CNA Tips for Alzheimer’s Disease – How to Handle Sundowning

According to data outlined by the Alzheimer’s Association, nearly 20 percent of Alzheimer’s patients experience a mystifying condition known as sundowning. Characterized as a shift in emotional and physical states as the sun begins to set, researchers and physicians do not know the true cause of this condition. If you chose to work in a nursing home or with elderly dementia patients, then you must learn how to effectively handle this rapid shift in moods, which include: delusions, hallucinations, insecurity, suspicion, disorientation, confusion and anxiety, just to name a few.

Effectively Dealing with Sundowning

As late afternoon approaches, you may notice your patient becoming more and more restless. This mild anxiety may swiftly switch into confusion, suspicion or disorientation. As the day progresses, a person with Alzheimer’s Disease may become tired or be less able to handle distractions, either real or imaginary. This inability to control themselves means they have a difficult time coping with natural processes around them. Instead of communicating this altering mental state, patients often exhibit strange and intense symptoms.

It’s important to realize that when an Alzheimer’s patient begins to showcase symptoms of Sundowning they may actually be behaving in such a way because they have a need they’re unable to express. A sudden outburst of anxiety or anger may be their way of letting you know they need to use the bathroom or they’re hungry. On the other hand, these outbursts may be an emotional need of needing a loved one who is no longer with them, such as a deceased spouse. Therefore, as a CNA you must actively work to determine what the Alzheimer’s patient truly needs.

Once you determine that the patient does not have a physical need, it’s time to delve deeper. Look for other clues that may reveal what her emotional need could be. Is the patient afraid of the dark? Are they worried about a situation that is not actually real, but to them, is quite real? Identifying the source of their aggravation or alteration is not easy; however, these patients behave like anyone else ñ they use nonverbal communication methods in an attempt to clarify their actual need; whether or not the need is based in reality.

Some of the most effective ways to handle a patient who is sundowning is to keep bedtime the same every evening. In many cases, developing a stable routine at the same time of day, or night, is an effective way to eliminate the severity of this mysterious condition. One of the most important things to remember is this patient is not behaving in such a way on purpose or to make your job difficult. Rather, the patient is trying to communicate a real need, desire or fear. By taking time to understand this and to learn your patient you can create effective remedies to reduce the severity and ensure the safety of your patient.

You should learn about this and other conditions related to Alzheimer’s in your CNA certification training. To find CNA training near you visit


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