You finally sit down after a long day, and that's when things get worse.
Your loved one starts pacing, gets agitated, or says things that don't make sense.
Every evening, like clockwork.
This pattern has a name: Sundowning. And while you can't eliminate it completely, small adjustments earlier in the day can take the edge off those difficult hours.
Let's dive in.
TODAY’S GAME PLAN
💆♀️ Small moves that make caregiving easier
Problem:
Sundowning is a cluster of symptoms, including confusion, anxiety, agitation, and restlessness, that shows up in the late afternoon and evening. It's not a separate disease. It's tied to damage in the part of the brain that regulates internal clocks. Most caregivers react to sundowning in the moment, trying to calm their loved one down once the agitation has already started. By then, the window for prevention has passed.
The key is to work earlier in the day. What happens between morning and mid-afternoon has a direct effect on how the evening goes. A few environmental and routine changes can reduce the intensity and frequency of episodes significantly.
How you can do this:
Get your loved one into natural light before noon, even 15 to 20 minutes outside or by a bright window
(Sunlight helps regulate the circadian rhythm, which is the internal clock that sundowning disrupts.)Limit caffeine and sugar after noon
(Stimulants later in the day can fuel the restlessness that peaks in the evening.)Start a calm, predictable wind-down routine around 3 or 4 PM. Dim overhead lights, play soft music, and reduce household noise.
(A gradual transition signals to the brain that it's time to slow down, rather than letting the sudden shift to darkness trigger confusion.)Turn on extra lamps before sunset so darkness never arrives all at once
(Sudden changes in lighting can increase disorientation. Keeping rooms well-lit through the evening reduces visual triggers.)If episodes persist or worsen, ask the doctor to review all current medications and check for pain or sleep disorders.
(Some medications actually cause or worsen sundowning as a side effect, and untreated pain is a common hidden trigger.)
Resources:
BrightFocus Sundowning Tips - Concise behavioral strategies from a trusted Alzheimer's research organization
UCLA Health Sundowning Guide - Expert video explaining what causes sundowning and how to respond.
NIA Alzheimer's Caregiving: Sundowning - Printable PDF with when to seek medical help and what to tell the doctor.
Trualta Caregiver Stress Guide - Focuses on the toll sundowning takes on you, with strategies to protect your own sleep.
Pick one step to try today. The evening doesn't have to be the hardest part of every day.
(None of the resources listed above are paid partnerships)
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FROM THE FRONT LINES
💬 From real caregivers this week
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🗣️ Real talk
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