May
Introduction
Sundowning in the elderly is a common challenge for families caring for someone with dementia. It refers to a pattern of increased confusion, agitation, or anxiety in the late afternoon or evening. If your loved one becomes unsettled around dusk, you are not alone. Understanding sundowning, its symptoms, causes, and how to manage it can make a significant difference. This guide is designed for family caregivers in the UK, offering practical advice and introducing support options like Classic Carers.
What is Sundowning in Dementia?
Sundowning is not a disease but a group of symptoms that tend to occur later in the day. It’s characterised by increased confusion, restlessness, and agitation as daylight fades. The term ‘sundowning’ comes from this timing, not from the sun itself. It is particularly common in mid-to-late stages of dementia and is well recognised by dementia care specialists in the UK.
Sundowning Dementia Symptoms
Sundowning symptoms typically appear in the late afternoon and evening and may include:
- Increased confusion or disorientation
- Agitation or aggression
- Repetitive behaviours or pacing
- Hallucinations or delusions
- Paranoia or suspicion
- Restlessness and poor sleep
These behaviours are often triggered by changes in routine, low lighting, tiredness, or unmet needs. The emotional toll on both the person with dementia and their caregiver can be significant.
Sundowning and Dementia: Emotional and Behavioural Impact
Sundowning has a deep emotional impact. The individual may feel scared or frustrated, unable to understand why they feel anxious. For caregivers, evenings can become the most stressful time of the day. It's important to remember that these behaviours are symptoms of the condition, not a reflection of the person's true feelings.
Sundowning Causes
Experts believe sundowning is caused by a mix of physical, environmental, and psychological factors:
- Disruption of the internal body clock (circadian rhythm)
- Fatigue or sensory overload
- Hunger, pain, or discomfort
- Reduced lighting and increased shadows
- Side effects of medication
- Underlying depression or anxiety
Sundowning Anxiety and Depression
While sundowning can be distressing, certain strategies can help:
Maintain a consistent routine: Keep daily activities predictable to avoid late-day confusion.
Let in natural light: Exposure to sunlight helps regulate sleep-wake cycles. Open curtains during the day and consider using a light therapy lamp.
Create a calm evening environment: Reduce noise and stimulation. Use soft lighting and play soothing music.
Engage in calming activities: Gentle conversation, looking at photo albums, or listening to familiar music can be comforting.
Avoid caffeine and heavy meals in the evening: These can disrupt sleep and increase agitation.
Address physical needs early: Ensure your loved one is not hungry, thirsty, or in pain.
Use reassurance and gentle communication: Avoid arguing or correcting. Instead, respond calmly and validate their feelings.
Introduce familiar bedtime rituals: Routine helps signal the transition to sleep.
Sundowning Effect: When It Becomes Unmanageable
Sometimes, despite best efforts, sundowning behaviours can become overwhelming. Signs that it may be time to seek professional support include:
- Physical aggression or unsafe behaviour
- Wandering or nighttime restlessness
- Emotional distress in the caregiver
- Sleep deprivation affecting family wellbeing
Getting Help: Dementia Care Services in the UK
In the UK, the NHS provides advice and access to dementia care. Organisations such as the Alzheimer’s Society and Dementia UK also offer helplines, support groups, and practical guides. You can speak to your GP about a memory clinic referral or request an assessment for NHS Continuing Healthcare or social care support.
How Classic Carers Can Help
At Classic Carers, we understand the challenges sundowning presents. Our dementia care services are designed to support both individuals and their families through:
- Trained dementia care specialists who understand sundowning and can respond with proven best practices
- Live-in care or flexible evening support tailored to your needs
- Continuity of care to build trust and reduce anxiety
- Family-centred planning to ensure your input shapes the care plan
We also provide emotional support to family members, helping you feel confident and empowered.
Sundowning Dementia UK: Key Takeaways
- Sundowning in the elderly is a recognised pattern of evening confusion in dementia
- Symptoms include agitation, anxiety, disorientation, and sometimes hallucinations
- Causes range from fatigue and low lighting to disrupted sleep patterns and emotional triggers
- Management strategies focus on routine, reassurance, and a calm environment
- If symptoms become severe, seek medical help or consider professional dementia care
Conclusion
Sundowning can be one of the most distressing aspects of dementia – but it is manageable. With patience, routine, and support from services like Classic Carers, families can regain a sense of control and wellbeing. If your loved one is showing signs of sundowning, do not hesitate to reach out for guidance. Help is available, and you are not alone.