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Sundowning: 5 Ways to Manage Afternoon Agitation

Does your family member with dementia become upset, especially as the day progresses? “Sundowning” is the term used to describe the agitation, irritability, confusion, and disorientation that as many as 20 percent of all people with dementia experience in the late afternoon and evenings.

What Causes Sundowning?

Although researchers don’t know what causes sundowning, some factors behind it may include:

Mental and physical fatigue

It can be easy to forget that having trouble making sense of your surroundings can be exhausting for a person with Alzheimer’s. A hectic environment increases confusion and can make this worse.

Nonverbal cues of frustration from caregivers

People with dementia often have difficulty interpreting their surroundings and knowing what they should pay attention to, and often look to others for cues about how they should behave or react.

Reduced lighting

When the sun goes down, increased shadows and darkness may make it difficult to identify surroundings.

Tips to Minimize Sundowning Behaviors

Sundowning is one of the most challenging situations that confront caregivers. The Alzheimer’s Association, NYC Chapter shares these tips that can help to minimize sundowning in your family member:

Look for triggers

As people come home from work or school, noise and activity can increase. Or perhaps your family member usually naps and an appointment kept him or her awake.

Limit the commotion

You might be speaking loudly to be heard over the TV, but your family member might think you’re upset and react with fear. Keeping the environment as quiet and calm as possible to minimize distractions may keep your family member’s agitation at bay.

Adapt your routine

When possible, take steps to accommodate your family member’s needs and schedule. In a recent issue of ADvancing Care, the NYC Chapter of the Alzheimer’s Association reports about the Beatitudes Campus, a nursing home in Phoenix, Arizona. Staff noticed that residents often looked tired or frazzled by the afternoon. The team decided that if someone looked tired, no matter if during a meal or activity, he or she would be given the opportunity to rest. As residents started to sleep when they were tired rather than at the convenience of staff or other residents, the staff noticed a remarkable change: residents were happier and even needed less psychotropic medication.

Boost the lighting

Keeping your home well-lit may reduce confusion—and may reduce falls, too.

Take care of yourself

Find ways to recharge your batteries, and be sure you get enough sleep. You’ll have more energy, and as you’re less exhausted your stress levels—and your family member’s agitation—may decrease.

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