Understanding Sundowners Syndrome

Suppose you know an elderly person afflicted with Alzheimer’s disease or some other type of dementia. In that case, you may have noticed that they may be increasingly confused, agitated, restless, or even angry when the sun is about to set. Add to that; there is increased memory loss at sundown, too. Unfortunately, this makes it a bit more challenging to deal with our beloved seniors during this time of day. As such, we must all strive hard to extend our patience as the day ends.

Why Is This Happening?

Should you be dealing with this scenario, know that you are not alone. We’ve noticed these odd changes in the behavior of our elderly loved ones struggling with dementia as well. What is it about sundown that makes it akin to a “witching hour” for elderly folks who grapple with some form of delirium? It seems the setting sun triggers a barrage of issues that brings discomfort and unrest.

Because we wanted to understand our elderly, we discovered that this drastic behavioral shift at sunset is dubbed as the sundown syndrome, which others call sundowners syndrome. Indeed, its name speaks volumes and perfectly describes the condition. When the sun goes down, our seniors with dementia issues get into a terrible mood.

Medical practitioners and scientists cannot say specifically what causes this syndrome. However, they do note that you can provide relief for your elderly loved ones by ensuring they avoid possible triggers. Through this, you can help them prevent shifting their mood at sundown. After all, radical mood shifts also take a toll on their physical and mental well-being. When we are armed with the proper information, we can steer our elderly loved ones in the right direction and help them manage the sundown symptoms in a better way.  We can also alert their trusted caregivers about what to expect and what to do.

The Definition of Sundown Syndrome

Unfortunately, there is no clear cut definition for this syndrome. Apart from sundowners syndrome, others also refer to this as sundowning. This sundown syndrome is generally characterized by the onset of neuropsychiatric symptoms in the late after afternoon, early evening, or even at night when the sun has set. Some also note that this can also appear in the early morning before the sun rises.

These sundown symptoms include a range of behavior like aggressiveness, increased confusion, relentless restlessness, palpable anxiety, and prolonged agitation when the day transitions into the night. It’s quite ironic how these dark behaviors crop up when daylight ceases to exist.

Noteworthy, this sundown syndrome primarily affects those with Alzheimer’s disease or some other dementia. In fact, the Alzheimer’s Association reports that sundown syndrome will afflict one out of five people diagnosed with Alzheimer’s disease.

Furthermore, this syndrome usually doesn’t influence those ordinary seniors with normal cognitive function. However, it can manifest when a normal senior recovers from illness or surgery in the hospital. Symptoms are also most likely to crop up when seniors are suddenly in an unfamiliar environment.

If you believe that the senior in your life is suffering from this, you must speak with your senior’s primary care physician to map out a plan of action. Should your elderly live in an assisted living community, you must also speak with a facility representative to find the best treatment and care protocols for your elderly loved one. You need a skilled facility with understanding caregivers that know what to do when your senior is suffering from memory loss and cognitive problems.

Common Behavior or Symptoms to Expect

The symptoms and behavior manifested depend on the individual. Although there may be a list of possible issues to watch out for, what may appear in your loved one could be several signs. For example, your loved one can exhibit only one symptom, while a friend living in the same nursing home facility could exhibit several behavioral issues happening all at the same time.

Discover the early warning red flags of sundowning syndrome

It is easy to make a mistake when figuring out this problem. Why? Because in the beginning, sundowning symptoms are subtle. In fact, they are so low key that you can easily overlook them.

Furthermore, at the start, the occurrence of behavioral issues is quite inconsistent. For instance, there may be one day when your elderly adult cries for no reason. The next day, it could be your senior feeling angry out of the blue.

Since the signs are trivial and vary, it is so easy for us to chalk it up to our seniors being moody, impatient, and irritable. It may take a while before you notice a observe a set pattern in their unruly behavior.

The typical signs that repetitively show up after sundown

If you are curious about the concrete signs of sundowning, look at this list. Your senior may experience several in one go, or your elderly can also exhibit one symptom consistently:

  • Take note of rapid mood shifts
  • Observe anxious behavior
  • Watch out for sudden anger
  • Incessant crying and depression happens
  • Your senior paces around nonstop
  • Any little trigger agitates your loved one
  • Sudden onset of unexplained fear, worrying
  • Feelings of restlessness occur
  • Your elderly becomes unreasonably stubborn
  • There is sudden shadowing or following around caregivers
  • Asking repetitive questions while interrupting the answers

Severe or extreme symptoms to watch out for

Though most people with dementia grapple with ordinary symptoms, for some elderly people, these instances could be more severe. At times, it becomes debilitating because the senior could end up harming others. The worst-case scenario is also self-harm. Take note of severe symptoms that you should watch out for:

  • Unbelievable hallucinations that could lead to untoward decisions
  • A habit of hiding stuff, including important personal effects
  • Strong sense of paranoia that could cause doubt towards others
  • Scary, violent acts that harm caregivers or themselves
  • Running away and wandering around that could result in accidents and getting lost.

