If your loved one with dementia becomes more anxious, agitated, or confused in the late afternoon or evening, you’re not alone. This is a common—and often overwhelming—phenomenon known as sundowning. As a nurse with over 20 years of dementia care experience, I’ve helped countless families understand and manage this difficult time of day.

In this post, I’ll walk you through what sundowning is, why it happens, and the strategies I recommend to reduce evening agitation and bring calm to your home.

What Is Sundowning?
This refers to a pattern of increased confusion, restlessness, or behavioral challenges that occur in the late afternoon, evening, or even overnight. 

It can show up as:

Pacing or wandering

Irritability or mood swings

Repetitive questions or vocalizations

Shadowing (following the caregiver closely)

Difficulty sleeping or nighttime waking

While not every person with dementia experiences sundowning, it’s common enough to be a frequent topic in dementia caregiving consultations and it can significantly affect the entire household’s well-being.

Why Does Sundowning Happen?
There isn’t a single cause of this phenomenon, but researchers and clinicians agree that several biological and environmental factors contribute to the behavior:

Changes in the brain related to dementia that affect circadian rhythms

Fatigue from the day’s activities

Low lighting or shadows that cause confusion or fear

Unmet needs like hunger, pain, or needing to use the bathroom

Overstimulation or too much noise during the day

In other words, sundowning tends to happen when the brain is least able to manage stress, and the environment isn’t offering clear cues for rest and relaxation.

5 Nurse-Recommended Strategies to Calm Sundowning Behaviors
Here are five practical, proven tips that can help reduce evening agitation and confusion in a loved one with dementia:

1. Create a Calm, Predictable Evening Routine
People with dementia thrive on consistency. Develop a wind-down ritual that begins at the same time each day—this might include a light snack, calming music, turning down the lights, or a warm blanket. Avoid introducing new tasks or visitors in the late afternoon or evening.

2. Control the Environment
Dim lighting and odd shadows can trigger confusion or fear. Increase lighting as the sun goes down, close blinds early, and reduce glare or reflection. Turn off the TV if it becomes overstimulating and opt for soft background music instead.

3. Limit Daytime Napping
While a short afternoon nap might be helpful, too much daytime sleep can throw off the body’s natural rhythms and make sundowning worse. Try to keep your loved one engaged and active earlier in the day—especially with light physical movement or time outside if possible.

4. Watch for Physical or Emotional Triggers
Is your loved one hungry? Cold? Uncomfortable? Bored? Often, sundowning is a signal that something is wrong—but they can’t express it clearly. Try offering a drink, a warm compress, or quiet companionship such as simply holding hands before the behavior escalates. Keep a journal to identify patterns.

5. Reassure with Your Presence
During sundowning episodes, your calm presence matters more than the perfect words. Sit quietly nearby, speak in a low and soothing tone, and avoid arguing or correcting.  Sometimes, just knowing you’re there is enough to lower anxiety.

When to Get Extra Help
If sundowning is escalating or interfering with your ability to provide care—or your loved one’s safety—it may be time to consult with a dementia care expert. Virtual consultations are available nationwide and can help you create a customized care plan that includes environmental changes, routines, and behavioral strategies.

Final Thoughts: You’re Not Doing This Wrong
Sundowning is difficult, but it doesn’t mean you’re failing. It’s a known part of dementia, and with the right tools and support, you can make evenings more peaceful for everyone. You don’t have to figure this out alone.

Need Personalized Advice?
If you’re dealing with sundowning or other dementia-related behaviors, I offer virtual consultations nationwide to help families create calm, confident care plans. Book a free 20-minute care consultation call to see how I can support you.

👉 Schedule your free consultation here. Book An Appointment | Wellness Strategies Group