What Is Dementia and Sundowning?
Dementia and Sundowning is a common and confusing mix of memory loss and late-day changes in behaviour. If you care for someone with dementia, you may notice they become more restless, upset, or confused as the evening approaches. This pattern is known as sundowning. It is not a separate illness but a group of symptoms that happen later in the day, often when the sun begins to set.
People with dementia may act fine during the morning and afternoon. But as the day fades, they might pace, ask to go home, or say things that don’t make sense. They may cry, shout, or believe they are in the wrong place. For loved ones and caregivers, this can be heartbreaking and exhausting.
Sundowning often starts without warning and may come and go. Some days may seem fine. On others, the person may act like a different version of themselves. These changes are linked to how the brain struggles with time, light, and routine.
In this blog, we will explore the connection between dementia and sundowning. You’ll learn what causes it, what stage it appears, and how to respond. We’ll also answer common questions, share useful examples, and offer simple ways to make evenings calmer for everyone involved.
What Is Sundowning in Dementia Patients?
Sundowning is a set of behaviours that happen late in the day in people with dementia. These may include:
- Pacing or wandering
- Yelling or crying
- Not recognising family
- Feeling lost, even at home
- Trouble sleeping or settling down
This behaviour can be hard to watch. Caregivers often feel helpless. However, it helps to know sundowning is common in dementia.
The changes in the brain associated with dementia make it hard for the person to understand the time of day. Light and dark may confuse them.
What Is Sundowning in Alzheimer’s Patients?
Sundowning is also seen in people with Alzheimer’s disease. Alzheimer’s is the most common form of dementia.
In Alzheimer’s disease, memory loss and confusion worsen over time. As this happens, the brain can no longer tell day from night.
When daylight fades, some people feel unsafe or confused. They may think they need to go home or go to work, even if they already are home or retired.
Their routine has shifted, and their brain doesn’t know how to respond.
What Stage of Dementia Is Sundowning?
Sundowning usually appears in the middle or later stages of dementia. By this time, memory loss is worse and confusion is stronger.
Early-stage dementia may cause some anxiety, but full sundowning is rare that early.
In later stages, the brain can’t make sense of normal surroundings. This is when sundowning becomes more visible and frequent.
You may see a pattern where your loved one acts out more in the evening. This is a clear sign that sundowning may be happening.
What Are the Activities for Sundowning?
Keeping the person busy during the day helps reduce sundowning. Choose calming and simple activities. Some helpful ideas include:
- Gentle walks in the morning
- Listening to soft music
- Folding laundry or pairing socks
- Looking at photo albums
- Watering plants
- Drawing or colouring
These tasks keep the mind active. They also help tire the body, which can improve sleep.
Avoid exciting games or tasks in the evening. Keep late-day activities quiet and peaceful.
How to Cope with Sundowning Behaviour?
There are many ways to ease sundowning. Every person is different, but the tips below often help.
1. Keep a Routine
Do the same things at the same time every day. Meals, naps, and walks should happen at regular hours. This helps reduce confusion.
2. Let in Natural Light
Sunlight helps the brain stay on a natural sleep-wake cycle. Open blinds in the morning. Let in sunlight all day.
3. Turn on Lights Early in the Evening
When it starts getting dark, turn on the lights before the room dims. This can ease fear or panic from falling light.
4. Avoid Naps After 3 pm
Too much daytime sleep can affect night sleep. Try to keep naps earlier in the day.
5. Reduce Noise and Distractions
As evening begins, keep the space calm. Turn off loud TVs. Play soft music. Avoid too many people or fast-moving events.
6. Offer Comfort
Stay close. Hold their hand. Speak slowly and gently. Familiar faces and voices help settle their mood.
7. Avoid Big Meals and Caffeine Late in the Day
Heavy meals or caffeine before bed can cause restlessness. Offer a light snack and warm drink instead.
8. Monitor for Pain or Infection
Sometimes, pain or infection makes sundowning worse. Watch for signs of illness or discomfort.
How to Reverse Sundowning?
Sundowning may not fully go away, but you can ease its impact. You can even prevent it from getting worse.
Try these simple changes:
- Use blackout curtains at night to block strange shadows
- Install night lights in halls or bathrooms
- Give the person a weighted blanket
- Stay calm, even if they are upset
- Encourage bathroom visits before bed
- If the person is taking a new medicine, speak to a doctor. Some drugs may make sundowning worse.
What Is the Life Expectancy of Sundowning and Dementia?
Sundowning itself does not shorten life. But it often happens in the middle or late stages of dementia, which comes with more risks.
On average, life expectancy after a dementia diagnosis is between 8 to 10 years. This depends on the type of dementia, the person’s age, and their overall health.
If sundowning becomes severe, it may signal a faster decline. However, managing stress and creating calm evenings may help improve the quality of life.
What Is Sundowning and Delirium?
Sundowning and delirium can seem similar, but they are not the same.
Sundowning happens often and builds over time. It’s part of dementia.
Delirium is sudden. It may appear after surgery, illness, or infection. It can make a person confused and agitated.
Unlike sundowning, delirium may come and go throughout the day. It often has a clear medical cause.
Doctors may test for infections, medication issues, or dehydration if delirium is suspected.
What Is Sundowning and Melatonin?
Melatonin is a hormone that helps control sleep. Our body makes more melatonin in the evening to help us feel sleepy.
In people with dementia and sundowning, melatonin levels may be off. This can lead to sleep trouble and restlessness.
Some people take melatonin supplements to help with sleep. But it does not work for everyone. Always ask a doctor before trying melatonin.
A better first step is to build healthy daily habits:
- Let them wake up with sunlight
- Keep dinner time early
- Dim the lights slowly at night
These steps help boost natural melatonin.
How Long Does Sundowning Last in Dementia?
Sundowning may last for hours or just a short time. It usually starts in the late afternoon and may last until bedtime.
For some people, it happens every day. For others, it comes and goes.
As dementia gets worse, sundowning may also change. It can become stronger, more often, or start earlier.
Track the patterns in a journal. Note the time it starts, what triggered it, and how it ended.
This can help you prepare for future evenings and know what helps.
Can Sundowning Occur Without Dementia?
Yes, it can. People without dementia may also feel worse in the evening.
Sundowning has been seen in hospital patients, especially those who are older or in unfamiliar places.
Poor sleep, low light, or illness can affect anyone. However, sundowning is more common and more severe in those with dementia.
If someone shows sundowning behaviour but has no diagnosis of dementia, it’s important to speak to a doctor.
Final Thoughts on Dementia and Sundowning
Dementia and Sundowning can be frightening for both the person and their family.
But with the right support and routine, you can reduce stress and ease the symptoms.
Small changes to the environment and daily habits can help a lot.
Focus on comfort, calm evenings, and gentle care. Most importantly, always stay patient and kind.
If you feel lost, speak with your doctor or a support group. You are not alone. Many others face this too.
Sundowning: What to know if your loved one with dementia experiences late-day symptoms