From the Research
Sundowning strategies should prioritize creating a calm, structured environment in the evening to reduce confusion and agitation in individuals with dementia, as supported by the most recent study 1 from 2023. Here are key recommendations:
- Establish a consistent routine: Set regular times for meals, activities, and bedtime.
- Manage lighting: Gradually increase indoor lighting in the late afternoon and evening to reduce shadows and improve visibility.
- Minimize noise and distractions: Keep the environment quiet and turn off TVs or radios in the evening.
- Encourage relaxing activities: Engage in calming activities like soft music, gentle massage, or reading before bedtime.
- Address basic needs: Ensure the person is comfortable, not hungry, thirsty, or in need of the bathroom.
- Limit caffeine and sugar: Avoid these stimulants, especially in the afternoon and evening.
- Consider melatonin: A 1-3 mg dose of melatonin before bedtime may help regulate sleep-wake cycles, as suggested by earlier studies 2, 3.
- Use familiar objects: Surround the person with familiar items to create a sense of security.
- Maintain a comfortable room temperature: Keep the environment neither too hot nor too cold.
- Monitor for pain or discomfort: Address any physical issues that may be causing agitation.
These strategies work by reducing environmental triggers that can cause confusion and anxiety, while promoting a sense of calm and routine. The goal is to create a predictable, soothing environment that helps the individual transition more easily into nighttime rest. Consistency in applying these strategies is key to their effectiveness, and it is essential to consider the individual's specific needs and circumstances when implementing them, as highlighted in studies 4, 5.