If your loved one with Alzheimer's or another dementia becomes more confused, restless, anxious, or upset as the day goes on, you're not imagining it. This pattern is often called sundowning, and it's one of the most exhausting parts of dementia caregiving. Here's what's going on and what can help.
What is sundowning?
Sundowning is a group of symptoms that tend to get worse in the late afternoon, evening, or night. It can include:
- Increased confusion or disorientation
- Anxiety, agitation, or irritability
- Pacing, restlessness, or wandering
- Asking to "go home," even when already at home
- Suspicion, yelling, or resisting care
- Trouble falling asleep or staying asleep
What causes it?
No one knows exactly why sundowning happens, but common triggers include:
- Tiredness at the end of the day
- Fading light and growing shadows, which can be confusing or frightening
- A disrupted body clock
- Hunger, thirst, pain, or needing the bathroom
- Too much noise or activity, or too little to do
- Picking up on a caregiver's own stress and fatigue
12 tips to make evenings calmer
- Keep a steady daily routine. Wake-up, meals, activities, and bedtime at about the same time every day.
- Get daylight and activity early. A morning walk or time by a sunny window helps set the body clock.
- Limit naps. A short rest is fine, but long or late naps can make nights harder.
- Turn the lights on before dusk. Bright, even lighting reduces shadows. Close curtains as it gets dark.
- Cut back on caffeine and sugar, especially after lunch.
- Serve a lighter dinner earlier. A big late meal can make it harder to settle.
- Plan calm late-afternoon activities. Folding towels, looking at photos, music they love, or a simple puzzle.
- Reduce noise and clutter. Turn off the TV news, keep visitors few, and keep the space familiar.
- Check for hidden discomfort. Pain, constipation, a full bladder, or feeling cold can show up as agitation.
- Respond to feelings, not facts. If they want to "go home," try comfort and reassurance ("You're safe, I'm here") instead of arguing.
- Keep a simple log. Note when episodes happen and what came before them. Patterns often appear.
- Talk to their doctor. A sudden change in behavior can be a sign of infection, such as a urinary tract infection, a medication side effect, or another treatable problem.
Take care of yourself, too
Evenings are often when family caregivers are most tired. Sundowning can lead to sleepless nights for everyone, and that wears down even the most devoted caregiver. Watch for signs of caregiver burnout, and don't wait until you're running on empty to ask for help.
How in-home care can help
A trained caregiver can keep the daily routine steady, plan calming late-day activities, and stay through the evening or night so family members can rest. Ardno provides Alzheimer's and dementia care, overnight care, and respite care in Lowell and nearby towns. Call (978) 479-0499 to talk it through. You may also find our list of activities for seniors with dementia helpful.
This guide is general information, not medical advice. Talk with your loved one's doctor about any new or worsening symptoms.