Your elderly mother has Alzheimer’s, so dealing with her restlessness, confusion and memory loss during the day is something that you’re used to. But lately you’ve noticed that as evening approaches mom’s behavior becomes even more strange and unpredictable. Her doctor said that it’s due to a condition known as Sundowner’s Syndrome, or “sundowning” for short. Caring for a senior with Sundowner’s Syndrome presents unique challenges. Here are some ways to manage it more effectively.

What Causes Sundowning?

Although there’s no known specific cause for Sundowner’s Syndrome, it appears to coincide with biochemical circadian rhythm (“body clock”) changes that occur in a senior’s brain when the sun starts to set. In other words, a biological “mix-up” between day and night takes place.

Sundowning triggers may include:

  • Being exposed to less light and more shadows
  • An inability to distinguish dreams from reality
  • End-of-day exhaustion
  • Boredom
  • Being in an unfamiliar place (Ex. the hospital)

As a caregiver, when you’re tired and frustrated it can also trigger your loved one – making them even more agitated and confused. Roughly 20% of all Alzheimer’s patients have Sundowner’s Syndrome, but seniors who have never been diagnosed with dementia or Alzheimer’s can also have sundowning episodes.

Symptoms of Sundowner’s Syndrome

Because it’s a neurological phenomenon sundowning tends to cause these symptoms:

  • Elevated confusion levels
  • Paranoia
  • Sleep disturbances
  • Hallucinations
  • Mental and physical fatigue
  • Nighttime pacing and wandering
  • Yelling and other aggressive behaviors
  • Dramatic mood swings

In most cases, the symptoms worsen at night and then improve by the next morning.

How to Manage Sundowner’s Syndrome

Keeping your loved one oriented to their surroundings is the key to managing Sundowner’s Syndrome. Here are some ways to make it happen:

Get them outside

In general, exposing someone with Sundowner’s to sunlight has been found to reset their body clock by stimulating the release of a sleep-inducing natural hormone called melatonin. During daylight hours take your loved one to the park, sit outside in the backyard and keep their window coverings open.

Establish a routine

For someone with Alzheimer’s or dementia establishing a set routine isn’t easy, but try to follow specific times for eating, bathing, going to bed and waking up. It’s also recommended to keep them from napping during the day. Do involve them in simple activities like folding laundry, setting the table or taking a walk.

Make dietary adjustments

Certain foods, beverages and other substances can aggravate sundowning, so try to restrict their intake of sugar, caffeine, alcohol and nicotine. On the other hand, and only with their doctor’s approval, supplementing your senior’s diet with gingko biloba, melatonin, St. John’s Wort or Vitamin E may be beneficial. Move dinnertime up to the late afternoon or early evening, serve them lar