Question

How should a patient with symptoms of "sundowning" be treated?

Answer

People with a dementing illness have more behavior problems in the evening. The frustrations and sensory stimulation build up throughout the day and, by "sundown", they are not able to cope as well with the confusing environment around them. They may become increasingly confused, agitated, and anxious and may pace the floor, begin to wander or show other nervous behavior.

To help minimize Sundowner's Syndrome, maintain a structured daily routine. This reduces the anxiety that decision-making can produce. Scheduled rest periods should be included in that routine. Try to keep the daily activities within the person's coping ability. Surprises, challenges or lots of new information can be very upsetting. Special occasions, outings, family visits, and other changes in routine should be explained in advance and approached gently. It's best to schedule these events after quiet days. Turn lights on inside the house well before dusk to lessen disorientation.

Links

• Alzheimer's Association: Sleeplessness and Sundowning