Sundowning Strategies for Family Caregivers

by | May 1, 2024 | Alzheimer's Disease, Caregiver Stress, Dementia, Dementia Behaviors, Sundowners

Sundowning, also known as “late-day confusion,” is a phenomenon commonly seen in individuals with dementia, characterized by increased agitation and confusion in the late afternoon and evening. This challenging behavior can be distressing for both the person with dementia and their caregivers.

However, with a better understanding of sundowning and the implementation of effective strategies, it is possible to manage and minimize its impact. In this post, we will explore the causes of sundowning, its effects on individuals with dementia, and practical solutions to help manage this challenging behavior.

1. What is Sundowning?

Sundowning refers to the emergence or worsening of behavioral symptoms such as agitation, confusion, restlessness, and mood swings in individuals with dementia during the late afternoon and evening hours. What are the common signs and symptoms of sundowning in dementia patients, and how does it impact their overall well-being and quality of life?

Sundowning is a complex phenomenon that can manifest differently in each individual. Common signs include increased confusion, anxiety, pacing, and vocalization. The impact of sundowning can lead to sleep disturbances, increased caregiver stress, and reduced functioning in daily activities.

2. Understanding the Causes of Sundowning and Strategies to Help

Sundowning Strategies

What are the potential triggers and underlying causes of sundowning behavior in individuals with dementia? How can external factors such as changes in light, noise, and routine contribute to the onset of sundowning?

There are many causes of sundowning. These may include disruptions in the sleep-wake cycle, fatigue, environmental changes, and sensory overload.

Other common triggers of sundowning include fatigue, hunger, thirst, pain, overstimulation, and environmental changes. Additionally, factors such as medication side effects, underlying medical conditions, and disruptions in routine can contribute to the onset of sundowning symptoms.

Factors such as decreased natural light, increased shadows, and disruptions in routine can contribute to heightened agitation and confusion in the evening.

Families need to become detectives to find the underlying cause that could be contributing to sundowning.

3. Strategies for Managing Sundowning

What are some practical strategies and interventions that can help manage sundowning in dementia patients? How can caregivers create a calming and structured environment to minimize the impact of sundowning behavior?

Effective strategies include:

  • Establishing a consistent daily routine

This is one of the most important strategies you can implement. Having a routine helps calm the confusion that dementia brings on.

  • Creating a soothing environment with soft lighting and calming music

Also, pay attention to your voice. Notice the tone and pitch. A soft soothing voice will help calm someone who may be getting agitated.

  • Engaging in gentle physical activity

A walk around the block, chair yoga, or another activity can also help.

  • Providing reassurance and comfort to the individual.

Take a look at some of Dementia expert Teepa Snow’s videos on how to talk to someone with dementia.

  • Additionally, healthcare professionals can help with medication management and behavioral therapies

4. Sundowning Strategies

Sundowner Strategies to bring back the joy

What are a few specific approaches and techniques caregivers should implement to address sundowning behavior? How can the use of technology, sensory stimulation, and personalized care plans contribute to mitigating the effects of sundowning?

Sundowning solutions may involve technology-assisted monitoring, sensory stimulation through aromatherapy or massage, and tailored care plans that address individual triggers and preferences. Engaging the individual in meaningful activities and providing emotional support are also integral components of effective sundowning management.

And music! Music is a widely accepted therapy for people with dementia. And it is a perfect sundowning strategy.

Identify Triggers

Notice changes that could be triggering. While these small changes may not affect you they could be disturbing for someone with dementia.

Are children or a spouse coming home from school or work? Is there more noise or multiple things going on? What is playing on the television? The news could be disturbing to someone confused about current events. Are you rushing to get dinner prepared? These can all be triggers.

Pay attention to what foods are being consumed throughout the day. Limit caffeine since that could be a trigger. And remember, caffeine comes in many forms: chocolate, sodas, tea, and coffee.

Make sure your home is well-lit, especially during the early evening hours.

5. When Sundowning Comes on Suddenly

Sundowning Strategy- UTI

When sundowning suddenly appears in someone who doesn’t normally exhibit this behavior it may be time for a doctor’s visit. Urinary Tract Infections (UTI) in the elderly will mimic dementia sundowning. Someone with a UTI may suddenly get agitated, sad, depressed, or even angry. The good news is a round of antibiotics will usually straighten out the situation.


In conclusion, sundowning presents a significant challenge for individuals with dementia and their caregivers. By gaining a deeper understanding of the causes and triggers of sundowning, as well as implementing targeted strategies and solutions, it is possible to alleviate the impact of this distressing behavior. Through a holistic and person-centered approach, caregivers can create a supportive environment that promotes comfort and well-being for individuals experiencing sundowning in the context of dementia.

We Are Here To Help

At Sycamore Creek Ranch Memory Care we are here to help. We want families to make the best decision for their situation.

Furthermore, the staff at Sycamore Creek Ranch is proactive. That means we are not waiting for a problem to arise. Instead, we are actively engaged with every resident. And with only 16 residents we can do that!

If you are looking for Memory Care in The Woodlands or Memory Care in Spring, Texas come for a tour at Sycamore Creek Ranch! See how we can help.

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