with Alzheimer’s experience sundowning.

“Sundowning, or sundowning syndrome, is a group of symptoms that occur in someone with memory loss at a specific time of the day,” explains Judy Kautz, LCSW, program coordinator of the Sierra Nevada Memorial Hospital Foundation’s Alzheimer’s Outreach Program. “Also known as late-day confusion, it can last into the night hours.”

Kautz says someone experiencing sundowning syndrome may experience agitation, irritability, confusion, delusions or hallucinations, have high levels of anxiety, pace or wander.

While there is no definitive cause of sundowning syndrome, there are factors that can aggravate it or make it worse, including fatigue, sleep disruption, change in surroundings, being hungry or thirsty, boredom, or depression. A patient’s health (including pain or an infection) can also impact sundowning.

“These factors are important to keep in mind to help trace back the trigger for the sundowning,” Kautz says.

To better understand sundowning, Kautz says it’s important to remember that those with dementia are working double time in their brains during the day in ways we cannot see.

“They have to work harder to process information, complete tasks and activities that used to come easily to them,” she explains. “Also, they are often trying very hard to hold it together when around others. All of this extra cognitive work can cause brain fatigue, so by the end of the day their brains are exhausted which leaves them more susceptible to experiencing sundowning.”

While one in five people with dementia will experience sundowning, it can also happen to older people who haven’t yet been diagnosed with dementia. Kautz says for that population, sundowning could be a warning sign.

“Those most likely to experience sundowning typically have some type of memory or cognitive challenge, or they could have a mild cognitive impairment that is perhaps on its way to becoming dementia,” she explains.

For those caring for someone experiencing sundowning, the episodes can be alarming.

“Sundowning can be very challenging to deal with as a caregiver and can even be frightening when first experienced,” Kautz says. “It can sometimes take time to determine what it is, but once caregivers can name it, it can help immensely in coping since you can then read and learn about it and understand that it is a normal symptom of various types of dementia.”

Kautz says getting educated is important to help a caregiver be better equipped to handle sundowning and the accompanying symptoms.

“The more you understand the disease, the better footing you will have in managing and coping with its accompanying challenging symptoms and behaviors,” she says.

In addition, asking for help is key to the health and well-being of both the caregiver and the patient.

“Caregivers who seek help — whether through their natural community or through professionals — are the ones who get the needed support to endure and thrive in their roles,” Kautz says. “Reaching out for help can be so very hard, but it is a crucial step in ensuring caregivers do not burn out in their roles. Getting respite and breaks is paramount as well as figuring out ways to prioritize self-care.”

A new onset of sundowning symptoms should be shared with their primary care physician. Kautz says there may be a gentle medication or sleep aid that can help to ease the restlessness.

Finally, participating in a caregiver support group is always valuable.

“Support groups give you a chance to learn from the experiences of others going through the same thing,” Kautz says. “This can provide both practical tips to address specific symptoms, as well as the feeling that you are not alone, which is profoundly important.”

Get the Help You Need

Sierra Nevada Memorial Hospital Foundation’s Alzheimer’s Outreach Program offers services at no charge to anyone in the community in need of support or resources. To access the program for a consultation, or for details on the support group, call or email Program Coordinator Judy Kautz, LCSW (530-557-5520 voice or text, or Judith.Kautz@CommonSpirit.org).

For information on our caregiver support series, contact Linda Aeschliman by voice or text at 530.648.0592 or email to linda.aeschliman@dignityhealth.org.


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