Sundowning & Dementia Night Care: Practical Steps That Help

Caring for a loved one with dementia is a journey filled with both challenges and moments of deep connection. One of the more difficult aspects families often face is sundowning - a pattern of confusion, anxiety, or restlessness that tends to appear in the late afternoon and evening. These episodes can be unsettling for both the person living with dementia and their family, often leaving caregivers exhausted, worried, and unsure how best to respond.

At A Class Care, we know how important it is to combine professional expertise with empathy. By understanding the signs of sundowning and putting practical strategies in place, families can create calmer evenings, safer nights, and a greater sense of reassurance.

There are an estimated 982,000 people with dementia in the UK in 2024, rising to 1.4 million by 2040. [S1]

What is sundowning?

Sundowning is a common behaviour linked to dementia, particularly Alzheimer’s disease. It describes a noticeable shift in mood or behaviour as daylight fades. Someone who has been relatively calm in the morning may become anxious, agitated, or even aggressive by evening. They might:

• Pace or wander the home

• Experience heightened confusion or fear

• Struggle with sleep, sometimes waking repeatedly through the night

• Resist care, meals, or medication at certain times

While the exact cause is not fully understood, sundowning is often connected to changes in the body’s internal clock, fatigue, or overstimulation during the day. For families, these episodes can be distressing and exhausting—especially when they disrupt much-needed rest.

Sundowning risk rises in moderate to severe dementia and is more common in autumn and winter. Source: Practical Neurology. “Wandering & Sundowning in Dementia.”

Across studies, sundowning prevalence in dementia ranges from 1.6 to 66 percent. [S3] Source: Frontiers/PMC. “Sundowning Syndrome in Dementia (2025).”

When these problems worsen in the late afternoon or early evening, it’s called sundowning.” Source: National Institute on Aging. “Coping With Agitation, Aggression, and Sundowning.”

Why evenings are so challenging

Evenings naturally bring a shift in environment: fading light, reduced activity, and changes in routine. For someone living with dementia, these cues can feel disorientating. Shadows in a dim room may be misinterpreted, noises can seem louder, and tiredness makes it harder to cope with confusion.

Alzheimer’s-related loss in the suprachiasmatic nucleus disrupts melatonin release and circadian timing. Source: Practical Neurology. “Wandering & Sundowning in Dementia.”

Loved ones often describe this time of day as the moment when their parent becomes “a different person.” What once felt like a peaceful evening can turn into hours of restlessness, worry, and wandering. This pattern not only impacts the person experiencing it but also contributes to caregiver fatigue, as family members struggle to manage their own rest alongside night-time needs.

The emotional toll on families

When sundowning becomes a nightly routine, families may feel overwhelmed, guilty, or even fearful of making the wrong decisions about care. Many of the frustrations and fears we hear from families include:

• The worry of a loved one falling or leaving the house at night

• Feeling exhausted and unable to balance work, family life, and night-time care

• Concern about whether home is still the safest place

Sixty-nine percent of unpaid carers report difficulty getting a good night’s sleep. [S15 Source: Carers UK. “State of Caring 2023.”

These feelings are natural—and it’s important to remember you are not alone. Families across the UK face the same worries, which is why compassionate professional support can make such a difference. Respite care for dementia is often a lifeline, giving family carers a chance to rest while ensuring their loved one receives round-the-clock attention.

Talk to us today about trusted night-time care options.

Recognising the early signs of sundowning

Just as spotting the early signs of dementia can make a difference in planning care, recognising the patterns of sundowning allows families to act sooner rather than later. Typical early indicators might include:

• Increased irritability or anxiety as dusk approaches

• A sudden insistence on going home—even when already there

• Repeated pacing between rooms or restlessness in a chair

• More frequent requests for reassurance or presence

• Difficulty winding down or falling asleep

By keeping a simple diary of behaviours, times, and possible triggers, families can start to identify what may be contributing—whether it’s certain foods, late-day visitors, or an overstimulating environment.

Keeping a daily behaviour and trigger journal helps tailor prevention and response. Source: Practical Neurology. “Wandering & Sundowning in Dementia.”

