09/11/2026
The Tiny Device That's Stopping Sundowning — On Day One
By Tauna Young, FNP-C
I want to be careful about how I write this, because I'm a clinician and I know the difference between an observation and a clinical trial. What I'm about to share is not a clinical trial. It's what I'm watching happen, in real time, in a real assisted living setting, with real residents.
And it is surprising me.
A Little Background
Recently, I approached The Cottages — a group of assisted living and memory care facilities across southwest Idaho that has been serving families in the region since 2001 — about participating in a small pilot study. The question: could CES, the FDA-cleared device known to significantly improve anxiety and insomnia — make a meaningful difference for residents who experience sundowning?
Sundowning is the pattern of increased agitation, confusion, and anxiety that occurs in the late afternoon and evening hours in people with dementia. The science behind it is well-understood: the brain's internal clock degenerates, melatonin production falls, and the nervous system gets stuck in a state of alarm it can no longer turn off on its own. What has been far less clear is what to do about it. Antipsychotics are the most common pharmaceutical tool, but they carry serious risks in elderly patients — increased falls, stroke risk, and accelerated cognitive decline. Clinical guidelines say to avoid them if possible. The problem is that "if possible" has always meant: if you have something else that works. For a long time, there hasn't been much else.
That's the gap I was dying to explore.
Shocking Results I Wasn't Ready For
The administrators at several Cottages locations agreed to participate — and so did the families of the residents involved, each of whom gave their permission before anyone's loved one was included. It would have been easy for all of them to say no. They said yes because they saw the potential for their residents to feel better in the evenings — and that reflects something I've observed firsthand about The Cottages: the people who work there bring a genuine love for their residents to work with them every day. This isn't just a job for them. You can see it in how they talk about the people in their care, and in the fact that when something came along that might make their residents' evenings easier, they didn't hesitate.
We've been at this for just a couple of weeks now. I want to be precise, because precision matters more than enthusiasm: I am seeing things I did not expect to see this quickly.
Several residents who were regularly needing PRN medications — as-needed doses of anti-anxiety drugs like Ativan — in the evenings are no longer needing them. Not because anyone decided to stop giving them. Because the evenings are different now. The need simply isn't there.
What surprised me most is how fast the change has happened. Staff are telling me consistently that sundowning symptoms stop on DAY ONE. Not after several weeks of adjustment. Day one. I did not anticipate that. I don't think anyone did.
Residents who previously paced, repeated the same questions, resisted care, and visibly suffered through their evenings are now, in the evenings, just themselves. Cooperative. Reachable. Present. That phrase keeps coming up. They're just themselves. It sounds simple. If you have ever watched a person with dementia sundown, you know it is not simple at all. It is everything.
And then there is the sleep piece. Residents who were previously up at night — wandering, unable to settle — are simply going to bed. Normally. At night. The way people are supposed to.
A Tool Geriatric Care Has Been Missing
For the first month of the study, I prescribed CES twice daily — morning and early afternoon — plus PRN as needed. The twice-daily structure is intentional: a loading phase designed to give the brain the opportunity to establish a calmer baseline. After the first month, once daily is typically sufficient, though it can be used more often.
Something happened in several instances that the staff didn't see coming — though I'll admit it didn't surprise me.
Staff placed the device on residents who were already in the middle of significant agitation — not as prevention, but as a response to someone who was already upset, already distressed. It calmed them down. Right there, in the moment. Quickly.
And then something equally striking: for residents who frequently resist taking their medications — a genuinely difficult challenge in memory care — staff found they could place the device, step out, and return twenty minutes later to a completely different interaction. The same resident who would have refused or become combative was now calm, cooperative, and reachable. The medication was passed peacefully. No struggle.
I noticed something in the way the staff were talking about this. They weren't just observing that their residents were doing better — they were experiencing something themselves: their jobs actually became easier. That matters more than it might sound. Caregiver burnout in memory care is real and well-documented, and anything that makes this work more sustainable is not a minor benefit.
