Understanding And Surviving Sundowners Syndrome

By way of introduction, I was my adorable Mom’s caregiver for the 5 years before her death in 2012. Mom moved in with me the day after Dad died and game was ON. Sadly, I had NO idea how to care for a 91 year old, no idea of the world I was about to enter.

Inside this new world was a syndrome I learned to understand and even find humor with once in a while.

That affliction is called Sundowners Syndrome, and I’m here to tell you what you can expect, how you can deal with an Alzheimer’s or dementia patient with Sundowners, and even, how you might be able to divert some of the symptoms.

So, come along and listen to the tale. A tale of a fated ship….Wrong story. Just come along.

Sundowners Syndrome Symptoms

So, what exactly is Sundowners Syndrome?

Good question as no one exactly knows. But, there are some predictable symptoms – symptoms that cause a state of confusion in the elderly when the sun goes down (makes sense, right?).

Typical symptoms of Sundowners Syndrome Include

• Wandering. A person ‘sundowning’ might become confused about where they are and might wander around trying to get centered again. Wandering in Alzheimers and dementia patients is particularly dangerous as these patients might not remember their name or address. My Mom would wander at night. I remember the intense frustration I felt at putting her back to bed – again – at 2 am only to find her getting out of bed at 2:10. I fixed that issue though with an anti-wandering bed alarm system.
• Anxiety. I saw some of this with my own Mom. She didn’t have any mental issues so I was surprised when she couldn’t tell me what she was anxious about.
• Suspiciousness. A friend’s aunt became a whole different person when the sun went down. She accused everyone of everything.
• Aggression. I also saw just a bit of this Sundowners symptoms with my normally gentle-natured Mom. She would get upset when I would tell her she had to stay up until 8 pm; if she fell asleep earlier, I didn’t have a chance for a night’s sleep. She would be up from 11 pm on…
• Mood swings. These came at Mom’s caregivers fast and furious around 5:30 pm. She’d be sweet as could be and then very challenging verbally.
• Ignoring directions. Sometimes, when Mom was Sundowning, she would look at me when I asked her to do something but couldn’t follow my directions. Her normally animated face would be flat of expression Confusion abounded. I learned not to give her directions between 5 and 7 pm EST!

What Brings On Sundowners Syndrome?

There is really no known reason for why the elderly react to the particular time of day when the sun goes down but they sure do!

There are though a few of the prevailing ideas about what exacerbate this syndrome are (and this is not a complete list…)

• Being overly tired
• Increased shadows in a room; shadows that might become unrecognizable and scary.
• Low lighting
• Pain – My Mom’s Sundowners actually started after she broke her hip and was in pain.
• Hospitalizations – Several caregivers note that Sundowners Syndrome seemed to be initiated by a senior citizen’s hospitalization.
• New environments. You might see symptoms of Sundowners if you move your elderly loved one to a new, unfamiliar place.
• Interrupted circadian rhythms. We all have an internal clock which, apparently, gets reset in a weird way with the elderly. I’ve always had a hard time adjusting to the new time change in MD in spring and fall. It was even harder for Mom to adjust. It sometime would take over 2 weeks to get her readjusted to gaining or losing an hour.

 Ibis & Orchid Angel Trumpet Night Light #50147

How To Help A Sundowner Relax

There are a few things that might (operative word: might) help alleviate some of the symptoms of Sundowners Syndrome. These are not scientific findings; they’re just thoughts.

• Get a Day Clock that shows the time of day AND if it is morning, evening or night. Here’s another article I wrote about Day Clocks.
• Add a nightlight to the bedroom of the patient. This might help as it seemed to keep Mom in place (at least for a while)
• Talk with your elderly loved one’s doctor about the possibility of using melatonin to help control some symptoms.
• Shut the blinds before the sun stars to go down. Tell your senior citizen loved one that it’s going to be nighttime. Note: make sure all blinds are up all day long to allow the natural light to come in.
• As strange as it sounds, leave the room. Wait a few seconds and re-enter. For whatever reason, and I have NO idea why, this sort of helped Mom out.
• Phototherapy. The thought of using phototherapy is that it may work with the circadian rhythm which might be what is causing the Sundowners.

Conclusion

I may not be able to help you with your particular situation, but you are definitely not alone (hopefully, you’re drinking a glass of wine while reading this).

Sundowners Syndrome is one of the leading reasons for caregiver burnout so you must try to care for yourself first. I know, I know – that’s almost impossible to do but you must find ways.

And, if at all possible, try to find any humor you can in the situation.

In the picture there to the right, Mom is standing in front of the kitchen oven clock which shows 6:19 am.

I had just put her back to bed at 6:00 am – for the 6th time since 1 am.

She was up again, sigh, with a bout of Sundowners symptoms.

As sometimes happens in life, the unexpected ensued.

I gave up trying to put her back to bed and decided to just join the party.

We sat that morning on the back deck and had a cup of coffee, a piece of coffee cake, and shared a few secrets and a beautiful sunrise.

It’s one of my favorite memories of being Mom’s caregiver.

So, you see, Sundowners is not to be feared. In fact, with the right attitude, it can just be one more dimension of a person. A dimension that is, yes, frustrating at times, and sometimes wonderful.