Managing Sundowning: Dealing with Late-Afternoon Confusion and Dementia

February 11, 2026

If you are looking after someone with dementia, you likely know the exact time of day when things start to get difficult. As the sun begins to set, many people experience a noticeable spike in confusion, anxiety, and restlessness. This is widely known as "sundowning." It can be one of the most challenging parts of the day because it often happens just as your own energy is running low.

In 2026, we understand that sundowning isn't a deliberate choice or "bad behavior." It is a physical response to an exhausted brain. When someone has dementia, their brain has to work much harder just to process basic sights and sounds. By late afternoon, that mental energy is spent, and the changing light or increasing noise in the house can trigger a "fight or flight" response. This guide covers why this happens and offers practical, everyday ways to make the transition into evening much calmer for both of you.

Why dementia makes the late afternoon so difficult

To help someone who is struggling with sundowning, it helps to first understand what is actually going on in their head. It isn't just "tiredness" in the way we usually think of it. When a person has dementia, the simple act of navigating a day—following a conversation, making a cup of tea, or figuring out where they left their glasses—requires an immense amount of mental energy. By the time 4:00 PM or 5:00 PM rolls around, they have often reached a point of total cognitive exhaustion.

Think of it like a battery that no longer holds a full charge. Once that battery runs dry, the person loses their ability to curb their anxieties or make sense of what they are seeing and hearing.

The mix of physical and mental fatigue

The brain uses a lot of fuel to keep us calm and oriented. In 2026, we focus on the fact that dementia physically damages the parts of the brain that regulate our "circadian rhythm"—the internal clock that tells us when to be awake and when to rest.

Internal Confusion: Because their internal clock is broken, the person’s body might be sending "wake up" signals just as the sun is going down. This creates a jarring sense of being "on edge" without knowing why.
Physical Needs: Often, what looks like agitation is actually a physical discomfort they can no longer put into words. They might be thirsty, need the toilet, or be in slight pain, but because they are exhausted, it comes out as pacing or wanting to leave.
Shadows and Misinterpretation: As the light changes, the brain has to work harder to identify shapes. A coat hanging on a door might look like a person standing there; a dark rug might look like a hole in the floor. For someone already feeling vulnerable, these "visual glitches" are terrifying.

The loss of the "Filter"

Most of us have a filter that helps us ignore background noise, like a humming fridge or traffic outside. Dementia wears that filter away. By late afternoon, every sound can feel like it’s at maximum volume.

If the TV is on, the kettle is whistling, and you are trying to talk to them, it can cause a "sensory logjam." The person becomes overwhelmed because they can’t pick out which sound to listen to. This usually leads to them wanting to escape the room or the house entirely just to find some quiet.

Memory "Loops" and Old Routines

For many, the late afternoon was historically a time of high activity—picking up kids from school, finishing a shift at work, or getting tea on the table. Even if they haven't worked in thirty years, that "muscle memory" is still there.

When the sun starts to set, their brain might trigger an old "program" that says it’s time to go. They aren't being difficult; they are literally following a script that has been written into their mind for decades. They feel a profound sense of duty to be somewhere else, and not being able to get there feels like a failure or a crisis.

By recognizing that this is a combination of a tired brain and a confused body clock, you can stop feeling like you’re doing something wrong. It’s not about your care; it’s about how their brain is processing the end of the day.

Sorting out the lighting and the room to keep things calm

One of the most effective ways to manage sundowning is to look at the physical space through the eyes of someone with dementia. As we discussed, the late afternoon brings changes in light that the brain can easily misinterpret. By making a few small, practical adjustments to the room, you can remove the "visual triggers" that often lead to fear or the sudden urge to leave.

The goal here isn't to create a clinical environment, but to make the home feel as steady and predictable as possible when the sun starts to go down.

Managing light and shadows

In the late afternoon, the sun sits lower in the sky, creating long, moving shadows across floors and walls. To a healthy brain, these are just shadows; to a brain with dementia, a long shadow across a hallway can look like a barrier, a hole, or even an intruder.

