Are laying in the dark and being mean part of sundown syndrome?

1 answer | Last updated: Sep 14, 2017
A fellow caregiver asked...

My father in law has Alzheimer's and I believe into late stages. Is it part of sundown syndrome when he wants blinds and door to his room shut all time and lay in the dark? Also he is starting to get mean and yell, is this all part of it?

Expert Answers

Joanne Koenig Coste is a nationally recognized expert on Alzheimer's care and an outspoken advocate for patient and family care. She is the author of Learning to Speak Alzheimer's. Also, she currently is in private practice as an Alzheimer's family therapist. Ms. Koenig Coste also serves as President of Alzheimer Consulting Associates, implementing state-of-the-art Alzheimer care throughout the United States.

Sundown syndrome (SS) is a definite possiblity as a reason for your father-in-law's behavioral changes late in the day. This specific syndrome, characterized by irritability usually directed at the caregiver, and confusion generally occurs in the earlier stages of Alzheimer's disease (AD). The ability to carry out routine tasks and to use appropriate language may also be affected. The majority of patient eloping or wandering happens during this time period. Although the cause of SS varies from clinician to clinician, many believe it to be the result of the brain being 'overloaded' with information by day's end resulting in frustration and 'acting out'. The need to escape the sense of feeling overwhelmed leads to leaving the setting where the SS occurs. Although Sundown Syndrome and dark rooms is not a common complaint, perhaps your father-in-law's desire to lie in the dark accomplishes the same goal. It is more difficult to process information and the dark room may help him to more easily do this. It is important to report this late day behavioral change to your physican and to discuss the possibility of a mild depression being at the base of his reaction. It is certainly not unusual for depression to occur as the limitations resulting from AD become more real as the day wears on. The good news is depression can be treated with a mild antidepressive medication. Your physician may have other suggestions for dealing with this behavior that is happening as the sun is literally going down. I sense your frustration and hope you are finding ways to care for yourself during this difficult time in the AD journey.