Understanding Sundowning in Dementia: A Guide for Carers and Families
- amycourtspooner
- Nov 3
- 2 min read
Caring for someone with dementia can bring many challenges, and one that can be particularly distressing is sundowning. This term describes changes in behaviour that often appear in the late afternoon or evening. Not everyone with dementia will experience it, but for those who do, sundowning can cause confusion, anxiety, and agitation.
What to look for: Signs of Sundowning
Carers and family members may notice that as the day goes on, the person with dementia begins to:
Become more confused or disoriented than earlier in the day
Show increased restlessness, such as pacing or wandering.
Appear more irritable, anxious, or distressed.
Experience sudden mood swings or anger
Struggle with hallucinations or delusions in some cases
Have more difficulty settling down to sleep
These behaviours are usually most noticeable from late afternoon through to bedtime, though the exact timing can vary.
Why does Sundowning Happen?
The exact cause is not fully understood, but possible factors include:
Fatigue after the demands of the day
Disruption to the body’s internal “body clock”
Low light and shadows increasing confusion
Hunger, thirst, or pain that is harder to express.
Underlying infections or side effects of medication (these should always be ruled out with a GP)
Strategies for Managing Sundowning
Although sundowning can be distressing, there are ways to reduce its impact and make evenings calmer:
Create a predictable routine: Consistency with meals, activities, and bedtime can help reduce anxiety.
Maximise natural daylight: Exposure to sunlight in the morning and during the day helps regulate body rhythms.
Encourage rest breaks: Short naps or quiet time earlier in the day can reduce late-day fatigue.
Keep evenings calm: Lower noise, dim bright lights gradually, and avoid over-stimulating TV or activities.
Offer comfort and reassurance: A calm voice, gentle touch, or familiar object (such as a favourite blanket) can ease distress.
Check for unmet needs: Make sure they are not hungry, thirsty, too hot or cold, or in pain.
Use soft lighting: Reducing shadows with lamps or nightlights can prevent confusion.
Stay active during the day: Gentle exercise or enjoyable activities earlier in the day can improve sleep at night.
Supporting Yourself as a Carer
Sundowning can be tiring and emotionally draining. It’s important to:
Take breaks when you can, and ask for support from friends, family, or local respite services.
Share experiences with other carers, as peer support can reduce feelings of isolation.
Seek advice from healthcare professionals if sundowning becomes unmanageable or suddenly worsens.
Sundowning can be unsettling, but with patience, observation, and supportive strategies, its impact can often be reduced. Remember that you’re not alone, support is available, and small changes in routine and environment can make a big difference.
