The morning goes well. Dad eats his breakfast and watches TV peacefully.
But as soon as the sun starts to set (around 4:00 PM or 5:00 PM), a switch flips.
He becomes agitated, confused, and anxious.
He might start packing his bags, yelling "I want to go home!" (even though he is home), or shadowing you everywhere.
By 8:00 PM, you are exhausted and crying.
This phenomenon has a name: Sundowning Syndrome.
It affects up to 20% of Alzheimer’s patients. Here is why it happens and how to stop it.
Disclaimer: Always consult a doctor before starting any supplements like Melatonin. Sudden behavioral changes can also be caused by infections (UTI).
How to Manage 'Sundowning' Without Relying on Heavy Sedatives
1. Why Does the "Sunset" Trigger Chaos?
Scientists believe Sundowning is caused by a disruption in the body's internal clock (Circadian Rhythm).
- Shadows are Scary: As the light fades, shadows in the house grow longer. To a dementia brain, a coat rack might look like an intruder.
- Mental Fatigue: By late afternoon, the senior's brain is "tired" from trying to process information all day. They lose the ability to cope with stress.
- Hormonal Imbalance: Melatonin (sleep hormone) production may be disregulated.
2. Strategy #1: The "Light" Therapy
The most effective non-drug treatment is Light.
💡 Turn on the Lights Early
Do not wait for the room to get dark.
At 3:30 PM, turn on every light in the living room and kitchen.
Close the curtains/blinds to block the view of the darkness outside. This tricks the brain into feeling safe and alert, reducing visual hallucinations caused by shadows.
3. Strategy #2: Watch the Diet (Caffeine & Sugar)
What did Dad have for lunch?
Caffeine and sugar can cause a crash in the afternoon, leading to irritability.
- Cut Caffeine: No coffee, tea, or soda after 12:00 PM (Noon).
- Limit Sugar: Avoid cookies or cakes in the late afternoon. Blood sugar spikes and crashes can worsen mood swings.
- Early Dinner: Serve a larger meal at lunch and a lighter meal at dinner to aid digestion.
4. Strategy #3: The "Distraction" Routine
Anxiety builds up when the senior has nothing to do but worry about the coming night.
Create a calming ritual specifically for the "Sundowning Hour."
- Play Favorite Music: Play Frank Sinatra or hymns from their youth. Music bypasses the damaged parts of the brain.
- Simple Tasks: Ask them to help fold towels or sort coins. Feeling useful reduces anxiety.
- Do NOT Argue: If he says "I need to go home," do not say "You are home." Say: "We will go in the morning. Let's have some ice cream first." (Validate and Redirect).
5. When to Call the Doctor
If environmental changes don't work, talk to a geriatric psychiatrist.
They might review current medications (some drugs worsen confusion) or suggest a low dose of Melatonin to help regulate the sleep cycle.
Warning: Avoid Benadryl (Diphenhydramine) or heavy sleep aids (PM formulas) as they often increase confusion in dementia patients.
You Are Not Failing
Dealing with Sundowning is the hardest part of caregiving. It happens when you are most tired.
Remember, it is the disease talking, not your loved one.
Try the "Light Therapy" today. A brighter room often leads to a brighter mood.
Action Plan:
- Buy "Blackout Curtains" to hide the night.
- Set an alarm for 4:00 PM to turn on all house lights.
- Create a "Sunset Playlist" of calming songs.
Helpful Resources:
NIH: Tips for Coping with Sundowning
Mayo Clinic: Sundowning Expert Answers
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