What is Dementia Sundowning? Symptoms, Causes, and Management

by | Sep 15, 2023 | Dementia, Dementia Behaviors, Sundowners


Dementia is a complex condition that affects millions of individuals worldwide. One challenging aspect of dementia is sundowning, a phenomenon characterized by increased confusion, agitation, and restlessness in the late afternoon and evening. In this article, we will delve into the symptoms of dementia, explore the causes of sundowning, and discuss effective management strategies to help individuals and their caregivers cope with this challenging aspect of dementia.

1. What are the common symptoms of dementia?

Dementia is a progressive neurological disorder that impairs cognitive functions such as memory, thinking, and reasoning. There are many different types of dementia including Alzheimer’s dementia. And each type may present different symptoms. However, some common symptoms of dementia include:

– Memory loss

– Difficulty with language and communication

– Impaired judgment and decision-making

– Confusion and disorientation

– Personality and behavior changes


2. What causes dementia sundowning?

Confusion about dementia sundowning

While the exact cause of sundowning is not fully understood, several factors have been identified as potential triggers for this phenomenon. These include:

– Disruption of the body’s internal clock: Dementia can disrupt the sleep-wake cycle, leading to increased confusion and agitation during the evening hours.

– Fatigue and exhaustion: Individuals with dementia may experience increased fatigue as the day progresses, making them more susceptible to sundowning.

– Environmental factors: Changes in lighting, shadows, and noise levels during the evening can contribute to increased confusion and restlessness.

– Medication side effects: Certain medications used to manage dementia symptoms may affect sleep patterns and contribute to sundowning.


3. How can dementia sundowning be managed in individuals with dementia?

Social connection helps with dementia sundowning

Although there is no cure for sundowning, there are several strategies that can help manage and reduce its impact on individuals with dementia. These include:

– Establishing a routine

Consistency is key when it comes to managing sundowning symptoms in individuals with dementia. Establishing and maintaining a consistent daily schedule can greatly help in reducing the severity of sundowning episodes.

By providing a structured routine, individuals with dementia are able to have a sense of security and familiarity, which can help alleviate the anxiety and confusion that often accompanies sundowning. It is important to incorporate activities and tasks that the person enjoys and finds engaging throughout the day. This can include hobbies, exercise, social interactions, and cognitive stimulation.

By implementing a consistent daily schedule, caregivers can effectively manage sundowning symptoms and improve the overall quality of life for individuals with dementia.

– Promoting a calming environment

Promoting a calming environment is essential for managing sundowning, a common symptom of dementia. Sycamore Creek Ranch has designed its memory care homes with this in mind.

Creating a calming environment involves minimizing sensory triggers that can exacerbate sundowning symptoms. This can be achieved by reducing noise levels, providing adequate lighting, and removing any potential hazards or obstacles in the living space. Using nightlights in hallways and bedrooms can help reduce confusion during nighttime wandering.

– Encouraging daytime activity and exposure to natural light

Engaging individuals with dementia in stimulating activities during the day can help regulate their sleep-wake cycle and decrease restlessness in the evening. Regular physical exercise, exposure to natural daylight, and social interaction can all contribute to improved sleep patterns and reduced sundowning episodes.

– Implementing relaxation techniques

Relaxation techniques such as deep breathing exercises, gentle music, aromatherapy, and massage therapy can promote relaxation and alleviate anxiety associated with sundowning. These techniques can be incorporated into a bedtime routine to help individuals with dementia transition into a calm and restful state before sleep.

To create a peaceful setting, consider reducing noise levels and eliminating any potential triggers that can contribute to anxiety or frustration. Soft, soothing music or nature sounds can be played to provide a sense of tranquility.

Dimming the lights or using warm, soft lighting can help create a soothing atmosphere. Establishing a predictable routine and keeping the environment clutter-free can also help reduce confusion and agitation.

Additionally, engaging in calming activities such as gentle exercise, reading, or listening to audiobooks can provide a sense of relaxation and promote a more peaceful state of mind. By implementing these strategies, caregivers can effectively manage sundowning and create a supportive environment for individuals with dementia.

Limit visitors at this time if possible. Ask if they can come earlier in the day. Any distractions may cause an episode of dementia sundowners.

– Engaging in stimulating activities:

Activity to ward off dementia sundowners

Providing mentally and physically stimulating activities during the day can help reduce restlessness and promote better sleep at night. Engaging in stimulating activities can be an effective way to manage sundowning, a common symptom of dementia.

By providing activities that stimulate the mind and body, individuals with dementia may experience a reduction in sundowning symptoms. Stimulating activities can include puzzles, reading, listening to music, or engaging in light exercise. These activities help to keep the brain active and distract from the negative effects of sundowning. It is important to choose activities that are suited to the individual’s interests and abilities. By incorporating stimulating activities into a dementia care plan, caregivers and loved ones can help create a positive and engaging environment for individuals experiencing sundowning symptoms.

– Medication adjustments:

Consultation with a healthcare professional may be necessary to evaluate and adjust medications that may be contributing to sundowning.

– Supportive caregiving:

Providing comfort, reassurance, and understanding to individuals experiencing sundowning is crucial. Caregivers should be patient, and compassionate, and seek support from healthcare professionals or support groups if needed.

Dementia redirection:

Dementia redirection is a crucial strategy for managing sundowning, a common symptom of dementia. Sundowning refers to the worsening of cognitive and behavioral symptoms in the late afternoon and evening. Understanding the causes of sundowning is essential in developing effective redirection techniques.

Factors such as fatigue, changes in the internal body clock, and sensory overload contribute to the onset of sundowning. By implementing redirection methods, caregivers can help individuals with dementia to stay focused and engaged, reducing the intensity of sundowning episodes.

Effective redirection techniques include providing a calm and soothing environment, engaging in activities that stimulate the mind, and promoting relaxation through gentle music or aromatherapy. This might be a good time for a relaxing hand massage with essential oils.

Using Essential Oils:

Essential oils for Sundowners

Essential oils have gained popularity as a natural approach to managing various health conditions, including dementia symptoms and sundowning. Essential oils such as lavender, chamomile, and lemon balm have been found to have calming properties that can help soothe agitation and restlessness associated with sundowning.

These oils can be diffused in the air, applied topically, or added to bathwater to promote relaxation. It is important to note that while essential oils may provide relief for some individuals, their effectiveness may vary from person to person. It is advisable to consult with a healthcare professional before incorporating essential oils into a dementia management plan.

Additionally, maintaining a consistent daily routine and ensuring proper sleep hygiene can also help manage sundowning symptoms. It is important for caregivers and healthcare professionals to collaborate and tailor individualized strategies to address the specific needs of each person with dementia.

Pet Therapy:

For many people with dementia having a calm pet to stroke can help to relieve symptoms of anxiety and mood swings. Bringing pets in for a visit before sundowners symptoms start is the best practice. If you know these symptoms begin every day at about 5 PM bring the pet for a visit at about 4:30. If possible have them stay for at least an hour.



Sundowning is a challenging aspect of dementia that can significantly impact the quality of life for individuals and their caregivers. By understanding the symptoms of dementia, identifying the potential causes of sundowning, and implementing effective management strategies, individuals with dementia can experience improved well-being and enhanced overall quality of life. With a compassionate and supportive approach, caregivers can navigate the complexities of sundowning, providing comfort and care to their loved ones.


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 each and 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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