, sometimes referred to as ‘late-day confusion,’ is a symptom that studies show effects 20 percent of people living with Alzheimer’s and other dementias.  Most often this occurs between late afternoon and early evening as daylight adjusts to darkness and shadows change…ergo the name ‘Sundowners.’ Generally these behaviors start around 4 to 5 PM and extend to midnight.  They manifest as confusion, hyperactivity, restlessness or agitation.  

The increase in symptoms tends to produce hazards such as wandering and falls. Additionally, there’s an increase in aggression that can cause serious injury to those around them. Fortunately, experts have some strategies to help deal with this situation.

The key is to recognize what triggers the behavior; a suggestion is to keep a journal or a smartphone app to track daily activities, environment, food, etc., to help to determine possible triggers. Any kind of turbulence or commotion (like people coming in the house or the hustle and bustle of meal preparation) can ignite symptoms. Other triggers include excessive daytime activities, sensory stimulation, fatigue and stress. Another factor is low lighting and an increase of shadows that emerge at the end of the day.

Because of the timing, sleep for both the family caregiver and the recipient is further eroded. Less rest makes the symptoms more pronounced. Yet the real danger is to the caregiver. It puts more strain on a situation that is already tough.

Currently there is no treatment for sundowning, but professionals have come up with ideas that seem to reduce some of the harsher effects.  Adoption of a healthy lifestyle, schedule and reducing the intake of caffeine is a first step. It also helps to lessen the level of noise and keep a calm atmosphere later in the day, consider playing soothing music. Closing blinds or drapes and using lights to keep the level of brightness consistent helping to control shadows developing, can also make a difference.

While these may reduce the symptoms, respite for the caregiver can’t be emphasized enough. Even the most devoted caregivers need a complete break to rejuvenate and replenish their health. Taking care of others requires fortitude. Caring for a “sundowner” consumes even more time and energy and interrups sleep. Getting rest provides a much-needed physical and emotional boost.  All caregivers and especially family caregivers need to put their self-care first.  Remember:  ‘self-care is not selfish’; it’s essential to maintain your health and well-being to navigate this journey that includes providing daily compassionate care to your loved one for as long as it takes.

As a sidenote, this year, COVID limitations appear to be feeding the occurrence of Sundowners possibly due to the impact of adjustments to routines that all of us have faced.


This article was submitted by:The Perfect Place logo

The Perfect Place, a 501(c)3, social and recreational adult day care facility in Chandler, AZ, provides a safe, structured environment for socialization and enrichment activities.  Its goal is to maintain and improve the physical, mental and emotional well-being of its participants.  The compassionate and dedicated staff continually assesses participants in order to ensure that their needs are being met. 

Learn more at or call 480-895-2892.