Sundowning: Finding Light in the Twilight

Introduction

Sundowning is one of those words that can unsettle people when they first hear it. It describes a pattern of behaviour often linked to dementia, where symptoms such as confusion, agitation, or restlessness become more noticeable in the late afternoon or evening. For those of us living with dementia, and for families and carers, sundowning can feel like an extra hurdle at the end of the day.

This blog aims to explain sundowning clearly, share practical strategies, and highlight sources of help, hope, and ways to support a sense of recovery in daily life. The focus is on the UK context, where long winter evenings and stretched health services make awareness and preparation especially important.

I apologise if I get a bit technical, but it's a difficult topic to describe without detail.

What Is Sundowning?

Definition

• A recognised phenomenon in dementia care

• Symptoms include confusion, irritability, anxiety, pacing, or withdrawal

• Typically occurs in the late afternoon or evening.
  

Why It Matters

• It affects both the person with dementia and those around them

• It can disrupt routines and increase stress levels

• Understanding sundowning allows families and carers to respond with confidence rather than fear.
  

Causes and Contributing Factors

Biological and Psychological

• Fatigue: Cognitive energy is depleted after a full day

• Circadian rhythms: Dementia can disrupt the body’s internal clock

• Stress accumulation: Small frustrations build up and spill over later.
  

Environmental

• Lighting: Shadows and dim light can cause misinterpretation

• Noise: Evening household activity may feel overwhelming

• Routine changes: Unpredictable schedules can trigger anxiety.
  

My Personal Perspective

Living with young onset dementia, I notice sundowning as a shift in clarity. Late afternoons can bring:

• Difficulty following conversations

• Restlessness or pacing

• Heightened anxiety about small details.

It is not constant, nor is it permanent. With adjustments, my evenings can become calmer and more positive.

Practical Strategies

Here are a few practical things that work for me:

Daily Routine

1. Consistency: Keep meals, medication, and bedtime regular

2. Activity timing: Schedule demanding tasks earlier in the day

3. Rest breaks: Short naps or quiet moments prevent fatigue.
   

Environment

• Lighting: I use warm, bright lamps to reduce shadows

• Noise control: I try to limit loud television or multiple conversations

• Familiar surroundings: I try to keep my rooms uncluttered and predictable (easier said than done when you're as messy as I am!).
  

Emotional Support

• Reassurance: Calm words and presence reduce my anxiety

• Humour: Light moments can ease my tension

• Connection: Holding hands or sitting together provides me with comfort.
  

Recovery of Balance

Small changes can transform my evenings. These things worked for me:

• A brighter lamp reduced confusion

• Familiar music restored calm

• A gentle reminder of safety eased anxiety.

These are not cures, but they are recoveries of balance—moments where sundowning loses its grip on me.

Community Strength

Support groups are a great help - I couldn't survive without them. Dementia cafés, and peer networks across the UK share strategies and encouragement. Families find hope in knowing they are not alone.

Myths and Realities

• Myth: Sundowning happens to everyone with dementia.

  • Reality: It is common but not universal.
    

• Myth: Sundowning signals decline.

  • Reality: It is a symptom that fluctuates, not a marker of progression.
    

• Myth: Nothing can be done.

  • Reality: Practical steps and emotional support make a real difference.
    

Role of Carers, Families and Friends

Carers

• Observe patterns and keep notes

• Adapt routines to reduce evening demands

• Stay calm—tone of voice influences atmosphere.
  

Families & Friends

• Offer patience and avoid taking irritability personally

• Provide presence, even in silence

• Celebrate small successes together.
  

Sundowning in the UK Context

Challenges

• Long winter evenings increase exposure to dim light

• NHS services face high demand, making self-help strategies vital

• Families often balance care with work and other responsibilities.
  

Sources of Help

• Alzheimer’s Society UK: Helplines and resources

• Local dementia cafés: Peer support and shared experiences

• GPs and memory clinics: Professional advice and referrals.
  

Key Takeaways

• Sundowning is a recognised but manageable aspect of dementia

• It is influenced by fatigue, environment, and routine

• Practical strategies and emotional support can reduce its impact

• Community resources in the UK provide help and hope

• Recovery is about regaining calm and dignity, not curing dementia.

So. In conclusion:

Sundowning doesn't have to dominate evenings. With awareness, preparation, and support, it can be softened and managed.

• Talk openly about sundowning

• Share strategies within families and communities

• Seek help from professionals and support groups

• Hold onto hope—every small recovery of balance matters
  

By shining a light on sundowning, we can replace fear with understanding and isolation with community. The twilight hours can still hold calm, dignity, and connection.

Don't worry about it. MANAGE and ACCOMMODATE it.