Sundowner’s Syndrome: How to Keep Your Loved One Safe

Caring for someone with dementia comes with many unexpected challenges, such as sundowner’s syndrome. This common symptom of Alzheimer’s disease or other types of dementia can cause sleepless nights for both you and your loved one. However, with the right proactive measures, you can help keep them safe and at ease.

What Is Sundowner’s Syndrome?

Sundowner’s syndrome refers to a pattern of increased confusion, anxiety, agitation, and behavioral changes that often appear gradually as the afternoon turns into evening and can vary from mild unease to more intense distress.

Common signs and symptoms of sundowning include:

• Agitation or irritability
• Restlessness or pacing
• Increased confusion
• Anxiety or fear
• Trouble sleeping

While the exact cause of sundowner’s syndrome isn’t fully understood, factors like fatigue, low lighting, disruption of the body’s internal clock, and overstimulation can all play a role.

Why Safety Becomes a Concern

As sundowning symptoms increase, your loved one’s ability to think clearly and make safe decisions may decrease. This can create situations where everyday environments suddenly feel unfamiliar or threatening to them. Even in a home they’ve lived in for years, confusion can lead to risky behaviors and increase the risk of falls, injuries, or getting lost.

During these episodes, your loved one may be more likely to:

• Wander or attempt to leave their home
• Misinterpret their surroundings, leading to fear or unsafe actions
• Forget their physical limitations
• Have difficulty recognizing familiar people or places

How to Keep Your Loved One Safe

Establish a Consistent Routine
A predictable daily structure can provide a sense of stability and reassurance. When your loved one knows what to expect, it can reduce anxiety and help ease the transition into the evening hours.

• Keep wake-up, meal, and bedtime schedules consistent.
• Plan calming activities, such as coloring or listening to music, in the late afternoon.
• Avoid sudden changes in routine.

Maximize Daytime Light Exposure
Natural light is important to regulate the body’s internal clock, which can become disrupted in those with dementia. Ensuring your loved one gets enough daylight exposure can help reduce the severity of confusion when evening comes.

• Open curtains and blinds during the day.
• Plan an easy outdoor activity, such as a short walk or a picnic.
• Sit near windows in well-lit areas when inside.

Create a Soothing Evening Environment
As the day winds down, too much noise or activity can feel overwhelming and may trigger agitation in your loved one. Creating a soothing and predictable environment in the evening can help your loved one feel more secure and relaxed.

• Lower the television volume or turn it off.
• Limit visitors in the evening.
• Turn on lights to reduce shadows.
• Play soft, familiar music.

Secure the Home
Safety-proofing the home is an essential step to prevent accidents and limit wandering, especially when your loved one gets confused. Even small, simple adjustments can significantly reduce risk and give you greater peace of mind.

• Install door alarms or motion sensors.
• Use locks placed out of direct sight.
• Remove tripping hazards, like loose rugs or floorboards.
• Ensure stairways are well-lit and have railings.

Monitor for Triggers
There are often underlying triggers that can make sundowning worse. By observing patterns in your loved one’s behavior, you may be able to anticipate and reduce these episodes before they escalate.

Be aware of potential triggers such as:

• Hunger or dehydration
• Pain or discomfort
• Fatigue
• Medication side effects

Offer Reassurance and Comfort
During sundowning episodes, providing your loved one with emotional support and comfort is just as important as keeping them physically safe. They may feel scared, confused, or overwhelmed, even if they can’t fully express it. How you respond in these moments can help de-escalate the situation.

• Speak in a gentle, steady voice.
• Avoid arguing or correcting.
• Use simple, clear sentences.
• Offer physical comfort if appropriate, like holding their hand.

Have a Bedtime Routine
A calming bedtime routine can help signal to your loved one that it’s time to wind down. Familiar, repeated actions can create a sense of comfort and reduce resistance to sleep. The goal is to make the transition into nighttime as smooth and stress-free as possible.

• Dim lights gradually.
• Encourage relaxing activities like reading or listening to music.
• Keep their bedroom comfortable and familiar.
• Avoid caffeine or heavy meals late in the day.

When to Seek Help

Despite your best efforts, sundowning symptoms may become more intense or harder to manage. This can be overwhelming, and it’s important to recognize when additional support is needed. Remember that getting help doesn’t mean you failed as a caregiver and that you are making the best decision for your loved one’s safety and quality of life.

Supportive Memory Care at Christian Health

Sundowner’s syndrome can be emotionally exhausting, both for caregivers and their loved ones. If you feel your loved one needs more specialized care than you can provide, we can help.

At the Courtyard at Longview, those with early-stage dementia thrive in a warm, friendly, and structured environment that promotes engagement, offers a familiar routine, and keeps them safe. No matter the level of support needed, our goal remains the same: to help each resident live their best life. To learn more, call (201) 848-4303 or take a virtual tour.

Heritage Manor offers compassionate, individualized skilled nursing care to meet various unique needs of older adults, including memory care. Our team members are specially trained to care for patients with Alzheimer’s and other types of dementia to ensure their comfort, security, and well-being. To learn more, please call (201) 848-5855 or take a virtual tour.

At Ramapo Ridge Behavioral Health, we provide specialized inpatient behavioral health designed specifically for older adults in a secure, supportive environment. With therapeutic activities and a gentle, soothing setting, with soft lighting and calming spaces, our care is designed to minimize agitation and promote calm. To learn more, please call (201) 848-5500.

Southgate Special Care’s healing, therapeutic environment provides care for older adults with behavioral disturbances associated with Alzheimer’s disease or other types of dementia. All team members receive specialized training in providing considerate, gentle care to residents and are certified in de-escalation techniques to resolve conflict and promote calmness. To learn more, please call (201) 848-5855 or take a virtual tour.