Sundowning in seniors is something many Broward County families notice before they have a name for it. Mom is calm at breakfast and herself at lunch, then around four or five in the afternoon she starts pacing, asking to go home when she is home, or getting upset for no reason anyone can see. By bedtime everyone in the house is worn out.
This guide explains what sundowning is, what it looks like, why it happens, what tends to help at home and what makes it worse. It also covers when a sudden change in behavior is a reason to call the doctor, because not every bad evening is sundowning. Tamarac Senior Center is not a medical provider, so for diagnosis and treatment, always work with your parent’s doctor.
- Sundowning is increased confusion, restlessness or agitation in the late afternoon and evening, common in people with Alzheimer’s and other dementias.
- Common triggers include fatigue, fading light, a disrupted body clock, and needs such as hunger or pain that the person cannot explain.
- Daylight in the morning, activity during the day, fewer late naps and lights on before dusk often help.
- Arguing or correcting usually makes it worse. Calm reassurance and redirection work better.
- A sudden change in behavior can be an infection, a medication problem or another illness. Call the doctor.
What is sundowning?
Sundowning is a pattern of increased confusion, anxiety, restlessness or agitation that starts in the late afternoon and can continue into the night. It is common in people living with Alzheimer’s disease and other forms of dementia. It is not a disease on its own, and it does not happen to everyone with dementia.
The National Institute on Aging has a clear page of tips for coping with sundowning, and the Alzheimer’s Association covers it with sleep issues. Its 24/7 helpline, 1-800-272-3900, also takes calls in Spanish.
What does sundowning look like?
It usually looks like a different person showing up late in the day: pacing, asking to go home while at home, following you from room to room, suspicion, crying, yelling, or trying to leave the house. The same person may be calm and cooperative in the morning.
- Restlessness and pacing.
- Asking to go home, or to see a parent who passed away years ago.
- Confusion about where they are or what time it is.
- Irritability, suspicion or yelling.
- Trying to leave the house or wandering.
- Trouble falling asleep, or waking up confused at night.
Keep a simple log for two weeks: the time it starts, what happened that day, what they ate, how they slept. Patterns show up quickly, and the log is useful for the doctor.
Why does it happen?
No one knows the exact cause, but several things seem to add up late in the day: fatigue after a long day, fading light and longer shadows that are harder to read, changes in the brain that disturb the body clock, and needs that the person cannot put into words, such as hunger, thirst, pain or needing the bathroom.
- Tiredness late in the day.
- Less light, more shadows, and a harder-to-read room.
- A disrupted sleep and wake cycle.
- Hunger, thirst, pain or constipation.
- Too much noise or activity, such as a busy kitchen at dinner time.
- Too little activity during the day, followed by a long afternoon nap.
What helps at home
Dementia care organizations commonly recommend changes to the daily routine rather than relying on anything said in the moment. Morning daylight, a predictable schedule, activity earlier in the day, limited naps and caffeine, and a calm, well lit home before dusk are the steps most often recommended.
- Get daylight in the morning. A walk outside or breakfast by a sunny window.
- Keep a steady routine. Wake up, meals and bedtime at the same times each day.
- Plan activity for earlier in the day. Appointments, bathing and outings in the morning.
- Limit late naps and avoid caffeine and alcohol in the afternoon.
- Turn on lights before dusk and close curtains to cut down on shadows and reflections.
- Offer a snack and a drink in the afternoon, and check for pain or a bathroom need.
- Lower the noise at dinner time: TV off, fewer people talking at once.
- Have a calming activity ready: familiar music, folding towels, looking at photos.
What tends to make it worse
Arguing, correcting and reasoning usually make sundowning worse, because the person cannot hold on to the explanation. It works better to stay calm, acknowledge the feeling, and gently steer attention to something else.
- Arguing about where they are or what year it is.
- Rushing or pulling them by the arm.
- A loud, crowded room in the evening.
- Changing the routine without warning.
- Leaving them alone and bored all afternoon.
If they ask to go home, try answering the feeling instead of the fact: “You miss home. Tell me about your house.” Then offer a drink or a short walk together.
Call (954) 694-1100 to visit Tamarac Senior Center and see how a supervised day at the center is structured.
How a structured day can help
Many families find that a predictable, active day makes the evening easier to manage. An adult day center can provide that structure: a set schedule, gentle exercise, social time and meals, with staff present. It cannot treat dementia or promise fewer difficult evenings, but it gives your parent a full day and gives you time to rest before the late afternoon.
- Gentle group exercise, seated or standing.
- Social and health programs in English and Spanish.
- Games, crafts and music that keep the mind engaged.
- Meals and snacks at regular times.
- Door to door transportation, Monday to Saturday, 8 AM to 4 PM.
Our guides on dementia day programs in Broward County and memory stimulating activities go further, and the activities calendar shows what is planned each month. If you are the one running out of energy, read our guide to caregiver burnout and respite care.
When to call the doctor
Call your parent’s doctor if the confusion is new, came on suddenly over hours or days, or is much worse than usual. A sudden change can be delirium caused by an infection, a new medication, dehydration or another illness, and that needs medical attention. Call 911 for chest pain, trouble breathing, a fall with injury, or if they cannot be woken normally.
- Confusion that appears or worsens suddenly.
- Fever, burning when urinating, or a new cough.
- A new medication or a dose change in the past few weeks.
- Not eating or drinking.
- A fall, even without a visible injury.
- Seeing or hearing things that are not there, if that is new.
Bring your two-week log to the appointment. It helps the doctor tell a pattern from a new problem.
Frequently Asked Questions
What is sundowning in seniors?
Sundowning is increased confusion, anxiety, restlessness or agitation that starts in the late afternoon or evening. It is common in people with Alzheimer’s disease and other dementias. It is not a separate disease, and not everyone with dementia experiences it.
What time of day does sundowning start?
It usually begins in the late afternoon, around the time the light starts to fade, and can continue into the evening and night. Keeping a log of when it starts helps you plan the day around it.
What helps sundowning at home?
Morning daylight, a steady daily routine, activity earlier in the day, fewer late naps, no afternoon caffeine, lights on before dusk, a quiet home at dinner time and a calming activity such as familiar music. Staying calm and redirecting works better than arguing.
Can an infection cause sudden confusion in an older adult?
Yes. Sudden confusion can be delirium caused by an infection such as a urinary tract infection, a new medication, dehydration or another illness. If confusion appears or worsens over hours or days, call the doctor.
Does adult day care help with sundowning?
An adult day center cannot treat dementia or guarantee fewer difficult evenings. Many families find that a structured day with activity, meals and company makes evenings easier to manage, and it gives caregivers time to rest.
Where can Broward County families get help with dementia care?
Start with your parent’s doctor. The Alzheimer’s Association helpline, 1-800-272-3900, is open 24/7 and takes calls in Spanish, and Florida’s Elder Helpline, 1-800-963-5337, can point you to local services. Tamarac Senior Center in Tamarac offers a supervised adult day program, call (954) 694-1100.
