Guide · 5 min read

Sundowning: what helps when dementia gets harder in the evening

Around 1 in 5 people with dementia experience 'sundowning' — 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 — 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 (shower, big meal, visitors) to before lunch.
Cut caffeine after midday, including iced tea. Even decaf affects some people.
Keep an early, light dinner and a quiet wind-down hour. No cable news in the background.
If they're pacing, walk with them rather than blocking them — five minutes of company resets most episodes.
Watch for pain, hunger, thirst, needing the bathroom, or a wet brief. Many sundowning episodes are unmet needs without words.
Rule out a UTI if it starts suddenly — same-day PCP appointment or urgent care. UTIs cause dramatic confusion in older adults.

What tends to make it worse

Arguing with the false belief ('the kids are coming') — agree, redirect, then change the subject.
Trying to do anything new or unfamiliar after 4pm.
Long visits from grandchildren in the late afternoon — lovely in theory, exhausting in practice.
Long naps after 3pm. Short rests before lunch are fine.