"Sundowning" causes severe confusion and wandering in the late afternoon and night. To prevent it, caregivers must maximize daytime sunlight exposure, establish a rigid evening routine, limit evening liquids to prevent bathroom trips, and use nightlights to reduce shadows that cause hallucinations.
For many caregivers, the most exhausting part of dementia care begins when the sun goes down. "Sundowning" is a symptom of Alzheimer's and dementia characterized by increased confusion, anxiety, and a strong urge to wander beginning in the late afternoon and continuing into the night.
Why Does Sundowning Happen?
Dementia severely damages the brain's internal clock (circadian rhythm). As daylight fades, shadows lengthen, which can cause visual hallucinations. Fatigue from navigating a confusing world all day also peaks, leading to a breakdown in coping skills.
Regulating the Internal Clock
To prevent nighttime wandering, you must start during the day. Ensure the senior gets plenty of natural sunlight in the morning and early afternoon. This helps reset their circadian rhythm. Keep them active during the day to ensure they are physically tired by bedtime. Avoid letting them take long naps in the late afternoon.
Creating a Safe Sleep Environment
- Manage the Shadows: Close the curtains before dusk to hide the darkening sky. Turn on plenty of bright, even lighting inside the house to eliminate scary shadows.
- Limit Evening Liquids: A full bladder is a primary reason seniors get out of bed at night. Limit heavy drinking after 6:00 PM to reduce the need for nighttime bathroom trips, which often lead to disorientation and wandering.
- Use Nightlights: If they do wake up, the room should not be pitch black. Use motion-sensor nightlights in the bedroom and bathroom. If they can clearly see their surroundings, they are less likely to panic and wander out of the house looking for familiar territory.
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