Understanding Sundowning, pt. 3

Sundowning is a group of symptoms that may occur later in the day in seniors with dementia. Some of the many contributing factors may include:

— Hunger or dehydration
— Overstimulation from noise or busy environments
— Boredom or lack of daytime activity
— Changes in routine or unfamiliar surroundings
— Stress or frustration from others in the home
— Pain, illness, or infection

In some cases, sudden worsening of confusion may be linked to medical issues such as urinary tract infections (UTIs), sleep problems, or medication side effects.

Sundowning cannot always be prevented, but minor adjustments throughout the day may help reduce symptoms and create a calmer evening routine.

— Keep routines consistent: Predictability often helps reduce anxiety. Try to keep mealtimes, bedtime, activities, and medication schedules as consistent as possible.
— Encourage activity during the day: Regular movement and daytime engagement may help improve sleep at night. Walking, light exercise, social interaction, or spending time outdoors during daylight hours can help support healthier sleep-wake cycles. At the same time, it is important not to overdo activities to the point of exhaustion. Moderate activity tends to work better than overly busy schedules.
— Reduce evening stimulation: As evening approaches, try to create a calmer environment. Loud television programs, clutter, chores, or too much background noise may increase confusion and agitation.

It is often helpful to:
— Dim harsh lighting while keeping rooms well-lit
— Close curtains before it gets dark outside
— Play soft music
— Look through family photo albums
— Encourage quiet conversation or relaxing activities

The objective is not perfection. Even little changes to the senior’s environment can sometimes make evenings feel less stressful.

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