A: The term sundowning refers to a state of confusion at the end of the day and into the night. Sundowning is not a disease, but a symptom that often occurs in people with dementia. The cause is unknown. Research suggests that a low dose of melatonin, a naturally occurring hormone that induces sleepiness in combination with exposure to bright light during the day may help minimize the disorientation associated with sundowning. Factors that may aggravate sundowning include fatigue, low lighting, increased shadows and disruption of the body’s internal clock.
Tips for reducing sundowning: Plan for activities and exposure to light during the day to encourage nighttime sleepiness, limit caffeine and sugar to morning hours, serve dinner early and offer a light snack before bedtime, keep a night light on to reduce agitation that occurs when surroundings are dark or unfamiliar, and bring familiar items such as photographs from home.
When sundowning occurs in a care facility, it may be related to the flurry of activity during staff shift changes. Staff arriving and leaving may cue some people with Alzheimer’s to want to go home or to check on their children or other behaviors that were appropriate in the late afternoon in their past.
Information provided by Julie Olson, RN, HCC, Windsor Manor Assisted Living, 1401 Wall St., Webster City, 515-832-1188.