You may not know it has a name… you may just know that your aging parent has been getting very agitated in the late afternoon. She may pace about, or “straighten up” by putting household items in strange places. Grandad may think he’s at his summer cottage when he’s really at home, or yell at you that he did not just ask for a ride to the store.
The name for this is “Sundowning”, defined as an increase or appearance of agitation/confusion and other behavioral symptoms in the late afternoon or early evening when the person is awake. It occurs in people who have mild to advanced dementia including Alzheimer’s Disease and describes behaviors like pacing, restlessness, aggression, and disorientation to time and place.
How to Handle Sundowning
Even if your aging parent is still living independently… especially if they are, they should not be left alone if they often exhibit these symptoms later in the day. Sundowning is considered one of the most challenging parts of family caregiving. Whether the family chooses to handle these difficult hours alone or hire a professional caregiver to alleviate caregiver stress, you can ease the impact of sundowning by planning the day’s activities around it.
- Don’t react to accusations or tempers flaring. They are not personal. Your aging parent may be confused or unable to contain their emotions.
- Plan walks, exercise and any decision-making in the morning. Caregiving pros say walks and other physical activity before noon usually mitigates sundowning symptoms.
- Create a calm atmosphere for your aging parent during late afternoon and evening.
- Provide plenty of light, starting at breakfast. Natural sunlight is best, but good lighting also seems to help.
- Monitor caffeine intake. Too much coffee or tea can induce pacing and anxiety in people with dementia.
- Suggest routine, simple activities during mid- to late-afternoon like folding laundry, playing cards, or singing along to their favorite music.
- If they seem agitated by your presence, step out of their line of sight for 10 minutes, but not out of earshot. Make sure they are in an unobstructed, safe place, and cannot wander outside.
The discovery of sundowning behavior upsets many family caregivers. Hiring an in-home care service during this care transition period, or for the long-term, cushions the shock and helps preserve a calm parent child relationship during the tough caregiving years.