What is sundowning?
Sundowning is a pattern of increased agitation, confusion, and behavioral changes that occur in late afternoon or early evening, commonly observed in people with dementia or Alzheimer's disease.
Sundowning refers to a pattern of agitation, confusion, and emotional distress that occurs in late afternoon or evening hours, particularly common among people with Alzheimer's disease and other forms of dementia. The person may become restless, anxious, or disoriented as daylight fades, sometimes accompanied by wandering, verbal outbursts, or difficulty recognizing familiar people or surroundings.
The exact cause remains unclear, though researchers point to several contributing factors. Reduced natural light in the evening can disrupt the body's circadian rhythm and interfere with the production of melatonin, the hormone that regulates sleep. Fatigue accumulated over the day may lower a person's ability to manage confusion or anxiety. Changes in staff or routine, increased shadows indoors, or background noise from meal preparation can also trigger or worsen sundowning episodes.
Understanding sundowning matters because it directly shapes how memory care facilities structure their daily schedules and environments. Many facilities schedule key activities and appointments earlier in the day when residents are more alert and less prone to distress. Lighting design is intentional, with brighter illumination during afternoon hours and calmer lighting in common areas as evening approaches. Staff plan for increased supervision and calm, predictable routines in late afternoon to reduce triggers and support residents through the vulnerable hours.