12/08/2026
PART TWO: SUNDOWNING
What Is Sundowning?
Sundowning is a term used to describe changes that can happen in some people with dementia during the late afternoon or evening.
A person may become:
• Confused.
• Anxious.
• Restless.
• Agitated.
• Frightened.
• Disoriented.
They may also repeat questions, pace around the home, want to "go home," or try to leave.
Sundowning is not a disease by itself.
It is a pattern of changes that can happen as the day moves toward evening.
Why Can Sundowning Be Frightening?
Imagine being tired at the end of the day but not understanding why you are tired.
• The room is becoming darker.
• Shadows are changing.
• People are moving around.
• Things may look different.
• You may not know where you are.
• You may not know what time it is.
• You may believe you need to be somewhere else.
That could be frightening.
This helps us understand why a person with dementia may become upset or confused in the evening.
________________________________________
What Might Sundowning Look Like?
A person may:
• Become anxious or frightened.
• Become restless or upset.
• Walk around the home.
• Ask the same questions repeatedly.
• Say they want to go home.
• Try to leave the house.
• Become suspicious of family or caregivers.
• Have difficulty understanding what others are saying.
• Cry, shout or become angry.
• Have difficulty doing something they managed earlier in the day.
• See or hear things that other people do not see or hear.
These behaviors can be very difficult for families and caregivers.
But it is important to remember:
The person may not be trying to be difficult.
They may be confused, frightened, tired or overwhelmed.
Their behavior may be their way of communicating something they cannot explain with words.
Why Does Sundowning Happen?
There is not just one reason why sundowning happens.
Several things may contribute.
1. Tiredness
After a full day, the person may simply be tired.
Dementia can also make it harder to deal with conversation, noise and activities as the day goes on.
2. Changes in the Body Clock
Dementia can affect the body's natural sleep and wake cycle.
The person may have difficulty telling the difference between daytime and nighttime.
3. Darkness and Shadows
As daylight disappears, shadows become longer.
Familiar objects may suddenly look different.
A coat on a chair might look like a person.
A reflection in a window might look frightening.
A dark hallway may seem unfamiliar.
Good lighting can sometimes help.
4. Too Much Noise or Activity
Television, loud conversations, visitors and household noise may become too much for the person later in the day.
Something they could handle in the morning may be overwhelming in the evening.
5. Too Little Activity
Having very little to do during the day can also contribute to restlessness.
Finding the right balance between activity and rest is important.
6. Basic Needs
Sometimes a person is trying to communicate that something is wrong.
They may be:
• Hungry.
• Thirsty.
• Tired.
• In pain.
• Uncomfortable.
• Needing to use the bathroom.
• Experiencing another health problem.
A sudden or major change in confusion or behavior should not automatically be blamed on sundowning. A healthcare professional should check for possible medical causes.
________________________________________
Preparing for the Evening
One helpful approach is to prepare before sundowning begins.
For example, if the person usually becomes confused around 5:00 p.m., begin preparing around 4:00 p.m.
You might:
• Turn on the lights.
• Close the curtains.
• Reduce unnecessary noise.
• Offer a familiar activity.
• Prepare supper.
• Create a calm environment.
The idea is to get ahead of the confusion instead of waiting until it begins.
________________________________________
Simple Things That May Help
Keep the Home Well Lit
Turn on lights before the room becomes dark.
This can help reduce shadows and make familiar objects easier to recognize.
Close Curtains or Blinds
Closing curtains as evening approaches can reduce confusing reflections and shadows.
Reduce Noise
Turn down the television.
Try not to have several people talking at the same time.
Save complicated activities for earlier in the day when possible.
Use Familiar Music
Soft, familiar music can be comforting.
Music from a person's younger years may bring back pleasant memories and provide a feeling of familiarity.
Look at Photographs
Looking through photographs can be a pleasant activity.
You do not have to ask:
"Who is this?"
Instead, you could simply say:
"Look at this picture. What a beautiful day that was."
There is no test.
There is simply a conversation.
________________________________________
Communication: Focus on Feelings
When someone with dementia says something that is not factually correct, it can be tempting to correct them.
But correcting them over and over may increase their frustration.
Instead, try to understand what they are feeling.
For example:
Person:
"I have to go to work."
Caregiver:
"You don't have to go anywhere right now. You're safe here. Let's sit down and have a cup of tea."
The goal is not always to prove what is correct.
The goal is to help the person feel safe.
________________________________________
When Someone Says, "I Want to Go Home"
This can be very difficult for a caregiver.
