A sundial representing sundowning in elderly people.

Sundowners In Elderly  

JUMP AHEAD

Sundowning is a state of increased agitation, confusion, disorientation, and anxiety that typically occurs in the late afternoon or evening in some individuals affected with dementia. Elderly men and women are vulnerable to become victims of sundowning. Those who suffer from Alzheimer’s, dementia, or Parkinson’s disease are more susceptible to Sundowning. Sundowning may occur in the mid to late stages of dementia and may progress as the stages of dementia worsen. Sundowning affects 1 in 5 people with Alzheimer’s disease. Alzheimer’s is the leading type of dementia, and as many as 5.8 million Americans live with Alzheimer’s disease. This number will nearly double for individuals who are past 65 years of age within the next five years. 

Having better knowledge of why sundowning occurs can help with dealing with someone who experiences sundowning. Doctors are not a hundred percent sure why sundowning occurs, however, some scientists believe that there is an imbalance in the brain. This imbalance changes the brain’s signals in elderly women and men who suffer from dementia2. These changes that occur affect the area of the brain that signals when you are awake or asleep which may cause confusion which can cause sundowning2.

Sundowning Behavior 

Unfortunately, there are many triggers associated with sundowning. Understanding these triggers and establishing patterns of behavior will assist you with dealing with someone who experiences sundowning. Once a pattern of behavior has been established you are able to limit the triggers associated with the patterns correlating with the sundowning episodes that may occur. An elderly person who is sundowning may become agitated, restless, irritable, confused, disoriented, demanding, or even suspicious2. Helping an elderly man or woman keep a daily routine, ensure they get a good night’s rest, and keep your evening routine calm with little activity may help limit the triggers that may cause sundowning. Avoid things that may cause sundowning to exacerbate, such as, serving coffee or any other caffeinated drink late in the day, serving alcohol which may lead to confusion and anxiety, or planning a full day of activities which may cause an elderly man or woman to become exhausted. 

Sundowning Care

If you encounter an elderly woman or man who is sundowning be sure to listen to what they are saying, stay calm, do not argue, reassure them of their concerns, and allow them to move about if needed but keep them safe by locking doors/windows2. Listening and understanding what your elderly loved one is saying is important. They may believe that they are living a moment in the past; do not bring them to the current time. Allow them to enjoy this past time as their past may be their reality and interfering with this will make them hostile, their reality maybe a trigger to sundowning. If you are frustrated or exhausted, you are not able to care for your loved one as needed. Do not be ashamed to reach out to a friend or family member for help. If sundowning episodes become more frequent or out of control consult with a doctor on guidance for your loved one. 

At Culpepper Place of Olive Branch, we take pride in helping our residents who suffer from sundowning within our Community. Please contact Culpepper Place of Olive Branch today to find out more!

1 Merriam-Webster. (n.d.). Sundowning. In Merriam-Webster.com medical dictionary. Retrieved August 13, 2021, from https://www.merriam-webster.com/medical/sundowning 

2 Web-MD. How to Manage Sundowning by Brenda Goodman, MA.  Retrieved August 13, 2021, from https://www.webmd.com/alzheimers/guide/manage-sundowning 

3 Matthews, K. A., Xu, W., Gaglioti, A. H., Holt, J. B., Croft, J. B., Mack, D., & McGuire, L. C. (2018). Racial and ethnic estimates of Alzheimer’s disease and related dementias in the United States (2015–2060) in adults aged≥ 65 years. Alzheimer’s & Dementia. https://doi.org/10.1016/j.jalz.2018.06.3063 4 National Institute on Aging. Alzheimer’s Caregiving Tips for Coping with Sundowning. Retrieved August 25, 2021, from Tips for Coping with Sundowning | National Institute on Aging (nih.gov)

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