Senior Health: Dealing with Sundowning Syndrome

As winter looms closer and the days shorten, many seniors with certain types of dementia may experience growing symptoms of Sundowning Syndrome. But what exactly is it, and how can residential assisted living providers help improve their seniors’ health in light of it?

Reducing symptoms Sundowning Syndrome can be challenging, but with the right support caregivers can increase the quality of life for seniors experiencing it.

What is Sundowning Syndrome and how does it affect the livelihood of seniors coping with it? Sundowning is a symptom of Alzheimer’s disease and other forms of dementia. It’s also known as “late-day confusion.”

When seniors deal with dementia, their confusion and agitation sometimes get worse in the late afternoon and evening.

In comparison, their symptoms may be less pronounced earlier in the day – this is what caregivers call Sundowning Syndrome.

9 Symptoms of Sundowning

  • Agitated, upset, or anxious
  • Confused or disoriented
  • Restless
  • Irritable or demanding
  • Suspicious
  • Getting angry or yelling
  • Pacing the room
  • Seeing or hearing things that aren’t there
  • Having mood swings

Others may have disrupted sleep schedules or restlessness at night, symptoms can vary.

Unfortunately, these symptoms are difficult to manage, so there is no quick fix. As a result, the stress of Sundowning can negatively affect the quality of life for older adults.

There are seven known ways to help manage and reduce these symptoms.


Current research shows that doctors aren’t completely sure why sundowning happens. Some scientists accredit changes in the brain of individuals with dementia.

It is said that the area of the brain that signals when you’re awake or asleep breaks down in people with Alzheimer’s. The breakdown of this mental clock could very well cause sundowning. Regardless of the cause, there are triggers that can ignite symptoms of Sundowning and tips to avoid it.

As a result, be sure that seniors in your residential assisted living home are not:

  • Too tired
  • Hungry or thirsty
  • Depressed
  • In pain
  • Bored
  • Having sleep problems
  • Occupying poorly light areas
  • Having trouble separating dreams from reality

Remember, when seniors experiencing Sundowning sense that caregivers are tired or frustrated, it upsets them. As a result, managing your emotions as a caregiver is extremely important – this will make a major difference.

Look for patterns. Keep a notebook indicating things that trigger symptoms and aim to avoid these behaviors if possible.


  1. Track Patterns in Behavior

The first step is to identify triggers by writing down behaviors in a notebook. Be specific as to identify only situations that cause agitation and anger. Pay close attention and annotate times. Knowing their triggers will help residential assisted living staff to avoid them.

  1. Attend to the Basic Needs of Seniors

Well before the symptoms start, make sure the basic needs of these seniors are accommodated. Avoid waiting for them to make a request. Most seniors experiencing Sundowning are now aware enough to adequately or properly communicate their needs or concerns.

  1. Minimize Distractions, Noise, and Shadows

It is important for seniors experiencing Sundowning to feel an added sense of safety – overstimulation can cause fear and anxiety. As daylight fades, shadows or dim lighting can play tricks on their eyes and brains – this is an extreme trigger of Sundowning. Close the curtains, turn on plenty of inside lighting, lower music volumes, avoid noisy chores, turn off the television, and eliminate evening visitations at your residential assisted living home.

  1. Be Conscious of Staff Stress Level

Feeling frustration is a frequent sensation felt by most caregivers – it’s natural. Some people with dementia have an extra keen awareness of sensing body language and voice tones. When these seniors sense elevated stress levels, it can cause them increased agitation and anxiety. Caregivers should reduce their own stress by taking mini breaks, asking for help, and relying on co-workers when necessary.

  1. Stick to Daily Routines

Regular routines reduce unwanted stress. Routines also ensure a sense of security which improves sleep. As a result, sticking to daily routines can reduce Sundowning symptoms. Keep routines in mind when waking seniors up in the morning, scheduling appointments, visitors, outings, meals, bath time and bedtimes.

  1. Create a Relaxing Residential Assisted Living Home

A calm and soothing environment creates a head start for reducing agitation and anxiety. Use soft music and aromatherapy to lighten the mood.

  1. Increase the Quality of Nighttime Sleep

Symptoms of dementia are mentally exhausting. Daytime napping makes it difficult to sleep throughout the night. Poor sleep habits at night causes a negative cycle that increases sundowning symptoms. If a nap is needed, make it a short nap earlier in the afternoon. Afterward, encourage gentle exercise and reading. These are great ways to improve sleep quality. Avoid heavy meals, smoking, caffeine, sugar, chocolate, or alcohol when seniors are diagnosed with dementia. Instead, try using a weighted blanket, aromatherapy, and a comfortable room temperature.


There’s no confusion about it, seniors deserve quality care, and those experiencing dementia need special care coping with symptoms of sundowning.

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