Winter’s earlier, darker nights wreak havoc on internal clocks and routines for almost everyone, but one group that already struggles with nightfall may face additional difficulty after clocks are set back for the winter.

Individuals living with Alzheimer’s and dementia often are affected by “sundowning,” which typically is seen during dark or evening hours and can disrupt the body’s sleep-wake cycle. Sundowning is marked by increased confusion, anxiety, agitation, pacing, and disorientation late in the day. Having the sun set at a different time, accompanied by shorter days and darker evenings, can cause additional stress for someone living with dementia and the people who care for them.

During National Alzheimer’s Disease Awareness Month (NADAM), the Alzheimer’s Association is providing an overview of sundowning and what caregivers can do to ease its effects.

Factors that may cause sundowning

• Mental and physical exhaustion from a full day trying to keep up with an unfamiliar or confusing environment.

• Nonverbal behaviors of others, especially if stress or frustration is present, may inadvertently contribute to the stress level of a person living with Alzheimer’s.

• Reduced lighting can increase shadows and may cause the person living with the disease to misinterpret what they see and become more agitated as a result.

These tips can help caregivers manage sundowning

• Caregivers should get plenty of rest to help reduce unintended nonverbal behavior.

• Schedule activities such as doctor’s appointments, trips, and bathing in the morning or early afternoon when the person living with dementia is more alert.

• Try to maintain a regular routine. When possible, include walks or time outside in the sunlight. Walking can reduce restlessness.

• Make notes about what happens before sundowning events and try to identify triggers.

• Reduce stimulation during the evening hours (i.e., TV, doing chores, loud music, etc.). These distractions may add to the person’s confusion.

• Offer a larger meal at lunch and keep the evening meal lighter.

• Keep the home well-lit in the evening. Adequate lighting may reduce confusion.

• Do not physically restrain the person; it can make agitation worse.

• Try to identify activities that are soothing, such as listening to calming music, looking at photographs, or watching a favorite movie.

• Talk to the doctor about the best times of day for taking medication.

• When behavioral interventions and environmental changes do not work, discuss the situation with your doctor.

ALZConnected is the Alzheimer’s Association’s online support community for caregivers. Visit alzconnected.org to find support and resources.

There are 220,000 Ohioans aged 65 and older living with Alzheimer’s disease, according to the Alzheimer’s Association “2023 Alzheimer’s Disease Facts and Figures.” That number is expected to increase to 250,000 by 2025. One in three seniors dies with the disease.

Those concerned about themselves or a loved one can contact the Alzheimer’s Association 24/7 helpline to schedule a care consultation and be connected to local resources, guidance, and support. To reach the helpline, call 800-272-3900.

Submitted by the Alzheimer’s Association.