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Sundowning: Navigating the Challenges of Evening Agitation in Dementia
Sundowning, also known as late-day confusion, is a common phenomenon observed in individuals with dementia. As the day transitions into evening, some people with dementia experience increased agitation, confusion, and restlessness. In this blog post, we’ll delve into the intricacies of sundowning, explore its causes and triggers, and discuss strategies for managing and supporting individuals experiencing this challenging symptom.

Understanding Sundowning:

Sundowning refers to a pattern of behavioral and psychological symptoms that often occur in the late afternoon or evening, typically worsening as the day progresses. These symptoms may include agitation, anxiety, confusion, wandering, and hallucinations. Sundowning can be distressing for both individuals with dementia and their caregivers, making it essential to understand its underlying causes and effective management strategies.

Causes and Triggers:

While the exact cause of sundowning remains unclear, several factors may contribute to its onset and exacerbation. These factors may include disruptions in the sleep-wake cycle, fatigue, sensory overload, hunger, thirst, pain, and environmental changes. Understanding the individual triggers for sundowning in each person with dementia is crucial for developing personalized intervention strategies.

Strategies for Managing Sundowning:

Managing sundowning requires a multifaceted approach that addresses the underlying causes and triggers while providing comfort and support to the individual with dementia. Some effective strategies may include:
Establishing a Consistent Routine: Maintaining a regular schedule for meals, activities, and bedtime can help stabilize the sleep-wake cycle and reduce agitation.
Creating a Calming Environment: Minimizing noise, clutter, and bright lights in the evening hours can promote relaxation and reduce sensory overload.
Encouraging Relaxation Techniques: Gentle activities such as listening to soothing music, practicing deep breathing exercises, or engaging in light stretching can help alleviate stress and anxiety.
Providing Comfort and Reassurance: Offering verbal reassurance, physical touch, and comforting gestures can help individuals feel safe and secure during episodes of sundowning.
Monitoring Medications: Certain medications or changes in medication schedules may contribute to sundowning symptoms. It’s essential to consult with a healthcare professional to review medication regimens and make adjustments if necessary.

Supporting Caregivers:

Caring for someone experiencing sundowning can be physically and emotionally exhausting for caregivers. It’s crucial for caregivers to prioritize self-care, seek support from healthcare professionals and support groups, and utilize respite care services to prevent burnout and maintain their well-being.


Sundowning poses significant challenges for individuals with dementia and their caregivers, but with understanding, patience, and proactive management strategies, it is possible to minimize its impact and enhance the quality of life for everyone involved. By addressing the underlying causes, creating a supportive environment, and providing personalized care and support, we can navigate the complexities of sundowning with compassion and empathy.
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