A confused, lonely monster on a hilltop at sunset. We talk about the sundowning phenomenon in those with dementia, its causes, and how to help in this episode. https://every1dies.org

January 24, 2025

S5E43: Sundowning: Understand The Causes, and Tips to Make it Better

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What causes sundowning, and is there anything you can do to decrease the effect?

Sundowning is a behavior change in people who become agitated, uncooperative, hallucinate, pace, or have increased confusion as the sun goes down. It has been found that these behaviors do not only occur for elders with dementia, but also older adults without the disease, young people, and older dogs.

In this Episode:

Transcript

01:44 – Recipe: Mississippi Chicken
02:13 – Notable Deaths from 2024
05:13 – Sundowning – What is It?
08:38 – Things that Make Sundowning Behavior Worse
09:17 – What Can Help Sundowning?
10:43 – Can Dogs Get Sundowning Behaviors?
14:33 – Ranata Suzuki – One Piece of Advice to Hold
16:00 – Outro

An infographic explaining sundowning, or "sundowner's syndrome" from Alzheimer's Association — Sundowning, also called “sundowner’s syndrome,” it is not a disease but a set of symptoms or dementia-related behaviors that may include difficulty sleeping, anxiety, agitation, hallucinations, pacing and disorientation. (Source: Alzheimer’s Association)

Understanding Sundowning

The behaviors that are associated with sundowning are confusion, anxiety, agitation or aggressiveness with increased motor activity (e.g. pacing, wandering), and yelling, all of which get worse as the sun is going down. So what causes sundowning? Read more below.

The Link to Circadian Rhythm

The current thinking is that these sundowning behaviors occur at sunset is because of an impairment of the circadian rhythm from damage to the sleep-promoting center in the hypothalamus and decreased production of melatonin. Listen to learn all about the current research.

Is There a Way to Help Decrease Sundowning?

We talk about several ways to help, from adjusting light exposure through the day, to adjusting the environment and activities, to possible medications. We also talk about additional physical conditions that can contribute to sundowning that you can watch for such as urinary tract infections and dehydration. Listen to the podcast for a detailed list of ideas.

This video summarizes much of what we talked about with sundowning, covering the causes and how you can decrease it

Related Episodes:

References:

Boronat, A. C., Ferreira-Maia, A. P., & Wang, Y. P. (2019). Sundown syndrome in older persons: a scoping review. Journal of the American Medical Directors Association, 20(6), 664-671.
Cameron, D. E. (1941). Studies in senile nocturnal delirium. Psychiatric Quarterly, 15, 47–53. https://doi.org/10.1007/BF01613953
Evans L. K. (1987). Sundown syndrome in institutionalized elderly. Journal of the American Geriatrics Society, 35(2), 101–108. https://doi.org/10.1111/j.1532-5415.1987.tb01337.x
The Lives They Lived – The New York Times
If I could offer you one piece of advice to hold… | A life half lived

Resources:

Renata Suzuki: If I Could Offer You One Piece of Advice…

“If I could offer you one piece of advice to hold in your heart, it would be to appreciate every second you have with the things that you love; be they places, objects or people…. Because there is a last time for everything and you don’t always get to know that it’s the last time when you’re in it.
There will be a last time you see a sunrise, a last time you taste ice-cream and a last time you smell a rose. 
There will be a last time you enter every room, a last time you hold every pet, and a last time you hear a loved one’s voice. 
Sometimes we know we’re in those moments and we can saver ever second of them - but so often we don’t know until that moment is gone and it’s too late to go back and relive it. 
So hold onto those moments while you have them… live inside them…. appreciate them to their fullest every time so you’ll never regret taking them for granted one day when they’re gone.”

- Renata Suzuki
Reposted from A Life Half Lived

Recipe of the Week: Mississippi Chicken

We’re touring the country for recipes and landing on this slow-cooker masterpiece that will be sure to please your family on a cold winter night. Head to Southern Living for the full instructions and Mississippi Chicken recipe.

Head to Southern Living for the full instructions and **Mississippi Chicken recipe.** (Image: Southern Living)

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