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Sundowning: what helps when dementia gets harder in the evening
Around 1 in 5 people with dementia experience 'sundowning' โ confusion, restlessness or distress in the late afternoon and evening. It almost always responds to small, boring, repeated changes.
What helps
- Turn lights on before dusk โ close the blinds, switch on lamps, keep the room evenly lit. The transition from light to dark is the trigger more often than the dark itself.
- Move the demanding parts of the day (bath, big meal, visitors) to before lunch.
- Cut caffeine after midday, including tea. Even decaf affects some people.
- Keep an early, light dinner and a quiet wind-down hour. No TV news in the background.
- If they're pacing, walk with them rather than blocking them โ five minutes of company resets most episodes.
- Watch for pain, hunger, thirst, needing the loo, or a wet pad. Many sundowning episodes are unmet needs without words.
- Rule out a UTI if it starts suddenly โ same-day GP appointment. UTIs cause dramatic confusion in older adults.
What tends to make it worse
- Arguing with the false belief ('the children are coming') โ agree, redirect, then change the subject.
- Trying to do anything new or unfamiliar after 4pm.
- Long visits from grandchildren in the late afternoon โ lovely in theory, exhausting in practice.
- Long naps after 3pm. Short rests before lunch are fine.