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Sundowners Syndrome: AKA My Mom Is Doing WHAT?

Updated on October 10, 2014

What The Heck Is Sundowning?!

"What the heck is Sundowners Syndrome?" I asked plaintively of my Mom's long time physician.

By way of introduction, I was my adorable Mom's caregiver for the 5 years before her death in 2012. Mom moved in with me the day after Dad died and game was ON. Sadly, I had NO idea how to care for a 91 year old, no idea of the world I was about to enter.

Inside this new world was a syndrome I learned to understand and even find humor with once in a while. That affliction is called Sundowners Syndrome and I'm here to tell you what you can expect, how you can deal with an Alzheimer's or dementia patient with Sundowners, and even, how you might be able to divert some of the symptoms.

So, come along and listen to the tale. A tale of a fated ship....Wrong story. Just come along.

Photo credit: All photos on this article are my own unless they're items on Amazon.com where I am an affiliate.

Sundowners Syndrome 101, Part 1

What is Sundowners Syndrome?

Sundowners Syndrome is a set of symptoms that cause a state of confusion in the elderly when the sun goes down (makes sense, right?).

Typical symptoms of Sundowners Syndrome:

  • Wandering. A person 'sundowning' might become confused about where they are and might wander around trying to get centered again. Wandering in Alzheimers and dementia patients is particularly dangerous as these patients might not remember their name or address.

    My Mom would wander at night. I remember the intense frustration I felt at putting her back to bed - again - at 2 am only to find her getting out of bed at 2:10. I fixed that issue though with an anti-wandering bed alarm system.

  • Anxiety. I saw some of this with my own Mom. She didn't have any mental issues so I was surprised when she couldn't tell me what she was anxious about.
  • Suspiciousness. A friend's aunt became a whole different person when the sun went down. She accused everyone of everything.

A Sundowners Caregiver's Best Friend - An Anti-Wandering Alarm

Wireless (Cordfree) Bed Alarm and Bed Pad/no Alarm in Patient's Room
Wireless (Cordfree) Bed Alarm and Bed Pad/no Alarm in Patient's Room

This alarm has a pad that goes on the bed under your elderly loved one. When your elderly loved one tries to rise off the pad, an alarm goes sounds on the caregiver's monitor. Some of these bed alarms also give a small alarm in the patient's room, however, that this alarm may cause even more confusion in some Alzheimers/dementia patients.

This is the anti-wandering alarm I bought to use with Mom. It worked perfectly, and I got better sleep knowing that the alarm would awake me if needed.

 
Here's my lovely Mom, Gertie, at 94. She was, and remains, my hero.
Here's my lovely Mom, Gertie, at 94. She was, and remains, my hero.

Sundowners Syndrome 101, Part 2

Additional symptoms of Sundowners may include:

  • Aggression. I also saw just a bit of this Sundowners symptoms with my normally gentle-natured Mom. She would get upset when I would tell her she had to stay up until 8 pm; if she fell asleep earlier, I didn't have a chance for a night's sleep. She would be up from 11 pm on...
  • Mood swings. These came at her caregivers fast and furious around 5:30 pm. She'd be sweet as could be and then very challenging verbally.
  • Ignoring directions. Sometimes, when Mom was Sundowning, she would look at me when I asked her to do something but couldn't follow my directions. Confusion abounded. I learned not to give her directions between 5 and 7 pm EST!

Senior citizen caregiving 101: Things I wish I'd known
Senior citizen caregiving 101: Things I wish I'd known

This is my own eBook that I wrote about my beginning in senior citizen caregiving. To put it mildly, I knew very little about caring for anyone, having chosen years before not to breed. All I learned about caregiving before Mom came to live with me was what my dogs had taught me.

 

A Non-Scientific Poll About Sundowners Symptoms

If you dealt with a Sundowners patient, what was their most prevalent symptom of the syndrome?

See results

What Brings On Sundowners Syndrome?

There is really no firm reason for why the elderly react to the particular time of day when the sun goes down but they sure do! A few of the prevailing ideas about what exacerbate this syndrome are (and this is not a complete list...):

  • Being overly tired
  • Increased shadows in a room; shadows that might become unrecognizable and scary.
  • Low lighting
  • Pain - My Mom's Sundowners actually started after she broke her hip and was in pain.
  • Hospitalizations - Several caregivers note that Sundowners Syndrome seemed to be initiated by a senior citizen's hospitalization.
  • New environments. You might see symptoms of Sundowners if you move your elderly loved one to a new, unfamiliar place.
  • Interrupted circadian rhythms. We all have an internal clock which, apparently, gets reset in a weird way with the elderly. I've always had a hard time adjusting to the new time change in MD in spring and fall. It was even harder for Mom to adjust. It sometime would take over 2 weeks to get her readjusted to gaining or losing an hour.

Click the link in the text to the left to see this beautiful night light (and a whole lot more).
Click the link in the text to the left to see this beautiful night light (and a whole lot more).

There are a few things that might (operative word: might) help alleviate some of the symptoms of Sundowners Syndrome. These are not scientific findings; they're just thoughts. They are:

  • Add a nightlight to the bedroom of the patient. This might help Talk with your elderly loved one's doctor about the possibility of using melatonin to help control some symptoms.
  • Shut the blinds before the sun stars to go down. Tell your senior citizen loved one that it's going to be nighttime. Note: make sure all blinds are up all day long to allow the natural light to come in.
  • Phototherapy. The thought of using phototherapy is that it may work with the circadian rhythm which might be what is causing the Sundowners.
  • Don't change the senior citizen's environment, if at all possible.

Day-light Classic Floor Stand, Neutral Color
Day-light Classic Floor Stand, Neutral Color

This phototherapy floor lamp might just help with your elderly loved one's symptoms at sunset. With an adjustable height, that light can shine bright on your senior citizen friend whether he or she is in bed or sitting in a favorite chair.

 

In Conclusion

I may not be able to help you with your particular situation, but you are definitely not alone (hopefully, you're drinking a glass of wine while reading this).

Sundowners Syndrome is one of the leading reasons for caregiver burnout so you must try to care for yourself first. I know, I know - that's almost impossible to do but you must find ways.

And, if at all possible, try to find any humor you can in the situation. In the picture there to the right, Mom is standing in front of the kitchen oven clock which shows 6:19 am. I had just put her back to bed at 6:00 am - for the 6th time since 1 am.

She was up again, sigh, with a bout of Sundowners symptoms. As sometimes happens in life, the unexpected ensued. I gave up trying to put her back to bed and decided to just join the party. We sat that morning on the back deck and had a cup of coffee, a piece of coffee cake, and shared a few secrets and a beautiful sunrise. It's one of my favorite memories of the times I was my precious Mom's caregiver.

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    • gottaloveit2 profile image
      Author

      gottaloveit2 2 years ago

      LindaSmith1: Bless you! The times I was in the hospital with my Mom, I was so grateful for the hospital workers. I could never do that.

    • gottaloveit2 profile image
      Author

      gottaloveit2 2 years ago

      Thanks for your kind comment. It is a challenge but it's a labor of love at the same time.

    • Nell Rose profile image

      Nell Rose 2 years ago from England

      What a beautiful memory that you sat outside with her in the morning and chatted, thats what its all about. Sometimes the best times are the unexpected ones. Yes we went through it too, my brother especially as he lived with mum and dad, my dad was the worse for sundown syndrome, he wandered around all night, my brother was exhausted, so yes I totally understand, nell

    • LindaSmith1 profile image

      LindaSmith1 2 years ago from USA

      I worked in hospitals and nursing homes. Sundowners is difficult to deal with for sure.