Sundowning is a dementia-related symptom that refers to increased agitation, confusion and hyperactivity that begins in the late afternoon and builds throughout the evening. Most sundowning emerges in mid-stage dementia and slowly worsens as the disease progresses. What causes it? Dementia may damage the body's internal clock, causing a disruption of sleep-wake cycles. Secondly, individuals with dementia become fatigued by their inability to process information; the more hours spent on this process, the more exhausted—and irritable—they may become.

Tips:

• Plan activities or outings in the morning.
• Do only simple, calming activities in the afternoon.
• Keep individuals awake during the day.
• Increase indoor lighting before dusk.
• Ensure that the individual is not suffering from hunger, thirst, pain or fear.
• Correct potential causes with basic interventions such as hydration and snacks.
• Remove excess stimuli and clutter.
• Watch for sundowning in early-stage dementia or rapidly worsening symptoms, both of which may suggest delirium.
• Consult your doctor to see if medications may help.
• Be twice as patient and kind during these hours.

For more information, please go to the Alzheimer's Foundation of America website.