If late afternoons bring new restlessness, confusion, or agitation, you may be seeing sundowning. It’s common in dementia and can be exhausting for families. The good news: small, steady changes—done early in the day—often reduce symptoms. Here’s what’s going on and what actually helps.
What is sundowning?
Sundowning refers to increased confusion, anxiety, pacing, or irritability that tends to occur late afternoon through evening. You might notice repeated questions, misplacing items, shadowing a caregiver, or resistance to bathing or dinner.
Why it happens (common contributors)
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Body clock shifts: Less exposure to daylight and reduced melatonin can disrupt sleep–wake cycles.
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Fatigue & unmet needs: Hunger, thirst, pain, constipation, or a full bladder amplify stress.
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Low light & visual contrast: Dimming light creates shadows that can be misinterpreted.
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Overstimulation: Busy days, loud TV, clutter, or too many visitors.
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Medication timing: Some meds wear off by evening; others can cause sedation or agitation.
The Calming Evening Routine (step-by-step)
Start the routine before agitation begins—usually 3:30–4:00 pm.
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Snack + hydrate (protein + complex carb; 6–8 oz fluid).
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Lights on, curtains closed before dusk; use warm lamps, not bright overheads.
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Familiar music at low volume; avoid news channels.
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Hands-on, simple task: fold towels, sort cards by color, match socks.
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Soothing sensory cue: hand massage with lotion, soft blanket, lavender scent (if tolerated).
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Early, light dinner (softer foods if chewing is tiring).
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Unhurried wind-down: bath/shower if that calms; pajamas; toileting; favorite photo album.
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Consistent bedtime with a nightlight to the bathroom and the path cleared.
✨Pro tip: One new change at a time. Consistency beats intensity.
Daytime habits that reduce sundowning
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Morning light & movement: Open blinds early; 10–20 minutes of walking or chair exercises.
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Predictable schedule: Same order each day—meals, meds as ordered, activities, rest.
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Limit long naps (≤40 minutes).
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Reduce caffeine after noon and large late-day fluids if nighttime urination is an issue.
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Declutter visual noise: Clear surfaces and walkways.
Communication that lowers stress
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Connect first: eye level, gentle tone, use their name.
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One-step directions; two choices: “Blue or green sweater?”
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Validate, then redirect: “I hear you want to go home. Let’s have tea, then we’ll call [name].”
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If stuck, reset: change rooms, dim lights, offer a warm drink.
Environment tweaks (quick wins)
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Warm, even lighting; cover mirrors if startling.
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High-contrast tape on step edges; remove throw rugs.
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Door chimes or motion sensors if wandering is a risk.
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Soothing “evening playlist” ready on a speaker or phone.
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When to call for help
Reach out to your clinician or home-health team if you notice:
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Sudden or severe behavior change (could signal infection, pain, dehydration, med side effect)
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New falls, unsafe wandering, or sleep collapse
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Caregiver burnout or uncertainty about next steps
✨How MedProUSA helps: Our nurses and caregivers assess triggers, set up a personalized routine and environment plan, adjust timing strategies around meds/fluids, train family on safe transfers and calming techniques, and coordinate with your physician to prevent avoidable ER visits.
Quick checklist
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✅ Lights on & curtains closed before dusk
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✅ Snack + hydration
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✅ Familiar music and one simple task
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✅ Reduce noise/screens; keep tone gentle
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✅ Toileting before bed; clear path + nightlight
Ready to build a calmer evening?
Memorial & Greater Houston families: we can help you create a sundowning plan that fits your home.
📞Call 713-932-0017 • Email Info@MPUHealthServices.com
Address: 9219 Katy Freeway, Suite 207, Houston, TX 77024 • Web: mpuhealthservices.com
