7 Ways to Reduce Dementia Sundowning Symptoms

As daylight softens and evening approaches, you might notice a troubling shift in an older adult living with dementia. Restlessness, confusion, or agitation can replace the day's relative calm—a phenomenon known as sundowning.

This transition can be one of the most challenging parts of the day, leaving you feeling helpless and searching for answers. But what if you could transform these difficult hours into a more peaceful time for everyone?

The good news is that with a few thoughtful strategies, you can. Here are seven practical ways to reduce sundowning symptoms and restore a sense of calm to your evening routine.

Many people with Alzheimer's disease or dementia get increasingly confused, anxious, and agitated later in the day. Others may have disrupted sleep schedules or restlessness at night.

These sundowning symptoms are disruptive and challenging to manage. They’re also stressful and negatively affect your loved one's quality of life.

What is Sundowning and What Causes It?

Sundowning is a phenomenon where individuals with dementia or other cognitive impairments experience increased confusion, agitation, and other behavioral changes in the late afternoon or evening. It's also known as “sundown syndrome,” interestingly enough.

This behavior tends to happen in the late afternoon or evening, which is why it's often called “sundowning.”

Some studies say that sundowning affects up to 20% of people with Alzheimer’s. And, it can also affect older people who don’t have dementia.

Scientists don’t know precisely why sundowning occurs, but they think changes in the brain cause it.

Their body clock, which regulates when we’re awake and when we’re asleep, might be affected by these changes.

What are the Top Sundowning Symptoms

A Loved One Might Feel:

• Agitated, upset, or anxious
• Confused or disoriented
• Restless
• Irritable or demanding
• Suspicious

They might show it by:

• Getting angry or yelling
• Pacing the room
• Seeing or hearing things that aren’t there
• Having mood swings

VIDEO: How to Reduce Sundowning Symptoms in Seniors

7 ways to Reduce and Manage Sundowning Symptoms

1. Track behavior and look for patterns

To reduce sundowning behavior, the first step is to identify your older adult’s biggest triggers—the things most likely to upset or agitate them.

Use a caregiving notebook to track their behavior and activities.

Write down your older adult’s daily routine and any symptoms you notice. Please pay special attention in the few hours before their sundowning usually starts.

After a few days, you’ll be able to spot clues that tell you which activities, environments, or needs are triggering their behavior or making symptoms worse.

Knowing their triggers helps you avoid or minimize them.

2. Make Sure Basic Needs are Taken Care Of

One or two hours before their symptoms usually start, check to make sure their basic needs are met.

Don’t wait for them to ask – they may not be aware enough or able to express their needs adequately.

Sundowning is more likely to happen when someone is:

• End-of-day exhaustion (mental and physical)
• Feeling pain or discomfort
• In need of the toilet
• Hungry or thirsty
• Bored
• Depressed
• Too hot or cold
• Having trouble sleeping

For example, you could make sure they eat a snack and drink some water at 2:30 pm, use the toilet every hour or two starting at 3 pm, or time their pain medication so it kicks in by 4 or 5 pm.

3. Minimize Noise, Distractions, and Shadows

Helping your older adult feel calm and safe will reduce sundowning behavior that’s triggered by overstimulation or fear.

As daylight fades, shadows or dim lighting can play tricks on their eyes and minds, causing fear or anxiety.

Increase feelings of safety by closing curtains and blinds before the sun starts setting so they won’t see reflections or shadows from outside. Turn on plenty of lights to eliminate scary shadows or dark corners.

It’s also essential to keep them calm by limiting noise and distractions.

For example, turn off the TV, lower the music volume, and don’t have visitors over. This is also a time to avoid activities that might upset or tire you, like bathing.

If there are others in the house, move the children to another room and ask people to be very quiet. Also, avoid noisy chores like vacuuming.

4. Be Mindful of Your Own Stress Level

After a long day, you might be frustrated, cranky, and exhausted by afternoon (it’s only natural!).

Even if it’s not apparent, people with dementia may be able to sense it. They’re often more sensitive to body language and tone of voice.

Picking up on your stress could cause your older adult to become “sympathetically” stressed, leading to an increase in agitation and anxiety.

To reduce your own stress, try coping tips like taking mini-breaks during the day, getting regular help, or taking a 2-minute stress-relief break 30 minutes before your symptoms usually start. (Get more stress relief tips here.)

5. Establish a Daily Routine

Sticking to a regular daily routine reduces stress, increases the feeling of security, and improves sleep.

All of that helps reduce sundowning symptoms.

Set regular times for waking up, meals, and going to sleep.

Schedule appointments, outings, visitors, and bath time in the earlier part of the day, when they’re likely to feel their best.

6. Create a Relaxing Environment

Creating an older adult’s environment as calm and soothing as possible in the late afternoon gives you a head start on reducing agitation and anxiety.

For example, you could play soothing music at a low volume or use aromatherapy to lightly scent the room with lavender.

7. Improve Nighttime Sleep Quality

Having dementia is exhausting, even if your older adult doesn’t do much. That’s why they may want to rest often during the day.

However, excessive daytime napping can make it difficult to sleep through the night —a top challenge for many caregivers.

Poor nighttime sleep can also worsen daytime fatigue, creating a negative cycle that intensifies sundowning symptoms.

Structure their daily routine to minimize afternoon naps. If a nap is needed, make it earlier in the afternoon and keep it brief.

Earlier in the day, encourage gentle daily exercise—it’s a great way to improve sleep quality.

In the evening, limit or avoid stimulants like heavy meals, smoking, caffeine, sugar, chocolate, or alcohol.

To improve their sleep, you might also try a weighted blanket, white noise machine, aromatherapy, or experimenting to find the most comfortable room temperature.

Final Thoughts About Sundowning

Managing sundowning is less about finding a single magic solution and more about building a compassionate, consistent toolkit of strategies that work for your unique situation.

By experimenting with these seven approaches—from harnessing the power of light to creating a serene environment—you are not just reacting to symptoms; you are proactively laying the foundation for better evenings.

Remember, even one small change that brings a moment of peace is a significant victory. Be patient with yourself and your loved one; you are both navigating this journey together, and every step toward calm is a testament to your care and dedication.

Recommended for you:

• Why a Daily Routine Is Important for Seniors
• 8 Coping Tips for Dementia Sundowning and Sleep Issues
• 2 Ways to Solve Senior Sleep Problems So You Can Finally Get Some Rest

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