Someone with Alzheimer’s or dementia may become more agitated or anxious starting in the late afternoon and lasting through the evening.

They could become aggressive, delusional, paranoid, want to walk, or accidentally wander away. Some may have disrupted sleep schedules or restlessness at night.

This behavior is called dementia sundowning because it typically begins around sundown – late afternoon or evening.

These dementia sundowning symptoms negatively affect your older adult’s quality of life and are challenging for you to manage.

We explain what causes sundowning and share 7 ways to manage the symptoms and behaviors. These suggestions make evenings calmer and easier for both your older adult and you.

What causes dementia sundowning?

Some studies show that sundowning affects up to 20% of people with Alzheimer’s. And, it can also affect older adults who don’t have dementia.

Researchers don’t know exactly why sundowning happens, but think that it’s caused by the changes in the brain due to dementia. The body clock, which regulates when we’re awake and when we’re asleep, might be affected by those changes.

7 ways to reduce and manage sundowning symptoms

1. Go along with their reality
Sometimes, a person with dementia will experience a different time in their lives, like when they were parents of young children, going to work, waiting for their parents as a child, or something familiar from their past.

If this happens, do your best to go along with their reality. Trying to force them back into our reality won’t work and will only cause upset or anger.

It may help to engage them in an activity that’s similar to what’s happening in their mind. For example, if they’re waiting for someone to come home, do something they would have done in that real situation. Maybe they would be making a snack, preparing dinner, or straightening up the house.

Think about their routines and activities when they were younger and brainstorm activities that would fit the situations that feel familiar to them.

Later, if needed, you could use a therapeutic fib to transition out of that activity and redirect their attention somewhere else.

For example, if they’re waiting for their mom to pick them up from school, you could help them get ready by gathering up their school bag, using the toilet, and getting their jacket. If doing that slowly isn’t enough of a distraction to transition to another activity, you could say that their mom called and said she would be a bit late so she asked that they went ahead and had a snack while waiting. During and after the snack, you’ll have more opportunities to transition to other enjoyable activities.

2. Listen carefully to understand the emotions behind their words
When someone is having sundowning symptoms, they may make strange requests, like asking for their mother or to go home.

Even if their words don’t make logical sense, listen for and respond to the emotion behind the words.

In some cases, they could be trying to express fear or loneliness. In other cases, they might be expressing frustration, discomfortanger, or other emotions.

3. Provide empathy, support, and comfort 
If your older adult is going through some tough emotions, they may not be ready to change how they feel. It may be kinder and more effective to support them while they take time to process their emotions.

You can do that by showing that you’re on their side. Some people might like you to sit with them, hold their hand, or give hugs. Others may simply like your company nearby or for you to be a sympathetic listener.

Neutral, but supportive, responses could include:

  • I understand.
  • That’s a lot to deal with.
  • Oh, that must be hard.
  • Of course you miss your Mom.