Sundowning in Dementia

Coping Strategies for Caregivers

Senior man with dementia experiencing sundowning symptoms, including confusion and restlessness

If you’re caring for a loved one with dementia, you know how challenging sundowning can be. Sundowning, or late-day confusion and agitation, can disrupt your loved one’s routine and leave them feeling anxious and disoriented. But don’t worry, we’ve got you covered! In this post, we’ll share five practical tips to help you and your loved one cope with sundowning and make the evening hours more peaceful and enjoyable. Let’s dive in!

Defining Sundowning

Sundowning, also known as sundown syndrome, is a condition that typically affects individuals with dementia or Alzheimer’s disease, although it can also occur in individuals with other conditions, such as Parkinson’s disease or stroke. It is characterized by a state of confusion, anxiety, and agitation that typically occurs during the late afternoon or early evening, and may continue throughout the night. The exact causes of sundowning are unknown, although it is believed to be related to changes in the circadian rhythm, which regulates the sleep-wake cycle, as well as changes in the brain that occur as a result of dementia.

Recognizing Sundowning

If you are caring for an individual with dementia, it’s important to be aware of the signs of sundowning. Some common signs to look for include:

  • Increased confusion or disorientation
  • Agitation or restlessness
  • Mood swings or emotional outbursts
  • Difficulty sleeping or staying asleep
  • Wandering or pacing
  • Increased irritability or aggression

If you notice these symptoms in your loved one, it may be a sign that they are experiencing sundowning.

Coping with Sundowning

If your loved one is experiencing sundowning, there are several strategies you can use to help them cope. Here are six ways to manage sundowning:

  • Stick to a routine: Try to establish a regular routine for your loved one, with consistent meal times, bedtime, and activities. This can help them feel more secure and less anxious. (download our daily care planner worksheet)
  • Create a calm environment: Make sure the environment is calm and quiet during the evening hours, with minimal stimulation. Reduce noise and bright lights, and consider playing calming music or using aromatherapy to create a relaxing atmosphere.
  • Provide comfort: Offer your loved one comfort items, such as a favorite blanket or stuffed animal, to help them feel more relaxed.
  • Use distraction: Engage your loved one in activities that they enjoy, such as listening to music, reading, or playing games. This can help distract them from their anxiety or agitation.
  • Monitor medication: Talk to your loved one’s doctor about adjusting medication dosages or timing to minimize the effects of sundowning.
  • Seek support: It’s important to seek support for yourself as a caregiver. Connect with other caregivers, join a support group, or seek professional counseling to help you cope with the challenges of caring for someone with dementia.

Sundowning is a challenging condition that can be difficult for both individuals with dementia and their caregivers. By understanding the signs of sundowning and using effective coping strategies, caregivers can help their loved ones feel more comfortable and secure during the evening hours. If you or someone you know is experiencing sundowning, be sure to talk to a healthcare professional for additional support and guidance.

Education and Support

To learn more and find support, connect with these organizations:


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Liz Craven
Author: Liz Craven

Liz Craven, co-publisher of Sage Aging ElderCare Guide with her husband Wes, combines personal experience and heartfelt dedication in her work. Their journey in eldercare began with a personal story—caring for Wes' grandmother, Mabel, who lived with Alzheimer's. This chapter in their lives not only highlighted the complexities of eldercare but also kindled a deep-seated passion to support others facing similar challenges. Since then, Liz and Wes have navigated caregiving three more times. These experiences have added layers of depth to their insights, allowing them to offer a blend of empathetic understanding and practical advice through the Sage Aging ElderCare Guide. Liz’s commitment to making eldercare more approachable and less daunting shines through in every piece of advice she offers, aiming to ease the caregiving journey for others.