Tips for Addressing Sundowning

September 5, 2016
Agitation among people with dementia may worsen near sundown. (Image courtesy of Sura Nualpradid/

Agitation among people with dementia may worsen near sundown. (Image courtesy of Sura Nualpradid/

As those who care for a person with dementia know, sundowning can be an issue. Following the tips below can help to address this common occurrence among people with dementia.

What is Sundowning?

The term “sundowning” (sometimes called “sundowners syndrome” or “late day confusion”) generally refers to the fact that many people with mid or late stage dementia frequently become more disturbed late in the afternoon or in the evening. They may become more confused, their anxiety levels may rise, and they may experience a marked increase in agitation and in behaviors that accompany confusion, anxiety, and agitation. Exactly why this occurs so frequently is not known, although it seems that issues like fatigue and a disruption in the body’s internal clock may play a role.

Tips to Manage Sundowning

Many professionals recommend the following to help manage sundowning.

  • Stay on schedule. It can be very difficult to establish and maintain routines with a person with dementia, but sticking as closely as possible to a set routine can be a big help in reducing sundowning. Unfamiliar circumstances can create confusion and anxiety in a person with dementia.
  • Work to encourage a good night’s sleep. People with dementia generally do better when they experience a restful night’s sleep. Factors that can impact this include lengthy daytime naps, taking in sugar and caffeine after lunch, and not getting enough sunshine and activity during the day.
  • Observe dietary effects. Some people react strongly to certain elements in their diets. Keeping a diary of foods served and subsequent moods/behaviors experienced can help to identify foods that may be causing disturbances.
  • Use lighting. Many believe that sundowning is a direct reaction to the natural diminishment of light. Try turning on lights in the house as sundown nears and keeping things brightly lit. As bedtime nears, reducing the lighting may help to transition into a proper sleep mode.
  • Limit evening stimulation. Reducing the amount of loud or distracting noise and limiting stimulating activities (including television viewing) can help to reduce agitation in many people with dementia. Many also respond positively to the sound of soft, gentle music or to recordings of natural sounds, such as leaves rustling or waves breaking on the shore.

As always, it is recommended that any issues with sundowning be discussed with the doctor who is treating the dementia. He or she may suggest some specific strategies to try.

Jason Sager

We hope this was helpful. If you have any questions or if you know of a senior who could benefit from our vast array of home care services in Fairfax Annandale, please call us at 703.750.6644 or email us. We work with most long term care insurance companies as well as Veterans Affairs, and Workers' Compensation.

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