Sundowners syndrome, a common problem associated with dementia, can dramatically affect the daily lives of seniors and their loved ones. As many as 20% of adults with Alzheimer’s disease experience sundowners syndrome.
This guide aims to define sundowners syndrome, elaborate on its symptoms, and explore various strategies for its management.
What Is Sundowners Syndrome?
Sundowners syndrome is a group of thoughts, feelings and behaviors that usually occur around sunset. It typically causes these symptoms:
- Difficulty sleeping
These symptoms often occur with other illnesses, so it’s necessary to distinguish sundowning from other medical problems. Physicians diagnose sundowners syndrome based on the timing and frequency of the symptoms.
For a clearer understanding, consider Alice, a 78-year-old with frontotemporal dementia. A few years ago, she loved to spend Friday nights at her local jazz club, sipping wine and listening to the dulcet sounds of the alto sax. Now that she has dementia, she often gets anxious early in the evening. Her anxiety stems from sundowners syndrome.
How Can Daily Routines Help Manage Sundowners Syndrome?
Dementia makes it difficult to deal with change, so seniors must follow consistent routines in the following areas:
- Sleep schedule: Seniors with dementia should go to bed at the same time each night and wake up at the same time each morning.
- Exercise: Exercise may help prevent sundowning or reduce the severity of the symptoms. If possible, seniors should walk in the morning or early afternoon.
- Daylight: Light exposure may reset the body’s clock, so it’s helpful to go outside or keep the shades open during the day.
- Daytime schedule: Sundowning symptoms may start in the late afternoon, so it’s best to schedule appointments and activities for the morning.
- Substances: Seniors with dementia should avoid caffeine and other stimulants late in the day. They should refrain from consuming alcohol, too.
How Can Medication Help Treat Sundowners Syndrome?
Medications and supplements don’t eliminate sundowning but can make the symptoms more manageable. These are some common treatment options:
- Melatonin: Melatonin is a natural hormone that affects the sleep-wake cycle. Seniors who experience difficulty sleeping may benefit from taking a melatonin supplement before bed.
- Acetylcholinesterase inhibitors: These drugs prevent the breakdown of acetylcholine, a chemical that may affect the sleep-wake cycle.
- Antipsychotic medications: Antipsychotic medications have sedative properties and may reduce agitation and other sundowning symptoms.
Do Home Treatments Help Treat Sundowners Syndrome?
In addition to medications, some seniors use home treatments to manage their symptoms. These are some of the most helpful treatments available:
- Light therapy: For seniors with dementia, light therapy may help prevent sleep problems, reducing fatigue.
- Aromatherapy: Aromatherapy may lower stress levels, which may prevent or reduce the manifestation of sundowning symptoms.
- Stress management: Stress can trigger sundowners syndrome, so meditating or participating in stress-management activities may reduce the frequency of sundowning episodes.
Is Memory Care Helpful for People with Sundowners Syndrome?
According to data from 2021, memory care costs an average of $5,625 per month. Moving to a memory care facility may benefit seniors who continue to experience sundowning episodes despite trying many home treatments. Memory care offers these benefits:
- Secure environment
- Trained staff members
- Opportunities to socialize
- Regular supervision
Is In-Home Care an Option for People with Sundowners Syndrome?
The biggest drawback of in-home care is the cost — an average of $5,148 per month in 2021. It can also be challenging to find the right home health provider.
Despite these disadvantages, home health care has many benefits:
- Ability to stay at home
- Trained professionals available to manage symptoms
- Assistance with home treatments for sundowning syndrome
What Is the Best Way to Afford Care for Sundowners Syndrome?
With the average cost of care exceeding $4,000 per month, many seniors worry about how they’ll pay for in-home or residential care. Fortunately, there are several potential funding sources.
What Veterans Benefits Pay for Sundowners Syndrome Care?
Certain veterans qualify for the Aid and Attendance benefit, a pension supplement offered by the Department of Veterans Affairs. The VA also provides a supplement for housebound veterans with permanent disabilities. Seniors can use the extra funds to pay for the following services related to sundowners syndrome:
- Homemaker assistance
- Medication copays
- Aromatherapy supplies
- Light therapy equipment
- Home health services
What Medicare and Medicaid Programs Pay for Sundowners
Medicare doesn’t pay for homemaker services, personal care or meal delivery, but it does cover medically necessary services. Therefore, seniors with sundowners syndrome may use Medicare benefits to buy medical supplies, durable medical equipment or part-time skilled nursing care.
Medicaid pays for home health care in all 50 states, but the coverage amounts vary. Beneficiaries may be able to use their Medicaid benefits to purchase medications or medical alert systems.
Can Social Security Benefits Pay for Sundowners Syndrome Care?
Seniors may use Social Security retirement benefits, Social Security Income payments or Social Security Disability Insurance benefits to cover the cost of sundowning care. To qualify for Social Security retirement benefits, a senior must earn at least 40 work credits in their lifetime. The SSI and SSDI programs have additional eligibility requirements.
All three programs provide cash benefits, giving older adults tremendous flexibility. Once a senior receives their monthly benefits, they can use the money to pay for everything from home health care to aromatherapy oils.
Can Health Savings Accounts and Flexible Savings Accounts Pay for Sundowners Syndrome Care?
A health savings account allows participants to set aside pre-tax dollars for future medical expenses. The funds roll over at the end of the year and help seniors save for large purchases. A flexible spending account works the same way, but the funds don’t roll over from year to year. HSA and FSA funds must be spent on approved health expenses, such as prescriptions, over-the-counter medications and medical supplies.