Sundowning in Dementia: 9 Strategies to Reduce Anxiety & Restlessness

Does your loved one with dementia become more anxious, restless, or confused in the late afternoon? This phenomenon—known as sundowning—can lead to wandering, agitation, and sleep disturbances. While the exact cause isn’t fully understood, studies suggest that nearly 1 in 5 people with dementia will experience these symptoms.

What Is Sundowning?

Sundowning refers to a pattern of increased confusion, anxiety, or agitation that occurs later in the day. Individuals may:

• Become more restless or anxious

• Experience mood swings or aggression

• Feel paranoid or delusional

• Struggle with disruptive sleep patterns

• Exhibit pacing or wandering behaviors

While sundowning can’t always be eliminated, there are effective ways to reduce its intensity and create a more peaceful environment.

9 Strategies to Reduce Sundowning Symptoms

1. Step Into Their Reality

People with dementia may believe they need to get home from work or pick up their children from school. Instead of correcting them, gently validate their emotions and redirect their focus.

💬 Example: “I know you’re waiting for Mom. She called and said she’s running late—let’s have a snack while we wait.”

2. Listen for the Emotion Behind Their Words

If your loved one says, "I want to go home," or asks for someone who has passed away, focus on their emotions rather than logic.

✅ Validate their feelings: “I understand you miss your mom. That must feel hard.”
✅ Offer comfort: “I’m here with you—we’ll figure this out together.”

3. Offer Comfort & Support Without Overwhelming

As a caregiver you don’t always need to talk - sometimes just sitting beside them can provide comfort.

💜 Try: Holding their hand, playing soft music, or offering a warm drink.

4. Create a Safe Space for Relaxation

If you haven’t already, set up a "comfort corner" with familiar items like:
🛋️ A cozy chair
📖 A favorite book
🌿 A soft blanket

This clutter-free space can be a retreat during anxious moments.

5. Engage in Calming Activities

Keeping hands and minds occupied can help redirect energy and ease tension.

✨ Try:

• Folding laundry

• Listening to soft music

• Cuddling a stuffed animal

• Simple coloring or painting

Find what works best for your person—it may take some experimenting!

6. Establish a Predictable Bedtime Routine

A structured evening routine helps signal the brain that it’s time to wind down.

🌙 Tips for a calming bedtime routine:
✅ Lower the lights to reduce shadows
✅ Use lavender aromatherapy for relaxation
✅ Avoid stimulating TV shows or loud noises
✅ Engage in quiet activities like looking through old photos

7. Address Their Basic Needs Before Sundowning Begins

Unmet needs—such as hunger, thirst, or physical discomfort—often trigger restlessness.

Be proactive:
🕒 Schedule snacks & hydration breaks
🛏️ Ensure they’re dressed appropriately for comfort
💊 Manage medications for pain or arthritis

8. Monitor Your Own Stress Level

Dementia patients pick up on caregiver stress. If you’re feeling overwhelmed:
☁️ Take deep breaths
🚶 Step away for a short break
🧘‍♀️ Maintain a calm tone & body language

9. Consider Medical Support If Needed

If non-drug strategies aren’t helping, consult a healthcare professional. Some medications may help, but they should be used cautiously to avoid increased fall risk or drowsiness.

Caregiver Ground Rules for Dementia Behaviors

Before implementing strategies, keep these essential principles in mind:

1️⃣ You cannot change the person. Adapt to their behavior rather than trying to control it.
2️⃣ Consult a doctor. Behavioral changes may stem from medical issues, like infections or medication side effects.
3️⃣ All behavior has a purpose. Look for the need behind their actions.
4️⃣ All behavior is triggered. Identify potential triggers to address the root cause.
5️⃣ What works today may not work tomorrow. Stay flexible and creative with your responses.

Final Thoughts

Sundowning symptoms can be distressing, but small adjustments can make a big difference. Try implementing these strategies one at a time to see what works best for your loved one.

You Are Not Alone

Remember, these behaviors are a symptom of the disease—not a reflection of your care.

🫂 Join the Conversation:

• Connect with others who understand your journey in the Dementia Caregivers Academy Facebook Group.

📚 Resources to Support You:

• Download the FREE Dementia Signs Tracker to document and manage behaviors.

• Explore the Dementia Caregivers Academy Course for in-depth strategies and support.

💜 You’re doing an incredible job. Even on the hard days. Especially on the hard days.

Let’s navigate this journey together—one evening at a time. 🌙

Want to be part of a bigger community?

Join our private Facebook community for dementia caregivers; it's a kind, supportive space with others just like you. It's free to join, just follow this link (opens in a new window).

PS.

This video is also posted on our YouTube Channel!