Sundowning in Seniors: Causes, Signs, and What Caregivers Can Do

Sundowning in the elderly is often linked to dementia, though some individuals may experience it before a formal diagnosis. The term “sundowning” may seem confusing, but many people recognize it through its symptoms. Are you frequently noticing confused, restless, or aggressive behavior from your senior family member in the evening or at night? You may have noticed this for weeks, and now it has become a pattern. Your aging parents may have started wandering, not sleeping, or behaving unusually at night while staying calm during the day. This can make their behavior seem unpredictable and leave you feeling overwhelmed.

As a caregiver, you may feel sleep-deprived and unsure about what’s happening. Initially, you might have thought it was due to aging, but now you may feel worried about their health. In such conditions, you need clear and reliable information to know if it’s normal, a sign of dementia, or something serious. This guide will tell you what sundowning is, its causes, and tips to follow as a caregiver, so by the end, you’ll better understand their condition and know what to do.

What Is Sundowning in Elderly People?

Sundowning is a condition in which older adults feel confused, agitated, and restless in the evening, especially those living with dementia or Alzheimer’s. They stay calm in the morning and daytime, and after sunset, their behavior visibly changes and continues into the night. Sundowning is commonly associated with conditions like Alzheimer’s disease, though not everyone experiencing it has a confirmed diagnosis. If your elderly family member is showing these signs, you need to stay attentive to their health.

Causes of Sundowning in Seniors

Sundowning can be triggered by many factors, as aging brings several challenges. Look at the causes below to understand why it occurs: 

• Fatigue: Elderly people tend to tire easily, and persistent fatigue may lead to confusion and agitation. 
• Environmental changes: Light dimming and shadows may create confusion and make them feel anxious or upset.
• Altered circadian rhythms: Our bodies run by a natural clock called “circadian rhythm,” and if it is disrupted due to lifestyle changes, people may experience behavioral issues.
• Chronic pain or discomfort: Consistent pain or discomfort may increase confusion and agitation in older adults. 
• Side effects of medications: Certain medicines’ side effects may also contribute to increased confusion and agitation in the late afternoon or evening. 

Sundowning Dementia Symptoms to Watch For

Signs of sundowning in elderly people are often linked to the progression of dementia. Studies suggest that dementia can alter the circadian rhythm, leading to aggression, an altered sleep-wake cycle, and confusion. The symptoms may vary from person to person. Some episodes last only a few minutes, while others can continue for hours. These are some common sundowning dementia signs you may observe.

• Anxiety, agitation, and nervousness. 
• Confusion and frequent forgetfulness, such as what they’re doing. 
• Reduced interest in activities. 
• Having false beliefs about reality. 
• Difficulty forming or understanding sentences.
• Forgetting common things, names, and people’s faces. 
• Irrational fear, anger, and irritability. 
• Extreme restlessness that stops them from settling down. 
• Hallucinations, such as seeing or hearing things that are not real. 

Why Sundowning Happens More in Dementia

Sundowning is more common in seniors with dementia, where they may suddenly feel agitated, angry, and confused in the evening and night. It usually happens due to brain changes, environmental factors, and poor sleep. Aging is often linked to neurodegenerative disorders like dementia, and sundowning can result from these conditions. Here are the key reasons why it happens: 

Brain Changes

In dementia, brain areas that regulate mood, sleep, and circadian rhythm are affected, which alters the sleep-wake cycle and makes it harder to sleep.

Disrupted Circadian Rhythm

Dementia disrupts the time and quality of sleep. The elderly may feel tired during the day and night, which affects their sleep patterns, leading to confusion. 

Extreme Fatigue

Low energy levels due to a busy day can lead to fatigue and stress. Seniors may feel triggered during hunger, thirst, or pain if not addressed. 

Medicines and Health Issues

Certain medications or conditions, such as urinary tract infections or sleep apnea, can make sundowning even worse. 

Overstimulated Environment

If the whole day is full of activities and crowded spaces, it may make the person irritable in the evening. 

Mood Swings & Cognitive Changes

Anxiety, depression, or delusions may worsen in the evening, and the brain can’t differentiate between dreams and reality. 

Sundowning Dementia Tips for Caregivers

Caregivers have a big role in managing the symptoms of sundowning in dementia, such as making structured routines, adjusting the environment, and offering companionship. In sundowning, elderly people often feel restless and irritated during the late afternoon or evening hours. In this situation, you can follow these tips as a caregiver. 

Tip 1: Make Structured Routines 

Following a proper routine is very important to manage sundowning. Hence, you can follow these tips to maintain a routine for your aging parents. 

• Schedule everything from bathing and meals to bedtime to keep them engaged throughout the day.
• Plan most things like appointments and outings in the morning or early afternoon to prevent episodes of aggression or agitation. 
• Encourage your older adults to engage in physical activities in the early morning for their well-being and to prevent restlessness. 

Tip 2: Change the Environment 

Sometimes, adjusting the environment also works in managing sundowning in seniors. It makes them feel calm and relaxed most of the time. Here are the tips to optimize the environment. 

• Keep your home well-lit to reduce shadows and confusion in older adults.
• Reduce noise, clutter, and loud conversations to minimize sensory overload.
• Maintain a comfortable and calm sleeping area with dim lights.
• Dedicate an area for only soothing activities with their comfort items. 

Tip 3: Manage their Nutrition 

Caffeine, alcohol, and sugary drinks may trigger their anxiety and restlessness in the evening, leading to poor sleep. Therefore, follow these tips to manage their nutrition and prevent symptoms.

• Limit consumption of caffeine, sugar, and alcohol during the day.
• Give them a nutritious meal at lunch and lighter meals in the evening to help them sleep well. 
• Observe their triggers, such as fatigue, pain, or emotional stress, and support them. 

Tip 4: Light Exposure and Sleep Hygiene 

A disrupted circadian rhythm affects the sleep cycle. It happens when older adults don’t get sufficient exposure to sunlight, and it makes their condition worse. Here is what to do. 

• Ensure that they get enough sunlight exposure to regulate circadian rhythms. 
• Ensure that they don’t take long daytime naps to improve nighttime sleep.
• Avoid overstimulating activities in the evening and let them relax. 

Tip 5: Offer Empathy and Companionship 

Your aging parents need your support when dealing with these symptoms. Hence, being empathetic and compassionate is very important, along with other efforts, to help manage their condition. If you see them suffering or worried, make time to talk to them or simply sit with them to let them know that you’re there for them.

Also Read:- Quality Dementia Care Services for Seniors in Orlando, FL

Elite Caregivers United: In-Home Sundowning Services in Orlando

We at Elite Caregivers United in Orlando are here to help your older adults with sundowning syndrome with our personalized in-home Alzheimer’s and dementia support. We understand the pressure you feel to care for your senior family member, and that’s why we provide 24/7 care to manage their routine and coordinate with their doctors and specialists to improve their condition. Our experts are certified to manage individuals with dementia to provide them with personalized care and support them with housekeeping, meal preparation, and personal care such as bathing and dressing. 

We also assist them with transportation and doctor appointments. Our experts also provide emotional support to improve their overall well-being. We also offer 24/7 family communication support via text or call to keep you updated on their health status. So, if your elderly family member is going through sundowning syndrome due to dementia, we’re here to support you through our services in Orlando, FL.