What do we mean by 'Sundowning'? How to support someone living with dementia during tougher times

For some people living with dementia, late afternoon and evening can bring about feelings of confusion, anxiety, or restlessness. This experience is often known as sundowning. It tends to happen around dusk and can sometimes become more noticeable when the clocks change for daylight saving time, making it even harder to adjust.

During these times, a person might feel uncertain about where they are, who they’re with, or what’s happening around them. For instance, they may express a longing to "go home" — even when they are already at home. In these moments, "home" often represents a deep need for comfort, safety, or familiarity, rather than a physical place.

Photo by Folco Masi on Unsplash

Why Might Sundowning Happen?

Although we don’t yet fully understand why sundowning occurs, several factors may contribute to these feelings:

• Changes in the person’s internal body clock brought on by dementia

• Feelings of tiredness or exhaustion as the day goes on

• Hunger, thirst, or physical discomfort

• A day that has lacked meaningful activity or structure

• Feeling overstimulated after a busy or noisy environment

• Not having enough exposure to natural daylight

• Natural hormonal changes that happen towards the evening

• Side effects of medications
  

Each person’s experience is unique, and often it’s a combination of these elements that makes evenings feel more difficult.

Can We Help Prevent Sundowning?

While it may not always be possible to prevent sundowning completely, there are compassionate ways to gently reduce how often it happens or lessen its intensity:

• Supporting a steady daytime routine with activities the person finds enjoyable

• Limiting alcohol and caffeine, especially later in the day

• Offering lighter meals in the evening

• Encouraging brief naps if needed, while trying to maintain a good balance with night-time sleep

• Creating a calming and familiar evening atmosphere — perhaps with soft lighting, peaceful music, or a quiet, comforting activity

Photo by Carlos Torres on Unsplash

Supporting Someone Through Sundowning

When someone is going through a period of sundowning, a calm, patient, and reassuring presence can be incredibly soothing. Here are some thoughtful ways to offer support:

• Keep communication gentle — avoid overwhelming with too many questions or instructions

• Speak slowly, using a soft and comforting tone

• Offer reassurance, reminding them that they are safe and that you are there to help

• Use short, simple sentences to avoid adding to any confusion

• Gently introduce a comforting distraction — such as a warm drink, a favourite song, or a quiet game

• Listen carefully if they share their feelings, and try to understand what might be troubling them

• Pay close attention to body language, as signs like restlessness, a frown, or grimacing may indicate discomfort or pain
  

Above all, it’s important to meet the person where they are emotionally. Even if what they say doesn’t reflect the current reality, what matters most is the emotion behind their words. By honouring their feelings, we can offer comfort and connection when it is most needed.