A Complete Guide to Sundowning

May 23, 2024

As the sun dips below the horizon, various symptoms, including agitation, confusion, and anxiety, often descend upon those experiencing this phenomenon.

In this guide, we’ll examine sundowning and its effects on you and your loved one.

What Is Sundowning in Dementia?

Sundowning is a pattern of symptoms that often occurs in people with dementia, particularly Alzheimer’s disease, as the day transitions into evening or night. During these late afternoon or early evening hours, individuals experiencing sundowning may exhibit increased agitation, confusion, anxiety, restlessness, or disorientation.

Why Does Sundowning Happen?

The exact cause of sundowning isn’t fully understood. Still, factors such as fatigue, changes in the internal body clock (circadian rhythm), hormonal imbalances, sensory overload, and environmental factors like reduced lighting or increased shadows may contribute to the onset of sundowning.

How Long Does the Sundowning Phase Last?

The duration of the sundowning phase can vary widely from person to person and even from day to day within the same individual. In some cases, sundowning symptoms may last for a few hours, while in others, they may persist throughout the evening and into the night.

While sundowning typically occurs during the late afternoon or early evening hours, it’s essential to recognize that each person’s experience with sundowning can be unique. Caregivers and healthcare professionals should monitor and assess the patterns and triggers of sundowning in individuals with dementia to develop personalized strategies for managing and minimizing its impact on daily life.

Daylight Saving Time (DST) and sundowning often go hand-in-hand.

The Struggles of Sundowning

Sundowning presents many challenges for both individuals experiencing it and their caregivers. Here are some of the struggles associated with it:

  • Increased Agitation and Anxiety: Sundowning often manifests as heightened agitation, anxiety, or restlessness in individuals with dementia. Agitation and anxiety can lead to emotional distress and discomfort, making it challenging for both the individual and their caregivers to manage.
  • Disorientation and Confusion: It can also cause individuals to become disoriented or confused about their surroundings, time of day, or even their identity. This can be frightening and frustrating for the person experiencing it and may lead to safety concerns.
  • Communication Difficulties: Sundowning can worsen communication difficulties in individuals with dementia, making it harder for them to express their needs or understand instructions. This can increase frustration and stress for both the individual and their caregivers.
  • Challenges for Caregivers: Caregivers of individuals experiencing this phenomenon face unique challenges, including managing unpredictable behaviors, ensuring the safety of their loved ones, and coping with the emotional toll of witnessing their decline.
  • Increased Caregiver Burden: Dealing with sundowning can significantly increase caregiver burden, leading to stress, exhaustion, and burnout. Caregivers may struggle to find time for self-care and may feel overwhelmed by the demands of caregiving.

How Sundowning Impacts You and Your Loved One

This phenomenon can profoundly impact both the individual experiencing it and their caregivers, affecting various aspects of their lives. Here’s how sundowning can impact both:

Individual Experiencing Sundowning

Emotional Distress

It often triggers heightened agitation, anxiety, or confusion in the individual. This emotional distress can be overwhelming and contribute to feelings of fear, frustration, or helplessness.

Disruption of Daily Routine

This phenomena can disrupt the individual’s daily routine, making engaging in activities, maintaining social connections, or performing self-care tasks independently challenging.

Sleep Disturbances

It can lead to sleep disturbances, such as difficulty falling or staying asleep. This can result in fatigue, daytime drowsiness, and cognitive impairment during waking hours.


Increased Stress

Caregivers often experience heightened stress when managing sundowning symptoms in their loved ones. The unpredictability of behaviors, emotional turmoil, and sleep disturbances can take a toll on their mental and emotional well-being.

Challenges in Caregiving

This phenomenon presents unique challenges for caregivers, requiring them to adapt their caregiving strategies to manage behavioral changes, ensure safety, and provide emotional support to their loved ones.

Difficulty in Managing Daily Routines

Caregivers may struggle to maintain daily routines and activities when dealing with this phenomenon. This can lead to feelings of frustration, exhaustion, and a sense of being overwhelmed by caregiving responsibilities.

Impact on Quality of Life

It can significantly impact the quality of life for caregivers, limiting their ability to engage in self-care activities, pursue personal interests, or maintain social connections outside caregiving responsibilities.

How to Sympathize With a Person Experiencing Sundowning

Healthcare professionals and caregivers play a crucial role in identifying and addressing sundowning symptoms, aiming to improve the quality of life for individuals affected by dementia and their caregivers.

Strategies to help cope with sundowning may include:

  • Maintaining a consistent daily schedule.
  • Ensuring adequate exposure to natural light during the day.
  • Creating a calming bedtime routine.
  • Minimizing caffeine and sugar intake in the afternoon.
  • Providing a comfortable and familiar environment during the evening hours.

Key Takeaways

Managing these symptoms can pose a significant challenge for individuals with dementia and their loved ones. Seeking professional help is not only reasonable but can also be highly beneficial.

At Fairmont Senior Living, we take proactive steps to support seniors during the onset of sundowning. Our approach involves engaging seniors in various activities, such as gardening, spring events, and cooking using homegrown vegetables. These activities promote physical activity, socialization, and a sense of purpose among our assisted living and memory care residents.

By incorporating these initiatives, we create a vibrant and supportive environment for seniors. We strive to foster a sense of connection, purpose, and well-being among our residents. Contact us today to schedule a tour of our facility and discover how your loved one can benefit from calling Fairmont home.