The importance of compassionate night-time care

Practical steps matter, but so does the emotional environment. Families often tell us that what their loved one needs most during these moments is not correction or confrontation, but calm reassurance.

Night-time dementia care is about more than safety—it’s about dignity. A consistent carer who knows a person’s history, favourite music, or the way they like their tea can help transform an anxious evening into a manageable, even comforting, routine. That’s the benefit of having live-in dementia care: continuity, familiarity, and a gentle presence throughout the night.

Practical steps to ease sundowning at home

Supporting a loved one through sundowning doesn’t mean overhauling your entire lifestyle. Often, small, thoughtful adjustments can make evenings calmer and safer. What works will vary for each individual, but the following approaches are widely recommended by dementia specialists and families alike.

Creating a calming environment

The physical surroundings play a significant role in how someone with dementia experiences the evening hours. Simple changes in the home can reduce confusion and provide reassurance:

• Lighting: Ensure rooms are well-lit before dusk to minimise shadows, which can trigger anxiety. Soft, warm bulbs and nightlights in hallways or bathrooms prevent disorientation.

• Curtains and blinds: Close them before it gets dark outside to reduce reflections in the glass, which may be mistaken for strangers. Source: Alzheimer’s Society. “Sundowning and dementia.” [S9]

• Reduce noise: Background noise such as televisions, radios, or household chatter can feel overwhelming in the evening. A quieter environment helps with relaxation.

• Safe spaces: Create a familiar area where your loved one feels comfortable—perhaps their favourite chair with a blanket and familiar objects close by.

These are small adjustments, but they offer a sense of control and calm during a time when the outside world feels less predictable.

Building a consistent evening routine

Routine is one of the most powerful tools in dementia care. A structured evening helps signal to the brain that it is time to wind down. Useful strategies include:

• Regular mealtimes: Aim for dinner at a consistent hour. Avoid heavy meals or caffeine late in the day, as these may disrupt sleep.

• Gentle activities: Calming tasks such as folding laundry, listening to soothing music, or looking through photo albums can provide focus without overstimulation.

• Winding down early: Start the evening routine before signs of sundowning appear. For example, dimming lights and encouraging relaxation around the same time each day.

• Avoiding overstimulation: Visitors, phone calls, or busy television programmes late in the day may increase agitation. Keep evenings predictable and calm.

Over time, these rituals become familiar markers that provide comfort and reassurance.

Sleep hygiene and night-time comfort

A restful night’s sleep is crucial for reducing sundowning episodes, yet many people with dementia struggle to settle. Creating good sleep hygiene can make a significant difference:

• Comfortable bedding: Ensure the mattress, pillows, and blankets are suitable for the season and provide both warmth and support.

• Bedroom temperature: Keep the room cool but not cold—around 18°C is often ideal.

• Nightlights: A soft light prevents disorientation if your loved one wakes and needs to use the bathroom.

• Familiar scents: Lavender sprays or a favourite hand cream before bed can trigger feelings of calm and routine.

• Limit fluids before bed: This helps reduce the need for multiple bathroom trips, which often disrupt sleep.

When combined, these small steps can improve both the quality and duration of sleep, supporting better wellbeing the following day.

Technology that supports night-time dementia care

Modern technology is playing an increasing role in supporting safe and independent living for people with dementia. Families may wish to consider:

• Motion sensors: Gentle nightlights that activate when someone gets out of bed reduce falls and provide reassurance.

• Door alarms: Alerts if an external door is opened, helping to prevent wandering at night.

• Bed sensors: Notify carers if a loved one has been out of bed for an unusual length of time.

• Video monitoring systems: Discreet, respectful systems that allow families to check remotely if everything is safe.

When used sensitively, these tools enhance safety without compromising dignity. They are particularly valuable for families who may not be able to provide constant supervision themselves.

The role of professional night-time carers

While family members often try to manage sundowning alone, it can quickly become overwhelming. Professional carers trained in dementia support know how to respond calmly to restlessness, use gentle distraction techniques, and provide reassurance through presence and routine.

