Sundowning: Why Evenings Can Feel Harder

Late afternoon can bring a noticeable change to the rhythm of the home. A person who has seemed settled earlier in the day may become restless, anxious, confused or unusually tired as daylight fades. This pattern is often called sundowning, and it can be distressing for the person experiencing it as well as for the family member trying to offer reassurance.

Understanding what may be happening can make evenings feel less uncertain. While there is no single answer that suits everyone, a calm routine, thoughtful environment and the right level of support at home can often make a meaningful difference.

What is sundowning?

Sundowning describes a pattern of increased confusion, agitation, anxiety or changed behaviour later in the day. It is most commonly associated with dementia, although not every person living with dementia will experience it, and its effect can vary from one evening to the next.

For some people, it may look like pacing, repeatedly asking to go home, becoming suspicious or finding it difficult to follow a conversation. Others may seem more withdrawn, upset, disorientated or unable to settle. A person may also have more difficulty recognising where they are or understanding what is expected next.

These behaviours are not deliberate. They can be a person’s response to feeling overwhelmed, confused, uncomfortable or frightened at a time when their ability to process information is reduced. Seeing the experience through that lens can help families respond with patience rather than trying to correct every detail.

Why sundowning may happen in the evening

There is no confirmed single cause of sundowning. Instead, several pressures may build across the day. Tiredness, a change in light, shadows in the room, noise at teatime, hunger, thirst, pain, constipation, infection or an unfamiliar routine can all contribute to a person feeling less able to cope.

The transition from day to evening can itself be difficult. Curtains closing, lights being switched on, visitors leaving and the prospect of bedtime can make the home feel different. A person whose sense of time is already affected may interpret these changes in a way that feels confusing or alarming.

A busy day is not always a bad day, but too much activity can be tiring. Equally, long periods without meaningful company or gentle stimulation can leave a person unsettled. The most helpful balance depends on the individual: some people feel reassured by familiar conversation and music, while others need fewer sounds, fewer choices and a quieter room.

Recognising the person behind the behaviour

It is easy to focus on the immediate problem: the repeated question, the attempt to leave the room, the sudden anger or the refusal to get ready for bed. Yet the most useful question is often, “What might this feel like for them?”

A direct correction such as “You have already asked that” may increase embarrassment or anxiety. A calmer response might acknowledge the feeling first: “You seem worried. I am here with you.” If the person says they need to go home, it can be more reassuring to ask what they miss about home than to argue about where they are. They may be looking for safety, a familiar role or someone they love, rather than literally planning a journey.

Simple language helps. Offer one idea at a time and allow space for a response. Keep your own tone low and steady, even if the moment feels demanding. A familiar photo, favourite programme, warm drink or quiet shared task may gently redirect attention, but there will be evenings when reassurance is more realistic than distraction.

Creating a calmer evening routine

A predictable, unhurried pattern can reduce the number of changes a person has to process. It does not need to be rigid. The aim is to make the later part of the day recognisable and comfortable.

Consider whether the room is becoming too dark or shadowed before lights are switched on. Soft, even lighting can make faces and familiar surroundings easier to recognise. Reducing background television, kitchen noise and multiple conversations may also help, particularly around mealtimes.

It can be useful to keep late-afternoon activities simple and familiar. Folding towels, looking through photographs, listening to well-known music, having a quiet chat or sitting together with a drink may be more settling than a demanding outing or a long list of instructions. If the person enjoys movement, a gentle walk earlier in the day may support a more restful evening, provided it is appropriate for them and their usual routine.

Notice patterns over a few days. A brief note of when changes begin, what happened beforehand, what seemed to worsen the situation and what brought comfort can give families and care professionals a clearer picture. It may reveal a practical trigger, such as a noisy household period or a room that becomes darker earlier than expected.

When a change needs professional attention

Although sundowning can be a familiar pattern for some people with dementia, a new, sudden or marked change in confusion or behaviour should not simply be assumed to be sundowning. Physical discomfort, illness or another health concern may be affecting the person.

Contact the person’s GP, pharmacist or relevant healthcare team for guidance if you are concerned about a noticeable change, pain, reduced eating or drinking, disturbed sleep, a possible infection, falls or any behaviour that is very different from their usual presentation. NHS 111 can help when you are unsure which service is appropriate. If there is an immediate emergency or someone is at serious risk of harm, call 999.

Do not make changes to prescribed medicines without speaking to an appropriate healthcare professional. The same care applies to sleep aids, supplements and over-the-counter products, which may not be suitable for every person.

How home care can support difficult evenings

Evenings can be particularly hard for relatives who are balancing work, children, their own health or travel between homes. Support does not have to replace family involvement. Sensitive, well-planned home care can complement it by bringing a steady, reassuring presence during the parts of the day that feel most demanding.

A care professional can get to know the person’s preferences, routines and communication style, helping to make personal care, meals and the transition towards bedtime feel less rushed. Familiarity matters, but so does clear communication among everyone involved, so that changes in mood, routines or wellbeing can be noticed and shared appropriately.

For families in Burton upon Trent, Swadlincote and the surrounding confirmed service area, Luxuricare can begin with a free assessment and care call to understand what support at home may look like. The right arrangement depends on the person, their household and the times at which reassurance is most needed.

A difficult evening does not mean you have failed, nor does it define the person you care about. Often, the most valuable response is simple: a familiar voice, a calmer room and someone who stays present until the moment feels more manageable.