Understanding Sundowner’s Syndrome

Sundowner’s syndrome, also known as sundowning, is a term used to describe the phenomenon where older patients, often in long-term care or a hospital facility, can become confused, angry or otherwise agitated during the late afternoon, evening or nighttime.



However, the whole concept of sundowning is kind of controversial and this is the exact reason why caregivers and medical professionals may feel uncomfortable when discussing it. They believe that the concept is used too casually to explain this erratic behavioral phenomenon.

This is why it is important to understand what 'sundowning' is and what it isn’t and how 'sundown syndrome' gets applied to a wide range of behaviors. This will help caretakers take actions that can help older patients improve their quality of life and also help the caregiver make it easier for them.

‘Sundowning’ can be best described as a subjective factor. It is usually seen in older adults with symptoms such as heightened confusion, anger and agitation and other such troubling behaviors. Patients who show this type of behavior are called 'sundowners.’ Unfortunately, there is no unifying medical term that explains these conditions.

So, what are the common symptoms of this ‘disease?’ First, the person may show continuous crankiness and anger at the end of the day in a pattern-like manner. Second, the person may become irritable, moody or generally angry over seemingly trivial issues. Thirdly, the person may not seem open to reasoning and negotiation.

What is it that causes this syndrome? This can be caused mainly by diseases such as dementia or middle to late stages of Alzheimer’s.

Here are some of the reasons why a person may behave like this:

1. Damage caused to the part of one’s brain that regulates sleep and wake cycles
2. Low blood sugar
3. Thirst from dehydration
4. Loneliness
5. Hunger
6. Chronic pain
7. Incontinence
8. Hormonal imbalance
9. Heart diseases
10. Alzheimer’s
11. Dementia

How should caregivers react to this phenomenon? For caretakers, you should understand the exact triggers of your patients. Once identified after spending time with your patient, you should try your best to avoid using those actions or words again. What your loved one needs most is sympathy and understanding. You can say that this syndrome is just a symptom of diseases like Alzheimer's or other noted conditions and with your care, you can help them overcome it.