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Sundowning (changes in behaviour at dusk)

Sundowning is a term used for changes in behaviour that occur in the evening, around dusk. Some people who have dementia experience a growing sense of agitation or anxiety at this time. 

Sundowning often makes the person with dementia feel very strongly that they are in the wrong place. They might say they need to go home, even if they are at home, or that they need to pick the children up from school, even if they’re now adults. Other symptoms might include shouting or arguing, pacing, or becoming confused about who people are or what’s going on around them. 

Sundowning has several causes. As the day goes on, the person with dementia becomes more tired, and this can lead to their dementia symptoms worsening. Hunger, thirst and physical pain can also play a part.  

As darkness falls, streetlights come on and people settle in for the evening. These changes can make the person increasingly concerned that they are in the wrong place, or that they have forgotten to do something vital during the day. 

  • Use distraction techniques: go into a different room, make the person a drink, have a snack, turn some music on, or go out for a walk 
  • Ask them what the matter is. Listen carefully to their response and if possible, see if you can deal with the reason for their distress 
  • Talk in a slow, soothing way 
  • Speak in short sentences and give simple instructions to try to avoid confusion 
  • Hold the person’s hand or sit close to them and stroke their arm 
  • Follow a daytime routine that contains activities the person enjoys, like going for a gentle walk or visiting the shops 
  • Try to limit their intake of caffeinated and alcoholic drinks. Instead, offer them caffeine-free tea, coffee and cola, or alcohol-free beer or wineYou might want them to consider stopping drinking alcohol altogether 
  • Try to limit daytime naps to encourage them to sleep well at night 
  • Close the curtains and turn the lights on before dusk to ease the transition into nighttime 
  • If possible, cover mirrors, windows and glass doors with a towel, sheet or curtain. Reflections can be confusing for people with dementia 
  • Avoid large meals in the evening as this can disrupt sleep patterns 
  • Introduce an evening routine with activities the person enjoys, such as watching a favourite programme, listening to music, stroking a pet etc. However, try to keep television or radio stations set to something calming and quiet – sudden loud noises like shouting can be distressing for a person with dementia 

If you need advice on any aspect of dementia, please call our free Dementia Helpline on 0800 888 6678 (Monday-Friday 9am-9pm, Saturday and Sunday 9am-5pm, every day except 25th December), email or you can also book a phone or virtual appointment with an Admiral Nurse.

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