Night care can take several forms:

• Overnight respite care: A carer provides supervision for one or more nights, allowing family members to rest.

• Waking night care: A professional stays awake throughout the night, ready to assist if your loved one wakes or becomes unsettled.

• Sleeping night care: A carer sleeps in the home but is available if needed, offering both reassurance and practical support.

Each option is tailored to the family’s needs, ensuring both safety and peace of mind. For many, professional input transforms nights from stressful to manageable, allowing everyone to rest more easily.

Supporting families through sundowning and night-time dementia care

Sundowning does not just affect the person living with dementia—it has a ripple effect across the whole family. Many carers describe evenings as the most stressful part of the day, when patience is tested and exhaustion sets in. Learning how to care for yourself while caring for a loved one is just as vital as any practical step.

Coping strategies for family caregivers

Caring for someone during sundowning episodes can leave family members feeling powerless or drained. These approaches can help protect your own wellbeing:

• Take regular breaks: Even short moments of respite during the day can restore energy for the evening ahead. A walk outside, a phone call with a friend, or simply sitting quietly with a cup of tea can make a difference.

• Share responsibilities: Involve siblings, neighbours, or community support services to avoid shouldering the burden alone.

• Learn calming techniques: Breathing exercises, mindfulness, or even gentle stretching can reduce your stress response in difficult moments.

• Acknowledge your feelings: Guilt, frustration, and sadness are common. Recognising these emotions, rather than suppressing them, helps you process them in a healthy way.

Most importantly, remember that needing help does not mean you are failing—it means you are committed to ensuring the best possible care for your loved one.

When to consider professional support

There comes a point when family-led care may no longer be enough to manage sundowning safely. Signs it might be time to seek additional help include:

• Your loved one is wandering outside at night, putting themselves at risk.

• You feel constantly sleep-deprived or unable to function during the day.

• There are repeated falls, injuries, or health scares.

• Tensions are rising within the family due to exhaustion or disagreements.

Professional carers can provide the calm, skilled presence needed overnight, while giving families the peace of mind that comes from knowing their loved one is never left vulnerable. If you’re unsure, reaching out for a care assessment can help clarify the level of support required.

The long-term benefits of live-in dementia care

While night care offers targeted support during the most difficult hours, live-in dementia care provides a complete solution. A dedicated carer lives alongside your loved one, offering 24-hour assistance while preserving the comfort of home. The benefits are significant:

• Consistency of care: The same familiar face reduces anxiety and builds trust.

• Personalised routines: Carers adapt to individual habits, from bedtime preferences to morning rituals.

• Immediate response: Whether it’s a night-time fall, confusion, or restlessness, help is always close at hand.

• Companionship: Beyond physical support, live-in carers provide meaningful social interaction, reducing loneliness.

• Relief for families: Knowing a trusted professional is present allows relatives to focus on quality time rather than constant supervision.

This type of care ensures safety without sacrificing independence. Families who choose live-in care at home often tell us it feels like lifting a weight off their shoulders while giving their loved one the dignity they deserve.

Reshaping the evening into a time of comfort

Though sundowning can be one of the hardest aspects of dementia care, it is not without hope. With the right blend of environment adjustments, calming routines, professional guidance, and emotional support, evenings can become gentler and more predictable.

Families are not expected to carry this burden alone. At A Class Care, our carers are specially trained in dementia support, with a focus on compassion, patience, and respect. We work alongside families to ensure each person’s unique needs are met—so that evenings can once again become a time of rest, rather than worry.

Final thoughts

Sundowning highlights the complex nature of dementia, where small changes in environment and routine can have a profound impact on wellbeing. By approaching it with empathy and proactive care, families can ease stress for both their loved one and themselves.

Whether you need occasional night support, regular respite, or the reassurance of full-time live-in care, professional help is available. Most importantly, you do not need to face this journey alone.

If your family is beginning to notice signs of sundowning, now is the right time to explore the support that could transform evenings from challenging to comforting—for everyone involved.

Sundowning and night-time dementia care: practical steps that really help