What is sundowning in dementia?
When caring for someone living with dementia, changes in behaviour can often feel unpredictable and difficult to manage. Behaviour can change throughout the day, but particularly more so as the day draws to an end. This is known as sundowning, a common symptom associated with dementia that can be distressing for both the individual and those around them.
At Consultus Care and Nursing, we’ve been supporting individuals and their families for over 60 years, offering compassionate live-in dementia care that helps people remain in the familiarity of their own home. Understanding what sundowning is, why it happens, and how the right support can help is a crucial step towards managing it effectively and improving quality of life.
What is dementia?
Dementia is a broad term used to describe a range of neurological conditions that lead to a progressive decline in cognitive function. This decline can affect memory, thinking, problem-solving, and even personality and behaviour. The most common form of dementia is Alzheimer’s disease, but there are many other forms, including vascular dementia, Lewy body dementia, and frontotemporal dementia. Each type affects the brain in different ways, but all forms of dementia can be life-altering, both for the individual, their families and for those who care for them.
Around 900,000 people currently live with dementia in the UK, and sundowning is estimated to affect roughly 20% of those with a common type of dementia called Alzheimer’s disease.
What is sundowning in dementia?
Sundowning - sometimes called “late day confusion” - refers to a pattern of increased confusion, agitation, anxiety or restlessness that tends to occur in the late afternoon or early evening. For individuals living with dementia, this time of day can be particularly difficult, and it may feel as though behaviours become more pronounced as the sun begins to set.
Whilst sundowning doesn’t affect everyone with dementia, it can be especially challenging for family carers, who may notice that just as they begin to wind down for the evening, their loved one becomes more distressed or unsettled. Sundowning often gives the sensation that you need to get home, even if you’re already home, or that an important task needs to be finished.
What are the symptoms of sundowning?
The symptoms of sundowning can vary in intensity from person to person, but they often follow a recognisable pattern that becomes more noticeable in the later afternoon or evening. For many individuals living with dementia, this time of day can bring about increased confusion. Understanding the signs can help families and carers anticipate challenges and put the right support in place.
Common symptoms of sundowning include:
Increased confusion or disorientation - The person may seem more unsure of where they are or what time it is, even if they appeared more settled earlier in the day. They might forget familiar people, places, or routines.
Restlessness or pacing - A person may feel the need to move around, walk back and forth, or constantly change positions, often unable to sit still or relax.
Agitation or irritability - Changes in mood can become more pronounced, with signs of frustration, anxiety, or even aggression, especially if they feel misunderstood or out of control.
Suspicion or paranoia - The person may become mistrustful of those around them, believing someone is trying to harm or deceive them. This can be distressing for both the individual and family members.
Sleep disturbances - Difficulty settling in for the night, waking frequently, or having disrupted sleep patterns can be a key sign of sundowning. In some cases, this leads to reversed sleep cycles, where the person is awake at night and tired during the day.
What causes sundowning?
While the exact cause of sundowning is not fully understood, there are a number of factors believed to contribute to this change in behaviour:
Disruption to the body’s internal clock (circadian rhythm), making it harder to distinguish day from night
Low lighting or shadows in the evening, which can cause confusion or misinterpretation of surroundings
Fatigue, both physical and mental
Unmet needs, such as hunger, thirst, needing the toilet, or feeling uncomfortable
Overstimulation, including noise, activity, or changes in environment
Pain or illness, which may be harder to communicate or recognise later in the day
Talk to us today
Give us a call to discuss your needs with one of our friendly, expert Care Advisors. They will guide you through your options to ensure you make the right choice for you and your family.
How live-in care help with sundowning
Having a dedicated, live-in carer offers a level of stability and reassurance that can make a world of difference to someone experiencing sundowning. Because live-in care takes place in the comfort of the person’s own home, it helps maintain familiar routines, reduce environmental changes, and offers consistent one-to-one support around-the-clock
A professional live-in carer can help with:
Maintaining a regular daily routine, which supports the body’s natural rhythms and can reduce confusion.
Providing gentle evening activities to promote calm and engagement, such as music, light conversation or a short walk.
Managing the environment, such as keeping rooms well-lit during dusk to reduce shadow confusion.
Ensuring basic needs are met, like timely meals, hydration, and trips to the toilet.
Reducing stress and stimulation, by creating a peaceful atmosphere free of noise or unnecessary interruptions.
Monitoring and responding to behaviours, offering reassurance, redirection, or support in the moment.
Dementia care at Consultus Care
At Consultus Care, we believe life is better at home - especially for those living with dementia. Our live-in dementia care service allows individuals to remain in a familiar and comforting environment, surrounded by memories and routines that help them feel safe and secure.
Whether you’re looking for live-in care on an ongoing basis or just beginning to explore care options for a loved one, our experienced Care Consultants are here to offer friendly, expert guidance. Call us on 01723 496715 or enquire online.
How to arrange dementia care
Speak to a Care Advisor
Our friendly, expert Care Advisors are here to guide you through your options, answer your important questions, whilst providing support along the way.
Care assessment
If you would like our managed live-in care service, a Care Consultant local to you, will complete a free assessment of your needs in your home.
Care starts
A fully trained carer will be carefully matched to meet your needs, and will start to provide our high-quality service in your home.
Why choose Consultus Care and Nursing?
One of the longest-established and most trusted providers
Founded in 1962, we have always been innovators in live-in care and live-in nursing. With over 60 years’ experience, we are one of the country’s longest-established, most highly recommended and experienced providers.
Unrivalled choice and control over your care
We understand that every person’s needs are different and every family’s situation is unique. With our choice of fully managed live-in care and nursing, and our introductory service, we offer more flexibility and personalisation than any other provider.
Highly trained nurses and carers
We are nationally recognised for the quality of our nurses and carers. With market-leading training, delivered at our own, multi-award-winning training centre, they provide exemplary, compassionate care tailored to individual needs, offering total peace of mind for clients and their families.
Expert care and support, dedicated to you
Our Care Consultants oversee our nursing and managed care services supporting only a small number of families. This means our service is truly personal, with unrivalled support and continuity of care. Reassurance that we are there when you need us most.
Family-founded, family-owned
We continue to be a family-owned and family-managed business. The largest wholly family-owned live-in care provider in the UK, we focus on what our clients and their families need from a high-quality care service, not on meeting investors’ expectations.
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