The Triggers of Sundown Syndrome

Many people wonder if this syndrome is temporary because it would be frightening if it persists all the time, all day long. The good news is sundowning is temporary because it only occurs during a specific time frame. As mentioned earlier, it mostly happens in the later afternoon at sunset or in the evening. But later, everything passes.

Noteworthy, it can also be normal for healthy seniors to act strangely after recovering from surgery or spending time in the hospital. Surgery involves anesthesia, which could temporarily alter their mindset. Similarly, a long-term stay in the hospital can be depressing. Consequently, it results in irritability and irrational behavior. That being said, this is also fleeting and merely event-related. It will pass as soon as the senior transfers to a different environment.

However, you must pay attention if you notice that patterns of irrational behavior become consistent when the sun finally sets. This signifies that your beloved senior may be developing sundown syndrome. As such, speak with your elderly loved one’s primary care physician to arrest the problem. Your doctor may note the common triggers of this disease, which are the following:

Frenetic pace at the end of the day

If your senior is extremely busy with a flurry of activities towards the end of the day, the stress and sudden adrenaline may lead to confusion and anxiety. To prevent any untoward outcomes, it would be best to slowly wind down, so there is no abrupt stop or lingering over excitement.

Over exhaustion

When older people get too tired, it can lead to crankiness and irritability. Over fatigue disrupts their system, so they feel ill at ease. At the same time, the lack of activities after dinner means they don’t have anywhere to vent their feelings. When they’re too tired and lack the proper time to calm down, it can result in irrational behavior.

Insufficient light

When the sun sets, it is normal for the light quality to become inferior. As the world plunges into darkness at sundown, the environment may also bring dark, negative emotions. Additionally, the elderly already have vision problems, so the low light quality makes it even harder for them to see clearly. Hence, it can lead to irritability.

Onset of hormonal imbalance

Some studies say that a hormonal disruption occurs in an older adult’s biological clock. This imbalance happens between waking and sleeping hours as the cognitive function tries to adjust between two polar events. With aging, the body may not be as agile or able to cope well, so this is considered a principal cause of sundown syndrome.

Seasonal depression

In areas where there is heavy winter, Seasonal Affective Disorder also commonly sets in. The reason for this is the nights are longer and the days are shorter. Because of the dark environment, it amplifies the symptoms of sundown syndrome.


Tips to Manage Sundown Syndrome

There is no specific blanket treatment that works for every single senior. However, there are several remedies you can try. Anecdotal evidence suggests that the following tips have been successful in minimizing sundowning symptoms. Look at them below:

Set up a schedule

You must set up a schedule for your elderly loved one. This means establishing a routine, which provides seniors a sense of comfort. When they know what to expect during the day, they feel safer. At this age, you must minimize surprises to avoid anxiety, confusion, and fear. When you draft the plan, make time for meals and regular activities the senior enjoys. It would be best to limit activities to no more than two major events in a day. Remember, seniors have less energy and need rest. Anything more than that could overwhelm them.

Encourage a healthy diet

Jot down notes to see if certain food items trigger unwanted behavior. It would be best to avoid caffeinated beverages or too sugary drinks late in the afternoon. This results in excess stimulation, which may disrupt their nighttime rest. Moreover, discourage alcohol to prevent agitation and confusion.

Minimize excessive noise

It would help reduce the volume emanating from devices like the TV, iPad, radio, etc., especially in the late afternoon. It would also help to avoid late visits to avoid overstimulation. Reserve the highly excitable activities for the morning. When the sun is about to set, it would be more beneficial to play calming music.

Consider light therapy

Try using full-spectrum lights as these gadgets can minimize the adverse effects of sundown syndrome. In the morning, make sure to open all windows to let natural light come in. The sun is calming and healing for the soul. As the sun sets, make sure the area is well-lit. The illumination helps seniors see better, and it provides positive feelings. Consider adding nightlights to reduce fear, stress, and anxiety in case your senior needs a bathroom break at night.

Medications to Calm Sundown Syndrome

Today, there is not much data on the efficacy of pharmaceutical medicine in easing sundown syndrome. When symptoms are linked with sleep disorders or depression, your senior’s primary doctor may recommend medication. That being said, it is advisable to talk about contraindications and side effects. After all, some pharma drugs are known to cause headaches, nausea, confusion, and dizziness. Sadly, this can lead to falls, which will be harmful to seniors with brittle bones.

Remember to be patient in handling your loved ones when they exhibit sundowning syndrome. They are not doing this on purpose to annoy you. Extend your patience and remain calm so you can help them out. If the behaviors become too much to deal with, seek help, and ask your doctor for advice. You can also explore additional care options, like help from an assisted living community.

Call For Help To Ensure Security and Comfort

Sundown syndrome is one of the things your older loved one may grapple with during their twilight years. Be supportive in helping them conquer this health setback. If you cannot be there all the time because of work commitments, you can entrust them with a reputable assisted living facility like Lakeside Manor. The caring staff will ensure the security and comfort of your elderly loved ones.