Education and Care - Coping with Sundowning

Alzheimer's Foundation of America

Sundowning is a dementia-related symptom that refers to increased agitation, confusion and hyperactivity that begins in the late afternoon and builds throughout the evening. Most sundowning emerges in mid-stage dementia and slowly worsens as the disease progresses. What causes it? Dementia may damage the body's internal clock, causing a disruption of sleep-wake cycles. Secondly, individuals with dementia become fatigued by their inability to process information; the more hours spent on this process, the more exhausted - and irritable - they may become.


  • Plan activities or outings in the morning.
  • Do only simple, calming activities in the afternoon.
  • Keep individuals awake during the day.
  • Increase indoor lighting before dusk.
  • Ensure that the individual is not suffering from hunger, thirst, pain or fear.
  • Correct potential causes with basic interventions such as hydration and snacks.
  • Remove excess stimuli and clutter.
  • Watch for sundowning in early-stage dementia or rapidly worsening symptoms, both of which may suggest "delirium".
  • Consult your doctor to see if medications may help.
  • Be twice as patient and kind during these hours.

©2007 Alzheimer's Foundation of America. All Rights Reserved


Home > Education and Care - Coping with Sundowning