Tips to Manage Sundowning

Sundowning is a common experience for people living with dementia, where confusion, agitation or anxiety tends to increase in the late afternoon and evening. It can be challenging for both the individual and their loved ones, especially when it disrupts routines or sleep patterns. Understanding how to manage sundowning effectively can help create a calmer, more reassuring environment.

In this article, we’ll share practical tips to help reduce the effects of sundowning and support your loved one with compassion and care, while promoting comfort and safety at home.

What is sundowning in dementia?

Sundowning refers to a pattern of increased confusion, restlessness or agitation that typically occurs during the late afternoon, evening or night. It’s most commonly associated with dementia, particularly Alzheimer’s disease, though it can also affect individuals with other cognitive conditions.

While the exact cause isn’t fully understood, sundowning is thought to be linked to changes in the body’s internal clock (circadian rhythm), fatigue and reduced light levels as the day ends. For some, it may also be triggered by unmet needs such as hunger, pain or boredom that become harder to express later in the day.

Recognising the signs of sundowning is the first step in managing it. These may include pacing, irritability, mood swings, confusion or difficulty sleeping. With the right strategies in place, it’s possible to ease these symptoms and help your loved one feel more secure and settled in the evenings.

Recognising the triggers

Sundowning can be influenced by a range of environmental and emotional factors. Often, it’s not just one cause, but a combination of subtle changes that build up over the day.

Common triggers include changes in routine, unfamiliar surroundings or increased noise levels. As the day progresses, tiredness and sensory overload can make it harder for someone with dementia to process what’s happening around them. Dimming light in the afternoon and early evening can also contribute, as shadows or reduced visibility may heighten confusion or anxiety.

Even small shifts – like a missed meal, an unexpected visitor or a delayed nap – can unsettle someone who relies on consistency. Paying attention to when and where symptoms appear can help you identify patterns, so you can adjust the environment or routine accordingly.

How to manage sundowning behaviour

While sundowning can be distressing, there are simple, practical steps that can help reduce its impact and create a sense of calm and reassurance in the evenings. These techniques focus on promoting comfort, consistency and a peaceful environment:

• Keep routines consistent
  Stick to regular times for meals, activities and bedtime. Predictability can be grounding for someone with dementia and helps reduce confusion.
• Limit daytime naps
  Too much daytime sleep can disrupt the body’s natural sleep-wake cycle. Encourage gentle activity and exposure to natural light during the day to support better rest at night.
• Use soft, ambient lighting
  As daylight fades, switch on warm, gentle lights to reduce shadows and keep the home well-lit. Avoid harsh lighting or complete darkness, which can increase disorientation.
• Reduce noise and stimulation in the evening
  Turn off loud TVs or radios, limit visitors and avoid busy or cluttered spaces during late afternoon and evening hours. A quieter space can help ease agitation.
• Create a calming wind-down routine
  Gentle activities like listening to soothing music, reading together or enjoying a cup of herbal tea can help signal that it’s time to relax.
• Keep surroundings familiar
  Try not to rearrange furniture or introduce new décor. Familiar objects, photos or soft blankets can provide comfort and a sense of security.
• Reassure and stay patient
  If confusion or agitation arises, respond calmly and with reassurance. A gentle tone, comforting touch and familiar words can go a long way in helping your loved one feel safe.

Building a consistent daily routine

If sundowning becomes increasingly difficult to manage at home or starts to affect your loved one’s safety and well-being, it may be time to consider additional support. While some changes can be managed with routine and environment, others may require professional input.

A GP or dementia specialist can help rule out any underlying medical issues, such as infections or medication side effects, that could be contributing to behaviour changes. In some cases, they may recommend tailored therapies or adjustments to care plans.

Home care services can also provide valuable support. Having a trained carer on hand during the late afternoon and evening can ease the pressure on family members and offer reassurance during more challenging times of the day. Whether it’s help with calming routines, companionship or overnight care, the right support can make all the difference.

Encouraging gentle activity and reassurance

When sundowning symptoms appear, gentle, familiar activities can help reduce agitation and provide a sense of comfort. The aim is to soothe, not stimulate – offering connection and calm without overwhelming the senses.

• Try gentle, everyday activities
  Folding laundry, setting the table or sorting items by colour can provide a sense of purpose without requiring too much concentration.
• Play soft, calming music
  Music has a powerful effect on mood. Choose familiar tunes or gentle instrumental playlists to create a soothing background atmosphere.
• Engage in quiet conversation
  Speaking in a calm, reassuring tone – even about simple, pleasant memories – can help reduce anxiety. If your loved one is upset or confused, respond with empathy and patience.
• Try sensory comforts
  A warm blanket, a softly lit room or a favourite scent (like lavender) can offer grounding sensory cues that promote relaxation.
• Avoid overstimulation
  Steer clear of bright screens, loud noise or fast-paced activities in the late afternoon and evening. A low-stimulation environment can help ease transitions into bedtime.

Creating a peaceful, predictable atmosphere – paired with emotional reassurance – can go a long way in supporting your loved one through sundowning episodes.

When to seek extra support

While many families manage sundowning at home through routine and reassurance, there may come a time when additional support is needed – especially if symptoms worsen or become too challenging to handle alone.

If your loved one’s behaviour begins to impact their safety or well-being, professional help can make a real difference. Whether it’s due to advancing dementia, a change in health or simply caregiver fatigue, bringing in experienced support can offer much-needed relief and peace of mind.

Services like postoperative care or live-in care provide consistent, one-to-one support from trained carers who understand how to respond calmly and compassionately to sundowning behaviours. With their experience, they can help manage more complex needs while creating a reassuring presence in the home – especially during the more unsettled hours of late afternoon and evening.

If you’re feeling unsure about next steps, a conversation with a care provider can help you explore your options and find a level of support that fits your family’s needs.

Dementia care at home

At Trinity Homecare, we understand that a dementia diagnosis can be overwhelming. We offer ‘Outstanding’ rated dementia care in the comfort of your own home. Studies show that 85% of people prefer to stay in their familiar surroundings, and we’re committed to making that possible.

With professional care tailored to your loved one’s needs, we help them enjoy a happy and fulfilling life while staying at home. For more details on how Trinity Homecare can support you, explore our live-in dementia care guide and discover the compassionate care your family deserves.

Talk to us today

At Trinity Homecare, our ultimate goal is to enrich your lifestyle in the comfort and familiarity of your own home. This allows you to live the independent lifestyle that you love without the daunting thought of moving into a care home. We are here to support you with various different forms of home care.

Call us now on 0207 183 4884 in confidence for a free, no obligation quotation. If enquiring outside of our opening hours, please complete our online form and we will contact you the next day.