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Sundowning and Wandering in People With Dementia: What to Expect and How to Prepare

Sundowning and Wandering in People With Dementia: What to Expect and How to Prepare

Sundowning and wandering are two of the biggest concerns for caregivers and family members of people with dementia. These behaviors can be extremely distressing for both the person with dementia and their caregivers.

If you suspect yourself, a loved one or a patient developing signs of sundowning and or wandering, this article is for you, as it will discuss what to expect from sundowning and wandering, as well as how to prepare yourself for these behaviors

What is Sundowning ?

Sundowning, also known as sundowner syndrome, is a set of behaviors that are exhibited by some people with dementia late in the day, around the end of the afternoon until nighttime. Sundowning is a complex symptom of dementia, such as Alzheimer's disease or Lewy Body dementia, for instance.

These behaviors can include:

  • Sleep problems
  • Late-day confusion
  • Pacing and wandering
  • Acute disorientation and anxiety
  • Agitated or irritable behavior
  • Hallucinations

Sundowning can be extremely distressing for  both the person with dementia and their caregivers. It can be difficult to cope with sundowning, as it can often lead to wandering.

Aggravating factors for sundowning:

  • Fatigue
  • Hunger
  • Boredom
  • Loneliness
  • Anxiety or stress
  • Overstimulation from loud noises or too much activity
  • Changes in routine 

Ways to manage sundowning:

  • Create a calm and comfortable environment
  • Establish a regular routine
  • Provide opportunities for physical activity earlier in the day
  • Make sure the person with dementia is well-fed and hydrated
  • Limit caffeine intake late in the day
  • Minimize loud noises and bright lights late in the day
  • Encourage relaxation techniques such as deep breathing or massage

What Are The Causes of Sundowning ?

There are many possible causes of sundowning. The most likely cause is the person with dementia's internal body clock, or circadian rhythm, being out of sync. This can be due to a number of factors, such as changes in the sleep-wake cycle, fatigue, hunger, boredom, anxiety or stress.

Other possible causes include overstimulation from loud noises or too much activity, changes in routine, and the person with dementia's medications.

It is important to note that sundowning is not a sign of mental illness. sundowning is a symptom of dementia that can be extremely distressing for both the person with dementia and their caregivers.

If you are concerned that sundowning is affecting your loved one or patient, it is important to speak with a doctor or dementia specialist. They will be able to rule out any other causes of the sundowning and help you develop a plan to manage the sundowning.


What is Wandering (dementia-related)?

Wandering is defined as walking about without apparent purpose and often accompanied by a feeling of being lost. It is a common behavior in people with dementia, and can be extremely distressing for both the person with dementia and their caregivers.

According to the Alzheimer's Association, six out of ten people living with dementia will experience at least one episode of wandering.

Wandering can be a dangerous behavior for people with dementia, as they are at risk of getting lost or injured.

Early signs of dementia-related wandering episodes:

  • Getting lost and confused in familiar places such as the home
  • Restlessness, pacing, late-day confusion
  • Forgetting how to get to habitual locations (relatives' houses, their own bathroom or bedroom)
  • Confusion about their whereabouts
  • Walks or drives that take longer than it normally should

Ways to manage dementia-related wandering:

  • figure out what is triggering the wandering episodes. As sundowning can often lead to wandering, it is important to identify any sundowning triggers and try to avoid them.
  • Set a structured schedule for each day of the week and keep them engaged with daily activities (cooking, cleaning chores, gardening, etc.)
  • Avoid new surroundings and areas that are crowded
  • It is also important to  create a safe environment for the person with dementia. This may include:
  • installing locks or alarms on doors
  • removing tripping hazards
  • making sure the person with dementia always has identifications or a GPS with them.

How Can You Prepare For Sundowning and Wandering in People With Dementia?

The first step to take in order to be prepared for sundowning and wandering in people with dementia is to educate yourself and learn as much as you can about what it entails, and to know the signs as early as possible. You also should see a doctor, who can provide more specific insights and personalized advice.

Then you might want to think about safe-proofing your home. There are many ways to make sure your house is fully secured for someone with dementia, and possible sundowning and wandering episodes. You can, for instance, get a wireless call button in case of emergencies or even door and window alarm magnets to avoid wandering complications.

Lastly, you might consider seeking a specialized facility for people living with advanced or progressing dementia, such as Memory Care.

Resources for further reading

For more information on Sundowning and Wandering in people living with dementia, here are some great resources :

https://www.alz.org/help-support/caregiving/stages-behaviors/sleep-issues-sundowning

https://www.alz.org/help-support/caregiving/stages-behaviors/wandering


Conclusion

Sundowning and wandering are common issues that arise in people with dementia. 

Sundowning is a condition where a person becomes agitated and confused as the day goes on, typically occurring in the late afternoon or evening. Wandering is when a person with dementia leaves their home or care facility without permission or an understanding of where they are going. There are many ways to manage Sundowning and Wandering episodes, but it is important to be prepared for them before they happen, to know the early signs and to seek medical assistance.