Sundowning: Why Evenings Are Harder in Dementia and What Helps
Sundowning: Why Evenings Are Harder in Dementia and What Helps
Short answer: Sundowning is a period of increased confusion, anxiety, and restlessness that happens from dusk through the night. You can lower its impact with a regular daily routine, keeping the home well-lit in the evening, and scheduling demanding tasks for the morning.
- Sundowning causes trouble sleeping, pacing, and disorientation as daylight fades.
- Common triggers include end-of-day exhaustion, disrupted body clocks, and shadows in dim light.
- A daily routine with morning sunlight, early demanding tasks, and a large lunch can reduce symptoms.
- Never argue with a loved one who is sundowning or use physical restraint.
- If wandering occurs and the person is missing for 15 minutes, call 911 immediately.
What sundowning is and when it happens
Sundowning brings increased confusion from dusk through the night. Your loved one may experience trouble sleeping, anxiety, pacing, and severe disorientation as the sun goes down.
Because sundowning happens at the end of the day, it is often exhausting for family members who are also tired. Managing these symptoms requires planning and patience. Finding the right dementia care resources can help you prepare your home and your schedule for these difficult evening hours.
Possible triggers for evening confusion
Several factors can cause or worsen sundowning. End-of-day exhaustion is a primary trigger. Unfamiliar environments or a disrupted body clock also make it harder for them to separate day from night.
Lighting plays a major role in evening anxiety. Shadows in dim evening light can add to confusion. Finally, your loved one can pick up on your stress. If you are frustrated or tired at the end of the day, they may sense that emotion and become agitated themselves.
Caring for a loved one with dementia is demanding. If you need a break, New Century Home Care can help. Call 215-974-0000 or fill out our contact form and choose “I am a client” then “I need services.” Our Philadelphia office staff speaks English, Russian, and Ukrainian.
What helps manage sundowning
You can reduce evening agitation by adjusting your loved one’s daily routine. The goal is to maximize daytime alertness and create a calm, well-lit environment as evening approaches. Try to stay calm and do not argue with your loved one. Practicing good communicating with someone with dementia focuses on the feelings behind their words rather than correcting their confusion.
| Time of day | What to do |
|---|---|
| Morning to early afternoon | Schedule demanding tasks such as bathing and appointments. |
| Daytime | Get daylight; limit long naps. |
| Lunch | Make lunch the main meal; keep dinner lighter. |
| All day | Avoid alcohol, caffeine and nicotine; keep a regular routine for waking, meals and bed. |
| Evening | Keep the home well lit; reduce noise and busy activity. |
| Evening | Calming activities: familiar music, photos, a gentle walk. |
When it is not just sundowning
If your loved one shows a sudden change in behavior, contact their doctor. Sudden confusion or agitation may have another cause, such as an illness, that the doctor should check. You should also ask the doctor about medication timing, as some drugs cause sleepiness or dizziness that worsens evening confusion.
Evening restlessness can go along with wandering. Six in 10 people living with dementia will wander at least once. Warning signs include restlessness, pacing, or wanting to “go home” even when they are already at home. You can lower this risk by using wandering prevention strategies like installing door alarms and keeping night lights on. If your loved one goes missing, search immediately. If they are not found within 15 minutes, call 911 and tell the dispatcher the person has dementia.
If you need advice or support, the Alzheimer’s Association Delaware Valley Chapter runs a free 24/7 Helpline at 800-272-3900. They can connect you with local support groups and safety resources.
How an evening aide can help
Managing evening routines alone can lead to caregiver burnout. Hiring a home care aide for the late afternoon and evening adds help during the hardest part of the day. An aide can help keep a regular routine for waking, meals, and bedtime, which keeps your loved one’s body clock on track.
Aides who provide specialized dementia care can help with the evening routine: turning on lights before dusk to prevent shadows, guide your loved one through calming activities, and supervise them to prevent wandering. This extra help serves as respite care for family caregivers, allowing you to rest and recharge while knowing your loved one is safe.
Need evening support for a loved one in Philadelphia? Contact New Century Home Care at 215-974-0000 or submit our contact form, selecting “I am a client” and “I need services.”
Frequently asked questions
Can you prevent sundowning?
You cannot completely stop sundowning, but you can reduce its severity. Sticking to a regular daily routine, limiting long daytime naps, and keeping the house well-lit in the evening help manage symptoms and reduce confusion.
How to help someone with dementia sleep through the night?
Limit daytime sleeping and avoid giving them caffeine, alcohol, or nicotine. Ensure they get daytime sunlight and schedule demanding tasks for the morning. You should also ask their doctor if their medication timing is disrupting their sleep.
How to calm down sundowning?
Stay calm, speak directly to the person, and do not argue. Try calming activities like listening to familiar music, looking at family photos, or taking a gentle walk. Keep the home well-lit to reduce shadows that cause fear.
How to stop someone with dementia from wandering at night?
Install deadbolts above or below eye level and use door alarms. Keep night lights on to reduce disorientation. If they do wander and are missing for 15 minutes, call 911 immediately and say the person has dementia.
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