How do I Care for Someone with Sundowners Syndrome?

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  • Written By: Malcolm Tatum
  • Edited By: Bronwyn Harris
  • Last Modified Date: 22 February 2019
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As a condition that sometimes accompanies dementia and Alzheimer’s disease, sundowners syndrome can take a huge toll on the resources of both the patient and the caregiver. The condition includes a wide range of symptoms, such as extreme agitation, sudden confusion, and even hallucinations, so caring for someone with this malady requires constant vigilance. Several common techniques, including creating a routine, staying calm, and helping the patient feel safe and secure, can help you to care for a patient.

Establishing a routine for the day is very important. While somewhat repetitive, the security and comfort found in moving through a predictable course of action can help minimize the discomfort and anxiety the patient experiences when the mind suddenly seems to lose track of what is happening. Since the actions for the day are just like those of other days, it is sometimes easier to slip back into the flow of the day with less trepidation or anxiety. As a bonus, you can use the repetitive steps of the routine to keep track of how well the patient is functioning in general.


Keeping calm is very important when dealing with someone suffering with sundowners syndrome. Often, the patient's agitation will come on suddenly and may lead to shouting, the use of strong language, and possibly even violent actions. By asking direct questions about the origin of the agitation in a calm and measured tone, you can help the patient begin to move past the agitation and avoid hurting himself or others in the immediate vicinity.

Exercising patience is also extremely important. Depending on how the condition manifests itself, you may find the patient following you closely, not unlike a small child or a pet. In other instances, he may exhibit a tendency to wander, making it necessary for you to keep close tabs on his location at all times. At other times, you may have to patiently walk through a hallucination with the patient rather than become irritated and try to use logic to snap the person back into reality.

Providing for the basic needs of the patient is another way to help manage and alleviate some of the discomfort associated with this condition. Make sure the patient gets sunlight in the morning, as this helps to maintain the internal clock. Keep clean clothes handy and gently encourage good personal hygiene. Nutritious meals served on time will also help the patient feel comfortable and relatively secure. Don’t forget to make sure the bed is comfortable, so the prospect of retiring for the night or taking a nap in the afternoon is appealing.

In an indirect manner, one of the best ways to care for someone with sundowners syndrome is to also take good care of yourself. This means making sure you get regular exercise, eat properly, and get enough rest. Doing so will make it easier to exercise patience and do all the little things necessary to care for your patient or loved one. When possible, also allow yourself an evening out with friends or a quiet moment for yourself, as this will also help you to maintain a positive attitude.

With so little information currently available about the causes of this condition, there is only so much that can be done in the way of treatment. This makes the function of the caregiver especially important. Learn what does and does not work with your patient, and don't forget to take care of yourself at the same time. Doing so will make life a lot easier for both of you.


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Post 8

How can I get my father to eat? He doesn't want any food and he needs to eat. What can I do? He is 80.

Post 7

My wife and I are caregivers for my mom who has sundowners that she got while in the hospital for 25 days and while there suffered a mild stroke to the right back side of her brain with some bleeding. Then she went to a rehab for two months so this also added to the problems. She has been back home for two months and it seems for the past 2 1/2 weeks things are getting a little worse. We also have to take care of my uncle (whom she use to take care of) who is mentally challenged. Things tend to take a toll on us, but we find ways to cope with this.

Post 6

@post #5: "Doctors are still trying to figure out the impact of a recurring bladder infection, and medication regulation, but there are no answers for my mother or the rest of us right now."

My mother (93 ears old) used to have a chronic problem with bladder infections (I suspect because she's forgotten to wipe from front to back). The doctor put her on daily dose of Bactrim (antibiotic)and she's not had problem now for over five years. Her dementia continues and she seems to be having a slight 'sundowner' issue this winter, but at least not the erratic behavior that accompanies a bladder infection.

Post 5

Like most people, this sundowning appears to have come on fairly rapidly. Doctors are still trying to figure out the impact of a recurring bladder infection, and medication regulation, but there are no answers for my mother or the rest of us right now.

My mother is currently in a rehab facility but she is very paranoid today and angry with all the nursing staff. It is extremely difficult for my father who visits her all day long. So many unknowns and it is tough to keep my dad healthy through this. We are wondering is a nursing home is the only next option or if someone could help maintain this as a 24-hour support person.

Post 4

I am a caregiver. My organization has been hired to assist a 93 year old woman with Sundowners Syndrome in an assisted living facility. The woman is a very sweet, with a wonderful repertoire of stories and a beautiful laugh.

We arrived before sunset, to help run interference when she begins wandering around, bothering residents, or trying to make phone calls. During the day, she makes friends with people and is a delight to be around. At night, she does not remember who they are or why she is in the facility.

In the evening, she becomes a very frightened confused person. She believes that people are out to steal everything, that family and friends are lying about her husband's

death, so they can get her home.

Yes it is difficult, and her case is extreme, complete with hallucinations of voices and people. She loses association with years, days, weeks and places. For her, it is inconsistent. She vacillates between having her husband waiting for her (he is has been dead six months), or her girlfriends are coming to pick her up. Some nights she is on a cruise ship, a hotel, a mental ward, or in a foreign country.

The most important thing is to remember she is not acting this way on purpose. She does not have any control over the fear or hallucinations.

Post 3

Michael T. I completely understand you. I'm only 27 and my mom is 64. I believe I'm seeing the signs of sundowners in her and I am an only child.

I have aunts that are helping but it is still hard to process all of this by myself. I am also in grad school/working and I find this so emotional and draining. I find myself crying every day over losing my mother. It's just so hard.

Post 2

My father is 80. I am an only child - and oh how I envy all of you that have brothers and/or sisters to assist you in your time of need. My mother does all she can and I fear for her.

I see why they call this the "long goodbye." My parents live two houses away. I was just laid off of my job. Perhaps this is a blessing in disguise so I may be able to help my dear mother more.

I don't know where my mother gets her strength to go on with this.

I am having such a hard time with all of this. My mother doesn't want to put him in a facility (and neither do I) as long as he still knows her in the mornings. We live out in the county in South West Idaho. When do the tears ever stop? Michael T.

Post 1

My sister and I were just informed by our dads doctor that if our dad attempts to wander from this assisted living place that we will have no choice but to transfer him to a locked ward/nursing home. This news is very disturbing to both of us. This all seemed to happen so fast. More so in the last six months but definitely started after our mom's death just over two years ago. We are reading posts to get some support for ourselves mostly.

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