When the sun goes down
Sundowning is a common and challenging phenomenon that many caregivers face when caring for seniors, especially those with dementia. As the day transitions into evening, some individuals experience increased confusion, anxiety, and agitation. Understanding sundowning and knowing how to manage its effects can greatly improve the quality of life for both the person experiencing it and their caregivers
While sundowning is most commonly associated with Alzheimer’s disease and other forms of dementia, it can also affect older adults without cognitive impairments.
Signs and Symptoms:
Increased confusion or disorientation
Agitation or irritability
Restlessness or pacing
Anxiety or fearfulness
Mood swings
Difficulty following instructions or communicating
Hallucinations or delusions
These symptoms can vary in intensity from person to person and may not occur every evening.
What Causes Sundowning? While the exact cause of sundowning is not fully understood, several factors are believed to contribute to it:
Circadian Rhythm Disruption: As we age, the body’s internal clock, which regulates sleep-wake cycles, can become less effective. This disruption may lead to confusion and agitation as evening approaches.
Fatigue: After a long day, individuals with dementia may become more tired, which can exacerbate feelings of confusion and frustration.
Low Light: The transition from daylight to darkness can create shadows and reduced visibility, which may cause confusion or fear.
Overstimulation: The accumulation of sensory input throughout the day can overwhelm some seniors, leading to agitation by evening.
Hunger or Dehydration: Skipping meals or not drinking enough water can contribute to irritability and confusion.
Managing Sundowning: If you’re caring for someone who experiences sundowning, here are some strategies that can help reduce its impact:
Establish a Consistent Routine: Maintaining a regular daily schedule can provide a sense of stability and reduce anxiety. Try to keep mealtimes, activities, and bedtime consistent. We can show you how at
Promote Daytime Activity: Encourage physical activity and exposure to natural light during the day. This can help regulate the sleep-wake cycle and promote better sleep at night.
Create a Calm Evening Environment: As evening approaches, minimize noise and activity. Soft lighting, soothing music, and a peaceful atmosphere can help ease the transition into night.
Limit Naps and Caffeine: While naps can be beneficial, limit them to short periods and avoid late-afternoon naps. Additionally, reduce or eliminate caffeine intake in the afternoon and evening.
Simplify the Environment: Remove potential sources of confusion, such as clutter or unfamiliar objects. Familiar surroundings can provide comfort and reduce anxiety.
Provide Reassurance: During episodes of sundowning, offer gentle reassurance. A calm, soothing voice and a comforting touch can help alleviate feelings of fear or confusion.
Consider Light Therapy: Bright light exposure during the day, or the use of light therapy boxes, may help regulate circadian rhythms and reduce sundowning symptoms.
Monitor Diet: Ensure your loved one eats regular meals and stays hydrated throughout the day. A light, healthy snack in the evening can also help.
Consult a Healthcare Professional: If sundowning becomes particularly disruptive, speak with a healthcare provider. They can offer additional advice or suggest medications that may help manage symptoms.
Sundowning can be a distressing experience for both caregivers and those they care for, but with understanding and the right strategies, its impact can be lessened. By creating a calm, structured environment and providing consistent care, caregivers can help their loved ones navigate the challenges of sundowning, ensuring a more peaceful end to each day for everyone. You learn more about Sundowing at
