Specialists have cautioned that a “distressing” indicator of dementia may emerge during evening hours. Referred to as “sundowning”, this phenomenon could alter someone’s behaviour and potentially persist throughout the night.
Dementia represents a syndrome, or collection of symptoms, associated with the gradual deterioration of brain function.
While many people recognise that memory loss constitutes one such symptom, it can additionally result in difficulties including personality alterations and mobility complications.
According to the Alzheimer’s Society, certain symptoms may manifest towards the day’s conclusion. Termed “sundowning”, the person affected might experience distress or become agitated.
The charity states: “Sometimes you might see changes in the person’s behaviour in the later afternoon or towards the end of the day. During this time the person may become intensely distressed, agitated and have hallucinations or delusions.
“This may continue into the night, making it hard for them to get enough sleep. This is sometimes known as ‘sundowning’ but is not necessarily linked to the sun setting or limited to the end of the day.
“Sundowning can happen at any stage of dementia but is more common during the middle stage and later stages.”
What triggers sundowning
Various factors can precipitate sundowning episodes. The precise cause remains unclear.
The Alzheimer’s Society explains: “The reasons why sundowning happens are not well understood, but it is possible that a range of different causes makes it more likely.”
These may include:
Fatigue, hunger, pain or other unaddressed physical requirementsInsufficient daylight exposure throughout the dayExcessive stimulation during daytime hours, such as from a loud or hectic environmentDisruption to their body clock resulting from brain damageAltered hormone levels that fluctuate throughout the daySensory difficulties, such as hearing or vision problemsExhaustion in others causing the person with dementia to become distressedMental health issues, such as anxiety or depressionReduced care staff availability to support the individual (in a care home)Adverse effects of prescribed medications
The charity adds: “Some of these are related to the time of day, and others may happen at any time. Try to identify which of these problems might be affecting the person, as each problem may need a different treatment.”
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How to help someone experiencing sundowning
If you believe someone is experiencing sundowning you could consider the following:
Sometimes, what appears to be “sundowning” could actually be the person attempting to communicate a need, such as needing the loo, feeling peckish or experiencing discomfortIndoor lighting that’s inconsistent and reflective surfaces can occasionally cause confusion by creating unsettling shadows or reflections. Draw the curtains or blinds once it begins to darken and cover the telly with a dust cover when it’s not in useConsider whether an event from the day has had an impact on them. If they seem restless, try to soothe them by diverting their attention, perhaps discussing a cherished memory or an event they enjoy reminiscing aboutIf they continue to be agitated, it might be that they have a need that isn’t being fulfilled
If you suspect a loved one is showing signs of dementia, it is advisable to consult a GP.
