Caring for a relative with dementia is incredibly tough. You might have a perfectly calm morning, but as the afternoon turns into evening, everything changes. Your loved one might suddenly become very anxious, upset, or agitated. This sudden shift is known as sundowning. It is a very common experience, and understanding what is actually going on gives you the best chance of managing these difficult hours.
What exactly is sundowning?
Sundowning isn’t a specific illness. It is just a word doctors use to describe a pattern of behaviour that flares up later in the day. During the late afternoon, you might notice your relative pacing the room, ignoring what you say, or trying to leave the house. Sometimes they might see or believe things that simply aren’t there. This confusion often stretches into the night and makes sleep very difficult for everyone.
Why does it happen?
Doctors don’t have all the answers just yet, but a mix of physical and environmental triggers usually sets it off.
A major factor is a broken body clock. Dementia damages the parts of the brain controlling sleep. Changing hormone levels throughout the day also play a huge part. Then there is your home environment. As daylight drops, low indoor lighting creates confusing shadows around the living room. To a brain struggling to process visual information, these shadows are genuinely frightening and uneven lighting / window reflections can cause real distress.
Extreme tiredness is another massive trigger. A busy, noisy day leaves a person completely exhausted by late afternoon. On the flip side, sitting around with nothing to do can also spark late-day confusion.
Sometimes, an episode of sundowning is simply your relative trying to tell you they are hungry, thirsty, in pain or they might just need the toilet. Sudden agitation could also point to a medical issue like a urinary tract infection, so it is always worth keeping an eye out for physical symptoms.
Practical ways to help at home
Remember, they aren’t doing this on purpose. They are reacting to a world that suddenly feels threatening. Validating their feelings diffuses tension much faster than correcting their facts. Home is a safe space, particularly for people who are losing their memories and finding day-to-day life confusing and difficult. These tips will help make each day more manageable and hopefully something you can enjoy.
- Keep a steady routine: Waking up, eating, and going to bed at the same time every day provides reassuring structure. Try to get outside into natural light earlier in the day to encourage better sleep later.
- Manage energy levels: Limit daytime naps so they are actually tired at bedtime. Keep caffeine and high-sugar snacks strictly to the mornings.
- Change the room: Before it gets dark outside, close the curtains to block out reflections on the glass. Turn on plenty of bright lights to banish confusing shadows.
- Turn down the noise: Turn off the television. Play some gentle, familiar music instead.
- Check the basics: Make sure they have had enough to drink and are physically comfortable.
If things escalate quickly then you should contact your doctor or healthcare team. They can check for underlying infections or review current medications.
Help and Support
Additional support to understand sundowning more effectively is available from a range of reliable sources including:
- Alzheimer’s Society: The UK’s largest charity dedicated to dementia support. They provide comprehensive clinical guidance, local peer support networks, and practical tools for managing symptoms like sundowning.
- Dementia UK: A charity offering specialist health advice and support for families. They provide expert guidance on managing distress, creating life stories, and improving communication.
- Dementia Adventure: A charity highlighting the benefits of outdoor activities and connecting with nature. They offer a practical guide on managing evening agitation.
At Shirecare, our trained carers can provide dedicated dementia and Alzheimer’s support. We assist with establishing calming routines, gentle redirection, and nutritious meals, working alongside families to ensure a safe and reassuring environment at home.
