The world may think you are only one person--But to one person, you may be their world.
Author Unknown.
4CNAs
The Online Magazine
for Certified Nursing Assistants
CNA Training
CNA Magazine

CNA Resources
Patient Care Technician Resources
Home Health Aide

CNA Tips - Making Alzheimers Sundowning Behaviors Less Likely

It is estimated that nearly 20 percent of Alzheimer’s patients experience a condition known as sundowning, according to the data that is provided by the Alzheimer’s Association. Although the exact cause of sun downing is unknown, certified nursing assistants need to be better prepared for the shift in emotional and physical states that residents experience as the sun begins to set in those who suffer from this illness. For those who chose to work with elderly dementia patients, having the proper knowledge and understanding of the illness can effectively make behaviors less likely to occur.

What is Sundowning?
Sundowning isn't considered a disease itself, but rather a group of symptoms that may happen at a specific time each day. Sundowning can often be a symptom of Alzheimer's disease and other forms of dementia.  Residents with Alzheimer’s disease and other dementias may become more confused and agitated when the sun is starting to set.

What Are the Symptoms of Sundowning?
Sundowning can have many symptoms.  The symptoms of sun downing is often less prominent earlier in the day.  These may include:

Delusions and Hallucinations-The resident may complain of seeing and hearing things that are not there. They may not be able to see well in dim light and can become confused.

Disorientation-The resident has an upset in their natural body clock that can often can cause disorientation between day and night time. 
Confusion-A resident may perceive things in new, and sometimes in an unusual way. 

Anxiety-The resident may communicates fatigue and stress to the person giving care such as the certified nursing assistant and may become anxious.

Sundowning can also lead to residents pacing or wandering. Wandering can occur in residents who are involved in activities during the day, but become  restless when there’s no activities to do in the late afternoon or evening.

Simple Tips for Making Alzheimer’s Sundowning Behaviors Less Likely to Occur

Those who suffer from sundowning may benefit from keeping active in the morning and then being encourage a rest after lunch.
Activities that are familiar to a resident from an earlier time in the their life may be helpful.  Bright lights and noise may have a negative impact on a resident from television and radios. This can sometimes cause confusion and anger. When did the resident normally bath before the disease? Baths that are given in the afternoon can cause agitation to become worse with those with Alzheimer’s sun downing.

If certified nursing assistant will take the time and identify what is causing the symptoms of the sundowning to occur, then they will be able to create effective solutions to reduce the behavior and ensure the utmost safety of the resident.  The more knowledge the CNAs have, the better they will be equipped  to handle these rapid shift in moods.