Sundowning and dementia
Sometimes a person with dementia will behave in ways that are difficult to understand more often in the late afternoon or early evening. This is known as 'Sundowning'.
- Changes in behaviour
- What causes changes in behaviour?
- Reducing and managing behaviour that challenges
- Agitation including restlessness
- Repetitive behaviour and dementia
- Shouting and screaming
- Sleep disturbance and waking up at night
- You are here: Sundowning and dementia
- Hiding, hoarding and losing things
- Trailing, following and checking
- Losing inhibitions
- Behaviour changes - other useful organisations
For example, people may become more agitated, aggressive or confused. This is often referred to as ‘sundowning’. This pattern may continue for several months and often happens in the middle and later stages of dementia.
Sundowning may be caused by:
- disturbance to the 24-hour ‘body clock’ that tells our bodies when to sleep, caused by the physical changes to the brain
- loss of routine at a previously busy time of day
- too little or disturbed sleep
- too little or too much light
- prescribed medication wearing off
- medications that worsen confusion and agitation
- lots of noise
- other conditions such as sight or hearing loss.
Sometimes you might think of the person’s behaviour as ‘sundowning’ and not realise that they’re actually trying to meet a need. For example, the person may be trying to communicate rather than behaving a certain way just because it’s late afternoon. Always consider what other reasons there may be for a person’s behaviour.
Sundowning – tips for carers
- Try to support the person to do things they find relaxing and enjoyable at this time of day.
- Think about what’s happened during the day. Could the person be trying to communicate a need, such as needing the toilet, feeling hungry or being in pain?
- It might help for the person to avoid daytime naps, although some people find a rest after lunch helps if they get tired during the day.
- Natural daylight can help the person – try to support them to get as much as possible by getting outside, and by making sure curtains are open and other objects aren’t covering windows.
- Think about the physical environment – is the lighting appropriate? If it’s too dark the person is likely to struggle to see things and if it’s too bright or noisy it may be making them feel more agitated.
- To help the person sleep better at night, see ‘Sleep disturbance – tips’ in the previous section.