If you’re caring for a loved one with dementia, you may have noticed that their confusion, agitation, or anxiety often worsens in the late afternoon or early evening. This behavior, commonly known as sundowning, can be one of the most challenging aspects of dementia caregiving.
You’re not alone—up to 20% of people with Alzheimer’s experience sundowning at some point.
What Is Sundowning?
Sundowning refers to a pattern of increased confusion, restlessness, or irritability that typically begins around dusk and may last into the night. Symptoms can include:
- Pacing or wandering
- Yelling or arguing
- Shadowing (following the caregiver closely)
- Hallucinations or delusions
- Sleep disturbances
It’s not fully understood why sundowning happens, but experts believe it may be related to changes in the body’s internal clock (circadian rhythms), fatigue, hunger, pain, or overstimulation.
Strategies to Help Ease Sundowning
Here are some practical tips you can try to help reduce evening confusion and improve comfort for your loved one—and yourself:
- Stick to a Consistent Daily Routine
Keeping a regular schedule for waking, meals, activities, and bedtime can help reduce anxiety. Sudden changes can increase confusion, especially late in the day.
Tip: Schedule more stimulating activities earlier in the day, and reserve late afternoons for calming routines like music, quiet conversation, or a short walk.
- Let in Natural Light
Exposure to natural light during the day helps regulate the sleep-wake cycle. Open the curtains, sit near windows, or spend time outside if the weather allows.
Bonus: Some caregivers use a light therapy box in the morning to help “reset” the internal clock.
3. Limit Naps and Caffeine
Too much daytime sleep or stimulants like caffeine can interfere with nighttime rest and worsen sundowning symptoms. Try to limit naps to no more than 30 minutes and avoid caffeine after lunch.
- Create a Calm, Cozy Evening Environment
As daylight fades, reduce noise and activity in the home. Turn off loud TVs, dim bright lights, and play soft music to signal that it’s time to wind down.
Try This: Use warm, soft lighting in the evenings and avoid overhead fluorescents, which can feel harsh or disorienting.
- Provide Reassurance and Comfort
Your presence and calm demeanor can make a big difference. Speak gently and offer soothing touches or familiar objects, like a cozy blanket or favorite pillow.
Remember: Arguing or correcting a person with dementia during sundowning rarely helps. Validation and redirection are more effective.
- Limit Stimulation Late in the Day
Try to avoid crowded or noisy environments, too much TV, or big household tasks late in the day. Even too many visitors at once can trigger anxiety as evening approaches.
- Ensure Basic Needs Are Met
Hunger, thirst, discomfort, or needing the bathroom can all contribute to agitation. Check in with your loved one’s needs regularly throughout the day and before bedtime.
- Talk to a Healthcare Provider
If sundowning becomes severe or doesn’t improve, talk to your loved one’s doctor. In some cases, changes in medication, untreated pain, or sleep disorders could be contributing factors.
You Deserve Support Too
Caring for someone with dementia is a deeply meaningful role—but also physically and emotionally demanding. Don’t hesitate to seek help, whether it’s respite care, adult day services, or joining a caregiver support group. You’re not alone, and support is out there.