None of this surprised me. I've seen CES work in real time with patients experiencing acute anxiety in my own psychiatric practice — the mechanism isn't mysterious. CES stimulates the nervous system toward a parasympathetic state, and that shift can happen quickly. I knew it could work this way. And now the caregiving staff at The Cottages has seen it too, in real time, with their own residents.
But watching it work that way in a dementia resident is significant in a different way. Because the alternative, at that moment, is a phone call to a prescriber. It is Ativan, or Haldol. Sedatives that carry real risk in an aging body — fall risk, respiratory risk, compounded cognitive effects in a brain that is already struggling.
Polypharmacy in elderly patients is already a serious concern. Every medication added to an aging person's regimen carries weight — interactions, side effects, the cumulative burden on a system that doesn't metabolize the way it did at forty. Geriatric clinicians have spent decades trying to reduce the medication load on elderly patients, not add to it.
The idea that you can simply place a small, non-pharmaceutical device on someone's earlobes in the middle of real distress and have it actually help, without sedating them, without altering their cognition further, without a phone call to a prescriber or a drug interaction to worry about — that is not a small thing. It is exactly the kind of tool that geriatric care has been missing.
Why I'm Writing About This Now
I'm writing now, while the study is still young and the data still coming in, because I think the caregiving community needs to know that something HUGE is happening here — even before the formal analysis is done.
I want to be honest about the limits of what I can say. This is a pilot. The sample is small. There is no randomized control group. This is how science works at the early stage: you watch, you document carefully, and you hold your excitement with both hands so it doesn't run ahead of the evidence.
What I can say with confidence is this: I am a clinician with more than a decade of hands-on experience, and I know what before and after looks like. What the staff are describing is consistent, specific, and clinically meaningful. These are not vague impressions — they are concrete, observable changes in behavior, medication use, and sleep patterns, reported independently across multiple residents and multiple locations.
In conversations with leadership from other long-term care and skilled nursing facilities in the region, I've found that the moment I describe what we're observing, the response is immediate — recognition of a problem they know intimately, and a potential solution they hadn't considered. There is genuine interest. Urgency, even.
The elderly population in long-term care may be one of the most overlooked potential beneficiaries of CES. A technology studied and used for over fifty years, and somehow the people who stand to benefit most — people for whom every additional medication carries real risk, people whose difficult evenings have simply been accepted as part of the disease — were largely left out of the conversation. We are in the early stages of changing that.
What It Means If This Holds
Sundowning affects up to 66% of people with Alzheimer's disease and is one of the primary reasons families transition a loved one into memory care. It is one of the biggest drivers of caregiver burnout. It is a daily source of suffering for people who have no ability to explain or control what their brain is doing to them in the evening.
If CES can interrupt that pattern — gently, without sedation, without drug interactions, without adding any pharmacological burden to a population already managing multiple medications — that is potentially a very large thing.
No published research has yet sought FDA clearance for CES specifically for sundowning. That's exactly why we're doing this. The science behind why it should work is sound: CES increases serotonin and melatonin production, reduces cortisol, promotes parasympathetic nervous system dominance, and modulates the circadian brain regions that degenerate in dementia. The biological drivers of sundowning and the documented effects of CES map onto each other with a precision that made me believe this was worth studying. What I'm watching in these first weeks is results which are more compelling than I even hoped.
I'll share more as the data comes in. In the meantime, if you are a caregiver navigating sundowning, or a memory care administrator looking for something beyond what the pharmaceutical toolkit currently offers — this is worth paying attention to — you can learn more about CES and sundowning here. https://program.neurovanacalm.com/dementia-sundowning/
More soon.
Tauna Young, FNP-C is the Founder & CEO of Neurovana and the owner of Harmony Mental Health in Boise, Idaho. The observations described in this post reflect early, preliminary findings from an ongoing pilot study and do not constitute clinical claims. Calm Ultra CES is FDA-cleared for anxiety and insomnia
Learn how Calm Ultra CES, FDA-cleared for anxiety and insomnia, may support caregivers exploring a gentle, drug-free approach to sundowning.
