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Concernlast1: Per the Alzheimer's Association "Sundowning is increased confusion that people living with Alzheimer's and dementia may experience from dusk through night. Also called "sundowner's syndrome," it is not a disease but a set of symptoms or dementia-related behaviors that may include difficulty sleeping, anxiety, agitation, hallucinations, pacing and disorientation. Although the exact cause is unknown, sundowning may occur due to disease progression and changes in the brain."
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Reply to Llamalover47

Gena, TouchMatters, gives a much more comprehensive explanation than I was going to. I would go through her list of possible causes, to see if you can identify anything in particular that may be causing the patient discomfort or anxiety.

I thought it was more related to a fear of darkness, night time, and going to sleep.
In my case, after I Googled sundowning, I started closing the drapes before it starts to get dark outside, and keep the room will lit as well as the hallway and any other rooms within sight, kind of disguising the darkness.
For me, that worked. But, as TouchMatters points out, the person could simply be tired, over-stimulated, in pain, so try to identify and make sure they are comfortable.
Anti anxiety meds can help. I prefer something that simply helps the person to relax and feel sleepy. Anti anxiety meds can create other unwanted side-effects.
Another thought I want to share regarding over-stimulation. When a person's brain isn't functioning at 100%, everything they see and hear can take a lot of work for their brain to process, wearing them out. And consistent routine is key!
Any variation in their daily routine, anything unexpected, can really be a lot for them to manage and will cause anxiety, especially late in the day when they're already exhausted just from thinking.
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Reply to CaringWifeAZ

Yes, as someone mentioned, it is very easy to google these things. I provided part of website so people here can print out. Always a good idea to ask MD (and/or facility management).

See this website:

In part:

What is sundowning?

Sometimes you might see changes in the person’s behaviour in the later afternoon or towards the end of the day. During this time the person may become intensely distressed, agitated and have hallucinations or delusions.
This may continue into the night, making it hard for them to get enough sleep.
This is sometimes known as ‘sundowning’ but is not necessarily linked to the sun setting or limited to the end of the day. Sundowning can happen at any stage of dementia but is more common during the middle stage and later stages.

What causes sundowning?

The reasons why sundowning happens are not well understood, but it is possible that a range of different causes makes it more likely.

These might include:

tiredness, hunger, pain or other unmet physical needs
not enough exposure to sunlight during the day
overstimulation during the day, such as from a noisy or busy environment
disturbance to the person’s ‘body clock’ caused by damage to the brain
disturbed levels of hormones that vary over the course of the day
sensory impairment, such as hearing or sight loss
tiredness in other people causing the person with dementia to become upset
mood disorders, such as anxiety or depression
fewer carers around to look after the person (in a care home)
side effects of prescribed drugs.

Some of these are related to the time of day, and others may happen at any time.

Try to identify which of these problems might be affecting the person, as each problem may need a different treatment.

Tips for reducing sundowning

Sometimes what seems like ‘sundowning’ could be the person trying to communicate a need. This could be needing the toilet, feeling hungry or being in pain.

Uneven indoor lighting and reflective surfaces can sometimes cause confusion by creating disturbing shadows or mirrors. Close the curtains or blinds once it starts to get dark and cover the television with a dust cover, if it’s not being used.
Think whether something that’s happened during the day has affected them. If they seem agitated, try to calm them by distracting them, perhaps talking about a favourite memory or event they enjoy thinking about.

If they remain agitated, it could be that they have a need that is not being met.

Gena / Touch Matters
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Reply to TouchMatters

Most things are very easy to look up online, but sundowning is basic the tendency for those with age related mental decline to become more confused at night that during the day. Most things are worse later in the day, amazingly, including pain.
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Reply to AlvaDeer

Below is a helpful link from Cleveland Clinic.

Sundowning can occur anytime and is a group of symptoms experienced by dementia patients.
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Reply to 97yroldmom

Sundowning occurs in late afternoon or early evening, and it can include behaviors such as agitation, confusion, anxiety, or aggressiveness. It can also cause hallucinations, delusions or disorientation.
There are medications that ones doctor can prescribe that help with most of the symptoms that come with sundowning.
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Reply to funkygrandma59


Welcome to are forum. Your profile doesn't say much other than you are taking care of mom.

Do you live with her, has she been diagnosed with dementia?

Sundown is when the sun goes down and dementia patients anxiety goes up, they pace, or scream, or cry, or have hallucinations.

If your mom has recently had issues, Google Teepa Snow, watch her videos on dementia, you will learn so much.

Ask as any questions you have and we will try to lead you in the right direction.
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Reply to Anxietynacy

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