When the sun goes down

Sundown (a.k.a. Sundowner’s) syndrome. It’s a term used to describe the onset of confusion and agitation for people with dementia and for some residents of hospitals and nursing homes, usually occurring in late afternoon or early evening. Symptoms can include argumentative or demanding behaviour, confusion, agitation, paranoia, anxiousness, restlessness, or requests to “go home.”

Sundown syndrome is still a bit of a mystery to doctors and researchers. Some believe it is an accumulation of sensory stimulation throughout the day. Some believe it is caused by hormonal imbalances that occur at night. Some attribute it to fatigue. Others believe it is caused by anxiety resulting from the inability to see well in darkness.

It is certainly stressful to watch someone suffer from sundown syndrome, but know that it’s even more stressful on the individual experiencing it. It’s also not something that he or she can control.

My first encounter with sundown syndrome was uncomfortable, dare I say even a bit scary. At the time, I wasn’t familiar with it, and I questioned whether I said or did something to prompt the change in behaviour as it seemed to come completely out of left field. I was relieved to read others’ stories, and intrigued by the uncanny similarities of our incidents.

Here are some practical tips you can try during your next encounter with sundown syndrome:

  • Help the person relax. Find a quiet space. Play some favourite songs or a soothing recording of ocean waves or a mountain stream at a low volume.
  • As the sun goes down, draw the curtains and turn on inside lights.
  • Use night lights to partially light a bedroom or hallway.
  • Give the person your full attention, and talk in a calm voice.
  • Avoid arguing.
  • Give the person a five-minute hand massage, or just hold a hand or stroke an arm for a few minutes, which can provide reassurance.

To prevent or minimize the symptoms of sundown syndrome, give these tips a try:

  • Discourage daytime naps.
  • Encourage exercise, like walking, or hobbies that get the person up and moving.
  • Limit caffeine and sugar to the morning hours.
  • Keep snacks light before bedtime.
  • Try to determine the triggers and then avoid them. Keeping a journal can be helpful.

What I’ve discovered is that different things work on different days, so don’t be too quick to write off any one tactic. What doesn’t work today may work wonders tomorrow.

Watching a friend or loved one suffer from sundown syndrome is difficult. But it’s up to us as friends, family members, and caregivers to be understanding and do what we can to help them through it.

Sources: www.caring.com, WebMD, www.agingcare.com