Why does my mum or dad get more confused in the evening? Understanding sundowning
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Dementia and sundowning can be challenging for families, particularly when a loved one becomes more confused, anxious or unsettled as the day comes to an end.
If your mum or dad seems more confused, anxious or unsettled as the day comes to an end, you’re not imagining it. This can be a common symptom of dementia known as sundowning or late-day confusion. Although it can be distressing for families, there are practical ways to ease its impact and help your loved one feel calmer.
For families across Leicestershire South, including Market Harborough, Oadby, Knighton, Leicester and the surrounding villages, understanding sundowning and why it happens can help make evenings less stressful for everyone.
Understanding sundowning?
Sundowning describes a pattern in which someone living with dementia becomes more confused, restless or anxious during the late afternoon or evening.
Not everyone with dementia experiences it, but it is more commonly reported during the middle and later stages of the condition.
Symptoms can include:
- Increased confusion
- Restlessness or pacing
- Irritability
- Anxiety
- Asking to “go home”, even when they are already at home
- Repeating questions more frequently
- Difficulty recognising familiar people
- Trouble sleeping
- Wandering
For family carers, evenings can become one of the most challenging parts of the day, particularly when symptoms are unpredictable.
Why does sundowning happen?
There isn’t one single cause of sundowning, but several factors are thought to contribute.
1. Tiredness
By the end of the day, someone living with dementia may be mentally and physically exhausted. This can make it harder to process information, communicate and manage everyday situations.
2. Changes in light
As daylight fades, shadows become more noticeable and familiar surroundings can look different. Someone with dementia may misinterpret these changes or become unsettled as the light levels drop.
3. Disrupted body clock
Dementia can affect the brain’s internal body clock, making it harder to distinguish between day and night and maintain a regular sleep pattern.
4. Hunger or dehydration
Not eating regularly or drinking enough throughout the day can contribute to confusion and restlessness.
5. Too much stimulation
A noisy television, several people talking at once or a busy household can become overwhelming, particularly later in the day when someone is already tired.
How can you help?
Although there isn’t a specific cure for sundowning, small changes to daily routines and surroundings can often help reduce symptoms and make evenings more manageable.
1. Keep a regular routine
People living with dementia often feel more secure when each day follows a familiar pattern.
Try to keep mealtimes, activities and bedtime consistent. Familiar routines can provide reassurance and help reduce uncertainty.
2. Make the most of daylight
Encourage natural daylight during the day and keep curtains open for as long as possible.
Good lighting in the evening can also help reduce confusing shadows and make familiar spaces feel more comfortable.
3. Avoid overstimulation
As evening approaches, try creating a calm and relaxing environment.
Soft music, quiet conversation and reducing background noise can help someone feel more settled. Avoid introducing too many activities or changes to their routine at this time of day.
4. Encourage activity during the day
Gentle exercise, a walk around the neighbourhood or attending a local dementia-friendly activity can help provide structure and support a healthier sleep routine.
5. Check for physical needs
Sometimes increased confusion or restlessness is linked to pain, constipation, needing the toilet, dehydration or an infection such as a urinary tract infection (UTI).
If behaviour changes suddenly or becomes noticeably worse, speak to your GP to check whether there may be an underlying cause.
Local support in Leicestershire South
If you’re supporting someone living with dementia, remember that you don’t have to manage alone.
Families across South Leicestershire can access advice and support through:
- Your GP
- Leicestershire Partnership NHS Trust Memory Assessment Service
- Age UK Leicester Shire & Rutland Dementia Support Service
- Dementia Harborough
- Alzheimer’s Society
- Local memory cafés in Market Harborough, Wigston and Leicester.
- Carer support groups across Leicestershire.
Talking to other families in a similar situation can provide reassurance, practical advice and a reminder that you’re not alone.
How GoodOaks Homecare Leicestershire South can help
Evenings are often when family carers feel most exhausted. After a full day of supporting a loved one, managing increased confusion or anxiety can feel overwhelming.
At GoodOaks Homecare Leicestershire South, our Care Professionals understand the challenges that dementia can bring and the importance of providing patient, reassuring support.
We offer personalised visiting care and live-in care across Market Harborough, Oadby, Knighton, Leicester and the surrounding communities, helping people remain safe and comfortable in familiar surroundings.
Our Care Professionals take time to understand each person’s routines, preferences and potential triggers. By providing familiar, consistent support, they can help create calmer evenings and offer reassurance when it is needed most.
For some families, even a few hours of support in the late afternoon or evening can make a real difference, giving family carers time to rest while knowing their loved one is in caring hands.
When should you seek medical advice?
Although sundowning is recognised in dementia, sudden or significant changes in behaviour should always be discussed with a healthcare professional.
Confusion that develops quickly could be caused by:
- A urinary tract infection (UTI)
- Dehydration
- Medication side effects
- Pain
- Delirium
- Other underlying medical conditions
If you’re ever unsure, contact your GP or NHS 111 for advice. Sudden confusion needs prompt medical assessment, as it may be a sign of an underlying illness.
You’re doing better than you think
Watching someone you love become more confused in the evenings can be upsetting. Many family carers worry that they’re doing something wrong, but sundowning is a recognised experience for many people living with dementia.
Understanding why it happens, making small adjustments to daily routines and asking for support when you need it can all help make evenings calmer and less stressful.
And remember, looking after yourself is just as important as looking after the person you care for.
Frequently asked questions
1. Does everyone with dementia experience sundowning?
No. Some people living with dementia never experience sundowning, while others may only notice occasional symptoms. It is more commonly reported during the middle and later stages of dementia.
2. What time does sundowning usually start?
Sundowning often begins in the late afternoon or early evening as daylight fades, although the timing and duration vary from person to person.
3. Can sundowning be treated?
There isn’t a specific treatment for sundowning, but maintaining familiar routines, reducing noise, improving lighting and making sure someone is well rested, hydrated and comfortable can often help ease symptoms.
4. When should I speak to a GP about increased confusion?
If confusion develops suddenly, becomes significantly worse or is accompanied by other symptoms such as pain, fever or changes in mobility, seek medical advice promptly. There may be an underlying medical cause that needs treatment.
5. How can homecare help with sundowning?
A familiar Care Professional can provide reassurance, maintain evening routines, prepare meals, offer support with personal care and help create a calm environment. This can make evenings more manageable for the person living with dementia and provide valuable reassurance for their family.
Need a little extra support?
If evenings are becoming more challenging, you don’t have to manage everything alone. GoodOaks Homecare Leicestershire South can help you explore personalised visiting care or live-in care to suit your loved one’s needs and routine.
Whether you need a few hours of support in the evening or more regular assistance, we’re happy to talk through the options and offer advice without pressure or obligation.
Get in touch with our Leicestershire South team to find out how we can help.