Close the curtains early: It sounds simple, but drawing the blinds or curtains before the sun actually starts to set prevents the person from seeing the transition into darkness. It also stops the glass from turning into a black "mirror" that shows confusing reflections of the room.
Keep lighting consistent: Try to avoid having one bright room and one dark hallway. Moving from a well-lit kitchen into a dim corridor can be disorienting. Aim for an even level of warm light throughout the areas of the house they use.
Watch out for glare: Shiny floors or glass coffee tables can catch overhead lights and create "glare spots" that look like water or ice. Using lamps with shades rather than harsh unshaded bulbs can soften the room and make it feel more secure.

Reducing the "Clutter" for the senses

By the end of the day, a person with dementia has a much lower tolerance for "background noise." What feels like a normal, busy household to you can feel like a chaotic environment to them.

Lower the volume: If the television is on, try to keep the volume at a steady, moderate level. Avoid news programs with flashing tickers or loud, sudden commercials, as these are high-intensity and can cause a "startle" response.
Limit "cross-talk": Try to avoid having multiple conversations happening at once, or having the radio playing in the background while you are trying to talk to them. The more sounds their brain has to filter, the more frustrated they will become.
The "Kitchen Shuffle": The noise of pots and pans clattering or the hum of a vacuum cleaner can be very grating during the sundowning hours. If possible, try to do the noisier chores earlier in the day so the late afternoon remains a quieter period.

Creating a "Safe Zone"

It helps to have one specific place where the person feels most comfortable—perhaps a favorite armchair with a familiar view of the room.

Sometimes, just changing where someone sits can make a difference. If their chair faces a dark window or a busy door, they might feel exposed. Turning the chair to face into the warmth of the room, near a familiar lamp, can provide a subconscious sense of protection.

By taking control of the environment, you are essentially doing the "filtering" work for them. You are removing the things that confuse their eyes and ears, which leaves them with more mental energy to stay calm and engaged with you.

Planning the afternoon to avoid too much noise and activity

While we often focus on what to do when the agitation starts, the best way to manage sundowning is actually to look at what happens in the hours leading up to it. If the person's "mental battery" is already drained by lunchtime, the afternoon is almost guaranteed to be difficult.

Structuring the day isn't about creating a rigid, military-style schedule. It’s about managing the person's energy levels so they aren't "running on empty" by 4:00 PM.

Front-loading the day

In 2026, we encourage a "heavy morning, light afternoon" approach. Most people with dementia are at their most alert and capable in the first few hours after waking up.

Do the "hard" stuff early: Appointments, baths, or visits from family should ideally happen in the morning. These activities require a lot of social and mental effort. If you save a doctor's visit or a shower for 3:00 PM, you are asking for high-level cooperation just as their brain is starting to shut down for the day.
Encourage physical movement: A bit of activity in the morning—like a short walk or some light gardening—can help regulate their body clock. It burns off physical energy and helps them feel more naturally tired (rather than anxious-tired) later on.
Keep the "big" meal at lunchtime: Processing a heavy meal takes physical energy. For many, having the main meal in the middle of the day and a lighter snack in the evening prevents that "sluggish" feeling that can turn into restlessness later.

The "Quiet Hour" strategy

Around 1:00 PM or 2:00 PM, it is helpful to introduce a period of deliberate low stimulation. This isn't necessarily a nap—though a short 20-minute rest can help—but rather a time where the world slows down.

If the person is constantly stimulated from breakfast until dinner, they will reach a "breaking point." By introducing a quiet hour where the TV is off and the house is calm, you give their brain a chance to "recharge" slightly. This can be as simple as sitting together with a cup of tea, listening to some very low-volume music, or looking through a familiar book.

Managing caffeine and sugar

It’s a simple point, but it’s often overlooked. What someone eats and drinks in the early afternoon has a direct impact on their behavior three hours later.

