Sundowning — increased confusion, agitation, and restlessness in the late afternoon and evening — affects up to 20% of people with Alzheimer's disease and other forms of dementia. For families providing care at home, it can be one of the most challenging and distressing behaviors to manage.
What Causes Sundowning?
The exact cause isn't fully understood, but researchers believe it's related to disruptions in the body's internal clock (circadian rhythm) caused by brain changes from dementia. Contributing factors include fatigue, low lighting, increased shadows, hunger, pain, and overstimulation during the day.
Signs of Sundowning
Sundowning can look different in every person, but common signs include: pacing or wandering, increased confusion or disorientation, agitation or irritability, anxiety or fear, yelling or crying, resistance to care, and attempting to leave the house.
Tips for Managing Sundowning at Home
Keep a consistent daily routine. Predictability reduces anxiety for dementia patients. Meals, activities, and bedtime should happen at the same times each day.
Increase lighting in the late afternoon. As natural light fades, turn on bright, warm lights throughout the home. Shadows and dim lighting can increase confusion and fear.
Limit caffeine and sugar after noon. Both can contribute to restlessness and sleep disruption later in the day.
Encourage physical activity earlier in the day. A morning walk or light exercise can help improve sleep quality and reduce evening restlessness.
Create a calming evening routine. Soft music, gentle activities, a warm drink (decaffeinated), and reduced noise can help ease the transition to evening.
Avoid arguing or correcting. If your loved one is confused about where they are or what time it is, gentle reassurance works better than correction. "You're safe, I'm here with you" is more effective than "It's nighttime, you need to go to bed."
When to Seek Professional Memory Care
If sundowning episodes are becoming frequent, intense, or dangerous — or if family caregivers are becoming exhausted — it may be time to bring in a trained memory care professional. Our caregivers at Sonoran Family Concierge are trained in dementia-specific techniques, including managing sundowning behaviors with patience and compassion.
We serve families throughout Scottsdale, Mesa, Paradise Valley, and the Greater Phoenix Area. Contact us for a free consultation to discuss how memory care can help your family.
