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Sundowning is a term used to describe a state of increased confusion, restlessness, and agitation that can occur in the late afternoon and evening, particularly in individuals with Alzheimer’s disease or other forms of dementia. It can be a challenging phenomenon for both the person experiencing it and their caregivers.

Here’s a breakdown of sundowning:

Key Characteristics:

  • Timing:
    • Symptoms typically worsen in the late afternoon, evening, or at night.
  • Symptoms:
    • Confusion and disorientation.
    • Agitation, restlessness, and irritability.
    • Anxiety and fear.
    • Pacing and wandering.
    • Hallucinations or delusions.
    • Sleep disturbances.
  • Variability:
    • The severity and frequency of sundowning can vary significantly from person to person.

Possible Causes:

The exact causes of sundowning are not fully understood, but several factors may contribute:

  • Disrupted Circadian Rhythm:
    • Changes in the brain can affect the body’s internal clock, leading to confusion about day and night.
  • Fatigue:
    • Physical or mental exhaustion can exacerbate symptoms.
  • Low Lighting:
    • Diminishing light can increase shadows and create visual confusion.
  • Environmental Changes:
    • Unfamiliar surroundings or changes in routine can trigger anxiety and confusion.
  • Physical Discomfort:
    • Pain, hunger, thirst, or the need to use the bathroom can contribute to agitation.
  • Medications:
    • Certain medications can cause or worsen confusion.

How to Manage Sundowning:

  • Establish a Routine:
    • Maintain a consistent daily schedule for meals, activities, and bedtime.
  • Maximize Daylight Exposure:
    • Encourage exposure to sunlight during the day to help regulate the circadian rhythm.
  • Create a Calm Environment:
    • Minimize noise and distractions in the evening.
    • Maintain adequate lighting to reduce shadows.
  • Limit Caffeine and Alcohol:
    • Avoid stimulants in the afternoon and evening.
  • Promote Relaxation:
    • Engage in calming activities, such as listening to music or reading.
  • Address Physical Needs:
    • Ensure adequate hydration, nutrition, and comfort.
  • Monitor Medications:
    • Review medications with a doctor to identify potential side effects.
  • Caregiver Support:

Resources for Sundowning:

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Family Caregiver Support Groups
Hallucinations

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