Understanding Sundown in Dementia

Sundown in dementia

“Don’t let the sun go down on me; although I search myself, it’s always someone else I see… I’d just allow a fragment of your life to wander free, but losing everything is like the sun going down on me…”

It is through this song by Sir Elton John that I’ve come to understand sundown in dementia. It is a point of confusion that often happens at the end of the day usually when the sun goes down. According to Dr. Glenn Smith from the Mayo Clinic, it comes in a variety of behaviors like anxiety, aggression, confusion, pacing, wandering and not following directions.

This condition is not a disease but has come to be known as a syndrome related to dementia patients in a specific time of the day; the exact cause is still unknown to experts on the field.

Some studies suggest that the person’s biological clock that regulates the times of sleeping and waking up is linked to the way our body responds to the levels of energy needed throughout the day and therefore manages our behavior. In people living with dementia this clock is somehow shifted and makes them more prone to reacting in the ways mentioned above when sundown happens.

The sundown in dementia is not only seen in this medical condition, other diseases see this happening too, like in diabetes where sudden changes on the glucose level in the blood may cause the same reaction. Other cases talk about people with vision problems and as the daylight starts fading they may also become confused and agitated.

Sometimes even parts of the house scenery could cause this sense of confusion and alter the person’s state. For example, someone who may have trees outside the window that cause human shaped shadows may think there is someone outside. The simple change of light can provoke sundown in dementia as they might feel they suddenly are in an entirely different place.

Not all people living with dementia react the same way and some may not even notice the sunset, however as caregivers it is important to know what triggers the sundown situation. It is also recommended to have a good set of lighting at all times to prevent sundown from happening.

A good tip provided by experts is to place a full-spectrum fluorescent lamp one meter from the person who might suffer sundown a few hours during the morning and then on the afternoon before the sun goes down while the person is distracted with a certain activity. This might get set their biological clock on track and avoid any agitation or confusion.

The meal time might also be a source of influence at sundown in dementia. Keep track of the times of the day when the person eats and when he or she might feel hungry (sometimes asking might not help since they probably will not know the difference). Keep a good schedule to prevent sundown caused by hunger. If it is not dinner time yet, try having a snack ready.

The important thing is to help the person living with dementia feel at ease and comfortable in their environment:

  • Keep a routine and try relaxing techniques like stroking their arm or back, hold their hand or do a hand massage.
  • Provide reassurance and remind yourself to speak in a calm voice.
  • Patience is quite necessary, do not get frustrated in a sundown situation as it will aggravate the person’s behavior and will provide no solution.

Here are the lyrics and video to this beautiful song by the excellence of Sir Elton John. Seeing it through the eyes of a person living with sundown in dementia can change the meaning of the song entirely… Enjoy!

I can't light no more of your darkness

All my pictures seem to fade to black and white

I'm growing tired and time stands still before me

Frozen here on the ladder of my life

 

It's too late to save myself from falling

I took a chance and changed your way of fife

But you misread my meaning when I met you

Closed the door and left me blinded by the light

 

Don't let the sun go down on me

Although I search myself, it's always someone else I see

I'd just allow a fragment of your life to wander free

But losing everything is like the sun going down on me

 

I can't find oh, the right romantic line

But see me once and see the way I feel

Don't discard me even if you think I mean you harm

But these cuts I have, they need love to help them heal

 

Don't let the sun go down on me

Although I search myself, it's always someone else I see

I'd just allow a fragment of your life to wander free

But losing everything is like the sun going down on me

 

Don't let the sun go down on me

Although I search myself, it's always someone else I see

I'd just allow a fragment of your life to wander free

But losing everything is like the sun going down on me

 

But losing everything is like the sun going down

 

Losing everything is like the sun going down on me

 

Related Read:

Light and Dementia

Cope with Dementia: Not an easy task

What is Dementia Advocacy?