Caring for someone with Alzheimer’s or another form of dementia presents many challenges. One of most vexing can be the struggles that often accompany the end of the day.

In late afternoon and early evening, many people with dementia will become particularly restless and agitated. This phenomenon is called “sundowning.”

There is no consensus among researchers for what causes sundowning, but being overly tired, in pain or depressed may be contributing factors. Hunger, changes in the body’s rhythms and lack of light, or more specifically sunlight, could also play a role.

While there is no “cure” or foolproof way to prevent sundowning, there are things caregivers can do to manage the behavior and mitigate its effects. In the Savvy Caregiver workshop that we offer through the BayPath Elder Services Family Caregiver Support Program, sundowning is one of the issues we address. Some of the strategies caregivers can take to deal with this behavior include:

• Provide an afternoon snack can be helpful, both to ease hunger pangs and provide needed energy. But avoid stimulants, such as coffee, soda or anything with caffeine that can affect getting to sleep, as well as alcohol, which can add to confusion and anxiety.
• Rest can also help, with a post-lunch nap helping get your loved one through the afternoon. Be careful though, as too long a nap or napping too late in the day can disrupt their internal clock and make getting to sleep at night harder.
• Involve your loved one in an activity to help calm them and make them feel more contented.
• Plan ahead. Knowing that late afternoon and early evening can be challenging, schedule doctors’ appointments and other major activities for earlier in the day.
• Keep the home well lighted. Reducing or limiting darkness can help avoid the confusion that is central to so many troubling behaviors, including sundowning. 

There are many more suggestions for strategies to cope with sundowning. The National Institute on Aging recently updated their Tips for Coping with Sundowning. The Alzheimer’s Association also has more information on Sleep Issues and Sundowning and a printable sheet with its own tips for dealing with sundowning (pdf).

And, as always, you can reach out to the Caregiver Specialist at your local Area Agency on Aging for additional help, information and support.