What to Do When Sundowning Starts
Sundowning is the name for restlessness, agitation, irritability, and confusion that begin or worsen as daylight fades, and the practical response starts hours before the hard part of the evening.
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When it starts, keep it simple: bright lamps, a quiet room, a calm voice, and stay with them.
Sundowning names a pattern in the day, not a separate condition. The Alzheimer’s Association describes it as increased confusion that people living with Alzheimer’s and other dementias can experience from dusk through the night.
It follows the fading light more than the clock, so it can shift with the seasons and with how bright the room is. In winter, when it gets dark earlier, the harder part of the day may start earlier too.
Once it has started, the simplest steps help most. The four below don’t ask you to have the right answer, only to keep things calm. If the last one is the hardest, there’s more on how to talk to someone with dementia. For the wider picture of what a day at home can look like, start with dementia care at home.
- Light
Turn the lamps on before the light goes, and keep the room bright.
Letting the room grow dim as the afternoon fades.
- Noise
Keep things quiet. One conversation, one thing on, or nothing on.
The television, a phone call and visitors all at once.
- Voice
Speak calmly and slowly. Your pace helps set the pace of the room.
Raising your voice to be heard.
- Belief
Go along with what the person believes is happening, without arguing.
Correcting them, or trying to win the point.
What helps earlier in the day
Much of what helps with sundowning happens hours before it. The National Institute on Aging suggests a short list of ordinary daily habits, and four of them are a good place to start.
They’re worth trying together, because they share one aim: that your mother or father isn’t overtired by the time the light goes.
Being overly tired
The institute names being overly tired as something that can increase restlessness in the late afternoon and early evening. So it helps to look at the whole day: how early it started, how full it was, and whether there was some quiet time before the evening.
Long and late naps
Discouraging long naps and dozing late in the day is on the same list. A rest earlier in the day is usually the better choice.
Caffeine and alcohol, late
Avoiding alcoholic drinks and caffeinated beverages such as coffee or cola late in the day is advised. The afternoon cup is easy to overlook because it has been part of the routine for so long.
Daylight, on purpose
Arranging a time each day to go outside or sit by a window is recommended. A short walk or a chair by the window both count.
Setting the room up before the light goes
Low lighting increases shadows, and the Alzheimer's Association notes that those shadows may cause a person living with dementia to become confused by what they see. So keeping the home well lit in the evening is one of the steps it suggests. It helps to have the room bright before the evening starts, rather than adding light later.
In most houses that means turning on more than feels necessary, and turning it on while there is still daylight in the window, so the room stays the same as the light outside drops. Corners are easy to miss: a single overhead light can leave the edges of a room in shadow.
When to call the doctor, and help in the evenings
Mention new, sudden or quickly worsening confusion to the doctor promptly, because changes like that can have other causes, some of which a doctor can treat. If anyone is in immediate danger, call 911.
15 minutesIf restlessness ever leads to someone walking off, the Alzheimer’s Association advises calling 911 to file a missing person report if the person isn’t found within 15 minutes. It’s worth agreeing a plan ahead of time, and dementia wandering and how to prevent it covers the practical steps.
Late afternoon is often when one person is doing everything at once. A caregiver can be scheduled for the end of the day: keeping your mother or father company, helping with dinner, keeping the routine steady and keeping an eye on things, so you aren’t managing that part of the day alone. To see what a regular evening schedule can look like, read about in home dementia care.
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Questions families ask
What is sundowning?
Sundowning is restlessness, agitation, irritability, and confusion that begin or worsen as daylight fades in the late afternoon and evening. In the moment, keep the room well lit, lower noise, stay calm, and avoid arguing with what the person believes. During the day, protect against overtiredness, discourage long late naps, and skip caffeine and alcohol later on. Persistent or worsening changes belong in a call to the doctor.
What time does sundowning usually start?
It tracks fading daylight rather than a fixed clock time, so it often begins in the late afternoon or early evening and can continue into the night. The Alzheimer's Association describes it as increased confusion from dusk through night, which is why the season and the room's lighting both matter.
Does more light in the evening actually help?
It can. Low lighting increases shadows, which may cause a person living with dementia to become confused by what they see, so keeping the home well lit in the evening is a recommended step. Daytime light matters too: arranging time outside or by a window is advised as part of preventing sundowning.
When should we call the doctor about sundowning?
Raise new, sudden, or worsening confusion with the physician promptly, since changes can have causes unrelated to dementia. If a person who has wandered is not found within 15 minutes, the Alzheimer's Association advises calling 911 to file a missing person report. Any immediate danger to the person or others is a 911 call.
Would help in the evenings make a difference?
Tell us when the day starts to feel harder and what usually helps. We’ll talk through how a caregiver could help in the late afternoon and evening. Daily-living care across Connecticut and New Jersey, and companion care in New York, from an agency registered with the state. The first conversation is free, and nothing starts until you say so.