Our first response might be:
"But you are already home."
However, "home" may mean much more than a building.
It may mean:
• Safety.
• Familiarity.
• Their parents.
• Their spouse.
• Their childhood.
• An earlier home.
• A time in their life when they felt safe and secure.
Instead of arguing about where "home" is, try responding to the feeling.
You might say:
"You want to go somewhere familiar. I understand. You're safe here with me."
Then gently change the subject.
"Let's sit down for a while. Would you like some tea?"
This does not mean agreeing with something that is not true.
It means responding to the feeling behind the words.
________________________________________
A Simple Evening Routine
Every person is different, but a simple evening routine might look like this.
Late Afternoon
• Turn on the lights.
• Close the curtains.
• Offer a drink or snack if appropriate.
• Play calming music.
• Reduce unnecessary noise.
• Offer a familiar activity.
Dinner
• Keep the meal familiar and simple.
• Give the person plenty of time to eat.
• Keep conversation relaxed.
After Dinner
• Look through photographs.
• Listen to familiar music.
• Watch a favorite television program.
• Fold towels or do another simple activity.
• Take a short, safe walk if appropriate.
Bedtime
• Keep pathways safely lit.
• Follow the same personal-care routine.
• Use familiar words and reassurance.
• Keep the bedroom comfortable and quiet.
The purpose is not to fill every minute.
The purpose is to create a predictable rhythm that helps the person feel secure.
________________________________________
Safety Is Important
Sundowning can sometimes include pacing or wandering.
If a person wants to walk and can do so safely, walking may be better than trying to physically stop them.
Make sure:
• Walkways are clear.
• Tripping hazards are removed.
• Doors and exits are appropriately secured.
• Lighting is good.
• The person receives the supervision they need.
• Important contact information is easy to find.
Physical restraint should not be used simply because someone is restless.
If there is a risk that the person may leave the home and become lost, additional safety planning may be needed.
________________________________________
Keep a Sundowning Journal
One of the most useful things a caregiver can do is keep simple notes.
For several days, write down:
• What time did it start?
• What happened before it started?
• What did the person eat or drink?
• Did they have a nap?
• Were there visitors?
• Was the television on?
• Was the room becoming dark?
• Did they complain about pain or discomfort?
• What helped?
Over time, you may begin to notice patterns.
For example:
• The person may become restless every day around 4:30 p.m.
• An evening bath may make things worse.
• A short afternoon walk may help.
• Turning on the lights earlier may make the transition into evening easier.
Every person is different.
What works for one person may not work for another.
________________________________________
And What About the Clock?
Perhaps the biggest lesson is that time can mean something different to each of us.
For most of our lives, we organize our lives around time.
We go to school.
We go to work.
We raise families.
We attend appointments.
We celebrate birthdays.
We retire.
We watch our children and grandchildren grow.
Then, for some people living with dementia, the clock that once helped organize their lives may no longer make sense.
That does not mean their life has lost meaning.
It means we may need to change the way we communicate time.
Instead of asking the person to understand the clock, perhaps we can become their clock.
We can provide the cues.
We can provide the routine.
We can provide the reassurance.
We can say:
"Good morning."
"It's time for breakfast."
"Let's go for a walk."
"It's almost supper time."
"The day is coming to an end."
"You're safe. I'm here with you."
________________________________________
The Most Important Thing About Time
We cannot stop time.
We cannot turn the clock backward.
We cannot bring yesterday back.
But we can decide what we do with today.
For someone living with dementia, a five-minute conversation may mean more than we realize.
It might be:
• A cup of tea.
• A favorite song.
• Looking at an old photograph.
• Holding someone's hand.
• Sitting quietly together.
• A smile.
• A little patience.
These moments may seem small to us.
But to someone living with dementia, feeling safe, respected and cared for may be more important than knowing what time it is.
Perhaps that is the real meaning of time.
We don't always need to know what time it is.
Sometimes, we simply need to make the time we have meaningful.
________________________________________
A Final Thought for Families and Caregivers
Sundowning can be exhausting, frustrating and sometimes frightening—for both the person living with dementia and the person providing care.
Remember that you are human too.
You cannot control every behavior.
You cannot fix dementia.
You do not have to have all the answers.
Sometimes the best thing you can offer is:
Patience.
Reassurance.
A calm environment.
And your presence.
When memory and time become confusing, the feeling of kindness and safety may remain long after the details are forgotten.
Sometimes, making a moment meaningful is more important than knowing what time it is.
