Understanding Sundowning: What It Is and How Home Care Can Help

If your loved one has Alzheimer’s or another type of dementia, you may notice changes in their behavior as the day goes on. This pattern is often called sundowning. Sundowning can be confusing and sometimes frustrating, but understanding it can help families provide better care and support.

What Is Sundowning?

Sundowning is a pattern of increased confusion, agitation, or restlessness that typically occurs in the late afternoon or evening. People may become more anxious, irritable, or even aggressive as daylight fades. They may pace, call out repeatedly, or try to leave the house. Sundowning is not a disease itself, but a symptom that can appear in people with dementia, including Alzheimer’s disease (Mayo Clinic, 2023).

The exact cause of sundowning isn’t fully understood. Experts believe it may be linked to changes in the brain caused by dementia, fatigue, disrupted sleep patterns, or changes in the environment such as dim lighting or shadows. Families who are still learning about cognitive decline may also benefit from understanding the distinction between Alzheimer’s disease and other forms of dementia, since symptoms and progression can vary from person to person.

Who Experiences Sundowning?

Sundowning most often affects older adults with Alzheimer’s or other forms of dementia. While not everyone with dementia experiences it, studies suggest that up to 20% of people with Alzheimer’s may show signs of sundowning at some point (Cleveland Clinic, 2023). It can be particularly challenging for families because it usually occurs when caregivers are tired and preparing for the evening routine.
In many cases, sundowning behaviors develop after earlier warning signs of dementia have already appeared. Increased forgetfulness, confusion, mood changes, or difficulty completing familiar tasks may all occur before evening agitation becomes noticeable. Recognizing these early symptoms can help families seek support sooner and create a safer, more structured environment at home.

Signs of Sundowning

Common signs of sundowning include:

• Increased confusion or disorientation in the evening
• Restlessness or pacing
• Anxiety, agitation, or irritability
• Wandering or trying to leave the house
• Repeating questions or statements
• Trouble sleeping at night (CDC, 2023)

Recognizing these signs early can help families anticipate challenges and create strategies to reduce stress for both the person with dementia and their caregivers.

How Home Care Agencies Can Help

A home care agency like FirstLight Home Care of Sunnyvale can provide vital support for families dealing with sundowning. Caregivers trained in dementia care can help prevent or manage behaviors that occur in the evening.

Here’s how home care can help:

• Routine and Structure: Caregivers can maintain consistent routines, which often reduces confusion and agitation in the evening.
• Safe Environment: Ensuring hallways and rooms are well-lit, removing hazards, and using locks or safety gates when needed can help prevent wandering or accidents.
• Calming Activities: Gentle conversation, music, or light exercise in the late afternoon can help reduce anxiety and restlessness.
• Monitoring and Supervision: Caregivers provide attentive supervision during peak times when sundowning is most likely to occur.
• Family Relief: Home care gives family members time to rest and manage other responsibilities, while knowing their loved one is safe and supported.

At FirstLight Home Care of Sunnyvale, our caregivers are trained to handle the unique challenges of sundowning with compassion and patience. We proudly serve families in Sunnyvale, Mountain View, Santa Clara, Milpitas, and San Jose, helping older adults with dementia feel safe, supported, and comfortable in their own homes.

Tips for Families Dealing with Sundowning

In addition to home care support, families can try simple strategies to reduce sundowning:

• Keep a regular sleep schedule
• Limit caffeine and sugar in the late afternoon
• Increase natural light exposure during the day
• Encourage physical activity during the day
• Reduce noise and clutter in the evening
• Use calming music or favorite activities to soothe restlessness

Every person is different, and what works for one loved one may not work for another. Home care professionals can help tailor approaches to meet your family’s unique needs.

Finding the Right Help

Sundowning can be exhausting, but families do not have to face it alone. With the right support, strategies, and compassionate caregivers, people with dementia can remain safe, comfortable, and engaged at home. If sundowning affects your loved one, partnering with a trusted home care agency can make a meaningful difference.

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Sources:

• CDC. (2023). Alzheimer’s Disease and Dementia. https://www.cdc.gov/alzheimers-dementia/index.html
• Mayo Clinic. (2023). Sundowning: Symptoms, Causes, and Tips for Caregivers. https://www.mayoclinic.org/diseases-conditions/alzheimers-disease/expert-answers/sundowning/faq-20058436
• Cleveland Clinic. (2023). Alzheimer’s Disease Overview. https://my.clevelandclinic.org/health/diseases/9633-alzheimers-disease