Sundowning in dementia: how to help at home

If you or your loved one is living with dementia, late afternoons may be harder than mornings. Confusion, worry or restlessness can build as the light fades. This is often called sundowning, and there are calm, practical ways to ease it at home.

What is sundowning?

Sundowning describes dementia symptoms that become stronger in the late afternoon or early evening. Dementia Australia explains that some people become more confused, anxious or restless at this time of day.

It isn't a separate condition but a pattern some people living with dementia experience, and it can change over time.

You might notice the person:

• Becoming more upset, demanding or suspicious

• Finding it harder to concentrate or follow a conversation

• Wanting to "go home", even when they're already at home

• Seeing or hearing things that aren't there

• Pacing, fidgeting or trying to leave the house

Why late-afternoon confusion happens

No one knows exactly what causes sundowning, but Dementia Australia says it seems linked to brain changes from dementia.

Everyday factors can add to it. Healthdirect and Dementia Australia describe several common triggers:

• Tiredness at the end of the day, or poor sleep the night before

• Changing light, which can affect the body clock

• Unmet needs such as pain, hunger, thirst or needing the toilet

• Changes in routine, or being somewhere unfamiliar

• Loneliness or a need for security, especially as the house gets quiet

Someone living with dementia may find it hard to say what's wrong, so restlessness can be their way of telling you.

Keep a simple record of what you notice

A short diary can help you spot patterns. Note when things change, what happened earlier that day, and what seemed to help.

Healthdirect suggests sharing these notes with the person's doctor or health team. They can help you make sense of the pattern and look for other causes.

Practical ways to ease sundowning at home

Small changes to the day can make the evening easier. Try one or two at a time, and keep what suits the person.

Build a calm evening routine

• Keep meals, activities and bedtime at similar times each day

• Start a familiar wind-down, such as closing the curtains together

• Invite the person to help with simple tasks, like setting the table

• Offer something comforting, such as favourite music or a hobby they enjoy

Adjust light and noise

Dementia Australia suggests plenty of natural light during the day. Later on, turn bright lights down so the room feels soft and settled.

Background noise can be unsettling at this time of day, so turning down the TV or radio can help.

Check the basics first

If the person seems restless, gently check whether something is bothering them. They may be hungry, thirsty, in pain, too warm or needing the toilet.

A drink, a snack or a trip to the bathroom can sometimes settle things quickly.

How to respond in the moment

When the person is distressed, how you respond matters as much as what you say.

• Speak slowly and calmly, using short, simple sentences

• Offer reassurance rather than correcting or arguing

• Acknowledge their feelings, for example "You seem worried. I'm here with you."

• Suggest a calm activity or a move to a quieter room

• Give them some space if it's safe, then try again a little later

If the person wants to "go home", it can help to talk about home and family. The feeling behind the words is often a need for comfort and safety.

When to talk to a doctor

Talk to the person's GP if sundowning starts suddenly, gets worse quickly or affects their safety. A doctor can look for health issues that add to restlessness and review whether medicines play a part.

Sudden confusion can be a sign of delirium, which is often a symptom of a serious illness. Healthdirect advises calling triple zero (000) or going to an emergency department if you're worried someone has delirium.

For information and advice, you can call the National Dementia Helpline on 1800 100 500. It's free, confidential and available 24 hours a day.

The Dementia Behaviour Management Advisory Service (DBMAS) also gives free advice on changed behaviours, any time, on 1800 699 799.

Look after yourself too

Late afternoons can be tiring for family carers as well. Some support at this time of day, or a regular break, can make the evening easier for everyone.

Carer Gateway offers free counselling, coaching and respite for unpaid carers. You can call 1800 422 737 on weekdays between 8am and 5pm.

Talk to us about dementia care at home

At HomeCaring, we're a registered Support at Home provider, trusted by more than 10,000 people and their families. We support people living with dementia to keep familiar routines in their own home. Our team includes registered nurses and allied health professionals, led locally by people who know your community.

Tell us which times of day are hardest, and we'll talk you through support that could help. Availability depends on the support involved, your location and the times you need.

We'll start with a free in-home assessment and keep you updated at every step. Reach out to our Care Specialists on 1300 875 377.