Watch the caffeine: Try to switch to decaffeinated tea or coffee after lunchtime. Caffeine can stay in the system for a long time and contribute to that "wired but tired" feeling that fuels afternoon pacing.
Steady blood sugar: Avoid sugary snacks in the late afternoon. The "sugar crash" that follows can lead to irritability and confusion. A snack with a bit of protein or slow-release energy (like a piece of toast or some fruit) is much better for keeping their mood steady.

Watching for "Activity Creep"

As carers, we are often busy in the afternoon—prepping dinner, checking emails, or tidying up. This "activity creep" creates a background hum of movement and noise that the person with dementia might find unsettling.

If they see you rushing around, they will mirror that energy. They might feel they should be doing something too, which leads to them asking, "What do I need to do?" or "Where should I be?" If you can, try to keep your own movements calm and purposeful. If you need to get things done, see if there is a way to involve them in a very simple, repetitive task—like folding napkins—so they feel included in the "work" of the house without being overwhelmed by it.

Simple ways to help them settle for the night

The final hour before bed is often the most fragile part of the day. After a long afternoon of managing sundowning, the goal is to shift the energy of the house from "alert and anxious" to "quiet and predictable." This transition is less about what the clock says and more about the signals you send to the person’s brain that the day is over and there is nothing left to do.

It helps to focus on creating a series of steady, low-stress habits that tell the body it is time to rest.

Establishing the "Night-time Signal"

Because dementia disrupts the internal clock, you have to provide clear external signs that night has arrived. Without these, the person may feel they are just "waiting" for the next task or event, which keeps their brain in an active, searching state.

Warmth as a cue: A drop in body temperature is a natural trigger for sleep, but many people with dementia feel the cold more acutely. A warm drink (caffeine-free), a heat pad, or a fleece blanket can provide a physical sense of being "tucked in."
Consistent smells: Using the same scent every night, like a specific soap or a gentle lotion, creates a sensory "anchor." Over time, the brain begins to associate that smell with the end of the day.
Rhythmic sound: If you use music, keep it at a slower tempo than a human heartbeat. Simple, predictable sounds are much more effective at settling an anxious mind than anything with lyrics or complex melodies that the brain might try to follow.

The Bedtime Transition

If the person is still restless or asking to go elsewhere, the way you lead them toward the bedroom matters. Avoid making it feel like an order, which can trigger resistance. Instead, focus on the comfort of the destination.

Prepare the room beforehand: Have the bed turned down, the pajamas laid out, and the room at a steady, comfortable temperature before you suggest moving. Walking into a dark, cold room can be a major trigger for someone to turn around and walk back out.
Use short, direct instructions: Instead of a long explanation about why it’s late, try: "Your bed is all warm and ready for you. Let’s get you settled."
Low-stress interaction: Once they are in bed, avoid talking about the next day’s plans or anything that requires them to think ahead. Keep your voice low and your sentences short.

Dealing with "Middle of the Night" Waking

Sundowning often leads to a disrupted sleep cycle. If they wake up at 2:00 AM and think it’s morning, your reaction will determine how quickly they settle back down.

Keep the interaction "boring": If they wake up, keep the lights low and your voice very quiet. If you turn on all the lights or start a full conversation, you are accidentally confirming to their brain that the day has started.
Brief reassurance: Use short, simple phrases like, "It’s still the middle of the night, everyone is sleeping. Let’s get back into the warm bed."
Safety checks: Quickly check if they are agitated because they are cold or need the toilet. Addressing the physical need immediately is the fastest way to get them back to sleep.

A Final Thought: Consistency Over Perfection

The most important thing to remember about sundowning is that it is a physical process happening in the brain. Some days, despite your best efforts with lighting, noise control, and routines, the person you care for will still be restless. That isn't a failure on your part; it is the nature of the condition.

The goal isn't to have a perfect evening every single night. It’s about reducing the overall friction in the house so that these difficult hours become more manageable for both of you. By staying consistent with these small changes, you create an environment that feels predictable. In a world that feels increasingly confusing to someone with dementia, that predictability is the most practical form of support you can offer.