Managing Anger & Sundowners Syndrome in Loved Ones With Memory Loss

October 15, 2021
Caring for a loved one with Alzheimer’s or dementia can be physically and emotionally draining, especially when they have behavioral changes caused by their anxiety and confusion. Many advanced dementia patients lash out at their caregivers with unexpected aggression later in the day or at night. The phenomenon is referred to as Sundowners Syndrome or “sundowning” because the disruptive behavior usually occurs after the sun has gone down and feelings of paranoia, sadness, fear, or anger seep into the mind, sometimes accompanied by delusions or hallucinations. Sundowning is stressful for both persons living with dementia and their caregivers. However, our healthcare professionals are here to offer helpful tips for managing anger and Sundowners Syndrome in loved ones with memory loss.

One out of five dementia patients suffer from sundowning
Elder care presents many unique challenges to caregivers. If you’re feeling overwhelmed about your loved one’s late afternoon or nighttime mood swings, the most important thing to remember is that you aren’t alone. According to scientific studies, as many as one out of five people living with Alzheimer’s or dementia suffer from Sundowners Syndrome. Much mystery shrouds this condition, but experts believe the neurological changes caused by dementia affect the individual’s inner body clock. This confusion about the time of day often manifests itself in the person shouting, pacing, and acting in aggressive manners. Sadly, these anger issues tend to worsen as the person’s memory loss progresses

Understand their anger isn’t directed at you or your actions
The first step to handling your loved one’s anger issues is to understand where this anger is coming from and recognize that it isn’t aimed at you or something you have necessarily done. Anger is usually caused by physical, emotional, or mental triggers. Your loved one may be angry because they cannot do the simplest tasks, such as tying their shoes or going to the grocery store. They could be experiencing physical fatigue, discomfort, or soreness you aren’t aware of, and they are unable to articulate how they are feeling.
Be aware that certain medications can cause behavioral side effects. Feelings of boredom or loneliness caused by their condition could also be the culprit for sudden outbursts. Memory loss and disorientation are often mental causes for aggression. Once you understand these underlying causes for your loved one’s anger, it may make it easier for you to cope and even avoid sources causing such behavior.

Observe what seems to trigger their aggressive behavior
Observing your loved one can provide valuable clues as to what’s prompting their aggressive behavior. Do they seem to lash out more when they’re hungry or haven’t had a restful night’s sleep? Sometimes, anger could be caused by overstimulation. Physical clutter, loud noises, bright lights, or lots of activity around them could cause this overstimulation. Consider light-blocking curtains to create a cozy atmosphere during the day, or on the flip side, surround your loved one with plenty of lights at night to alleviate fears when it’s time to go to sleep. Someone living with dementia may also become upset by anything that disrupts their day, such as diverting from their typical routine or switching caregivers. First-to-second shift rotations typically occur in the late afternoon or early evening hours at most group homes and could be the cause of disruptive patient behaviors.

Evaluate how you communicate with your loved one
Much of caring for a loved one with Alzheimer’s or dementia is learning how to communicate with them. Always speak softly and slowly with easy-to-understand instructions. Try not to say too much or ask too many questions at once, as this could lead to overstimulation. People often pick up on feelings of uncertainty or irritability, so it’s crucial to remain calm and reassuring at all times. Even if your loved one lashes out at you verbally or physically, try not to get upset. Never react with force or violence. If they’re in a safe place or someone else can keep an eye on them, walk away from the situation and give yourself time to think and calm down.

Consider defusing the tension with music or activities
Often, you can defuse anger and tension with a relaxing activity, such as massage or music. Try to redirect your loved one’s attention to something other than what triggered the behavior. Try putting on your loved one’s favorite TV show, suggest taking a walk, or doing something else you know they enjoy.

Remember to be kind and empathetic at all times
Above all, remember to be kind and empathetic at all times when caring for someone with Alzheimer’s or dementia. You care about this person and their well-being. They are suffering from a disease and often have little to no control over their thoughts, feelings, or actions. Never punish or reprimand them for bad behavior. It is not their fault, and they will likely not remember the scenario afterward. Seek help from their primary care physician or a support group to learn how to detect, defuse, and prevent angry outbursts.

Identify what caused the aggression so you can fix it
Try to figure out what happened right before the aggressive behavior, so you can take steps to correct it. Keeping a consistent log of your loved one’s behaviors and reactions can help you spot patterns and determine potential solutions. If you believe it’s the person’s diet, sleep pattern, surroundings, or medications, consult their physician to make adjustments as necessary to avoid anger triggered by these factors. Be on the lookout for any signs of discomfort or pain and seek immediate medical attention if you believe this is the cause of your loved one’s anger. Any time you are concerned about changes in your loved one’s behavior, habits, or moods, consult their primary care physician. They are there to provide professional support and information. Ask about the possibility of prescribing anti-anxiety or anti-depressant medications to modify behavior.

Consider professional elder care from BrightStar Care®
It’s important to recognize when you need help with caring for your loved one living with Alzheimer’s or dementia. BrightStar Care® has nurses, CNAs, and caregivers available around the clock to provide compassionate care in the comfort and familiar surroundings of home. Caring is more than a job to our nurses and caregivers – it’s their passion. Your family is our family!