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  • Agitation and Anxiety
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  • Refusal to Bathe
  • Refusal to Take Medications
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  • Sexually Inappropriate Behaviors
  • Sleep Disturbances
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  • Common Challenges: Alcohol Abuse
  • Common Challenges: Driving
  • Common Challenges: Lack of Eating
  • Common Challenges: Paranoid Thoughts
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Sundowning

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Caregiver Training Part XIII: Sundowning

Scenario

Lauren's father's behavior gets worse as the sun goes down. He appears restless.

Lauren wants to know what she can do to help her father get through this time of the day without getting confused or agitated.

  • English
  • Español

Common response: Lauren works on her laptop while her father searches for his checkbook. Instead of attending to her father, she tells him to "Sit down and watch TV." He continues to search and walks into the kitchen alone. Lauren hears something break and rushes to the kitchen.

Expert explanation: SUNDOWNING, aka SUNDOWNER'S SYNDROME, is a common behavior that occurs in early evening. It is not a disease, but rather a set of symptoms characterized by confusion, anxiety, aggression, or agitation. This is caused by damage to the area of the brain that regulates a person's internal clock. The sleep-wake cycle becomes disrupted and may lead to increased napping during the day and difficulty sleeping at night. SUNDOWNING is triggered by reduced light and is exacerbated in a person with unspent energy from a boring day.

Recommended response: Lauren sees her father looking for his checkbook. She gets up and makes the room brighter by turning on the lights. She speaks to him with a pleasant tone and engages him in a new activity that they do together.

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View the Facilitator & Advanced Learning Notes.

Download the Take Action Worksheet: pdf | doc

The project described was supported by Grant Number 1C1CMS330982 from the Department of Health and Human Services, Centers for Medicare & Medicaid Services. The contents of this publication are solely the responsibility of the authors and do not necessarily represent the official views of the U.S. Department of Health and Human Services or any of its agencies. This project was funded, in part, by the Archstone Foundation.

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