Sundowning: The hardest hour of the day.
A note to start
The hardest hour of the day
Welcome back — and thank you for your patience. It’s been a few weeks since our last issue. Caregiving has a way of rearranging everybody’s calendar, ours included.
We promised you sundowning, and we’re keeping that promise while there’s still time in World Alzheimer’s Month, which wraps up September 30. If you care for someone with dementia, you probably know the pattern already: the morning goes fine, and then somewhere around late afternoon, everything gets harder.
This issue covers why that happens, what tends to set it off, and the small, practical changes that take the edge off those evening hours.
We’re also introducing our September Caregiver of the Month, Sarah Harris, chosen by August’s honoree Dugan Meredith. Sarah is a nurse and a mom of three who cared for her husband’s grandmother through dementia, a fitting story for this month. Let’s dig in.
Did you know?
Sundowning is real, and it isn’t anyone’s fault
The National Institute on Aging describes sundowning as restlessness, agitation, irritability, and confusion that show up as daylight begins to fade. It can mean pacing, asking to “go home” while already at home, shadowing you from room to room, or getting upset for reasons that are hard to pin down.
It isn’t stubbornness, and it isn’t something you’re doing wrong. It’s a brain that’s worn out by the end of the day and struggling to make sense of a world that’s getting darker. The good news: it often has triggers, and many of those can be changed.
What tends to set it off
- ✓ An overfull day. Mental and physical exhaustion builds up. A busy morning with appointments, visitors, and errands often shows up as a rough evening.
- ✓ Fading light and shadows. Low light makes rooms harder to read. Shadows can look like people, holes, or things that aren’t there.
- ✓ A body clock that’s out of sync. Dementia can scramble the sleep-wake cycle, so someone feels drowsy all day and wide awake at night. Long naps late in the day make it worse.
- ✓ Needs they can’t put into words. Hunger, thirst, pain, boredom, a full bladder, or an infection. When the words go, discomfort often comes out as agitation instead.
- ✓ The mood in the room. The Alzheimer’s Association notes that people with dementia can sense a caregiver’s stress and frustration. That’s not a reason to feel guilty. It’s one more reason your own evening matters too (more on that below).
One gentle nudge: if evenings suddenly get much worse over a few days, call their doctor. Mayo Clinic lists infections such as a urinary tract infection among the things that can aggravate late-day confusion, and a sudden change is worth checking out rather than chalking up to “the disease getting worse.”
Did you know?
What helps when 4 p.m. rolls around
Most of what helps sundowning happens before the evening starts. Guidance from the NIA, the Alzheimer’s Association, and Mayo Clinic lines up around the same handful of ideas:
- → Front-load the day — save appointments, baths, and outings for the morning or early afternoon, when your person is most alert. Keep late afternoon simple.
- → Get daylight and movement early — time outside or by a sunny window, plus some gentle activity. It helps set the body clock so nighttime feels like nighttime.
- → Keep naps short and early — a long doze at 4 p.m. can make for a long night.
- → Move caffeine and sugar to the morning — and skip alcohol, which the NIA recommends avoiding.
- → Turn the lights on before it gets dark — keep the house well lit in the evening, and put night lights in hallways, bedrooms, and bathrooms so rooms never go suddenly dark.
- → Turn the volume down — less TV, fewer visitors, less background noise. Familiar, gentle music works better than the evening news.
- → Answer the feeling, not the facts — if they want to “go home,” arguing about where they are rarely helps. Try reassurance, a snack, a short walk, or a familiar task.
If sundowning comes with getting up and wandering after dark, it helps to know the moment your person is on their feet, so you can sleep without keeping one ear open all night. And before trying any sleep aid, including over-the-counter melatonin, check with their doctor first.
Shop our Movement Alarms — bed, chair, floor mat and door sensors →
Here’s the cruel timing of sundowning: it tends to hit right when you’re most tired too. You’ve already done a full day, and now the hardest stretch begins.
So plan for you, not just for them. Eat something real before the late afternoon, not after. Save your hardest phone calls and chores for the morning. If someone can tag in, even for one evening a week, make that the evening shift. And give yourself one small thing to look forward to once the house is quiet.
A calmer you really does make a calmer room. That isn’t pressure, just permission to protect your own energy. Please take care of yourself.
Simply Sarah: A Nurse, a Mom, and a Sandwich Caregiver
Chosen by August’s honoree Dugan Meredith, Sarah Harris is a registered nurse who stepped back from her operating-room career when her newborn son needed specialized care. Then the family took on more: rather than move her husband’s grandmother, “Baba,” into a nursing home, they welcomed her into their home. For nearly four years, Sarah cared for Baba through dementia while raising three young children.
She’s honest about what it cost. Burnout, she says, felt like “constantly running on empty.” She got through by using routines and teamwork, accepting help, and learning to meet each person where they were that day.
“Your loved one does not need a perfect caregiver. They need someone who makes them feel safe, loved, and not alone.” — Sarah Harris
Thank you, Sarah, for showing so many of us that “good enough, with love” really is enough.
Read Sarah’s story →More from the Heart of the Home series
Two stories worth your time
Enter by signing up for our mailing list at www.EnhDme.com and staying subscribed until the contest ends. Winners are drawn from active subscribers on December 25, 2026.
• You must sign up for our newsletter to qualify
• One entry per person
• Must be 18 years of age or older
• Must reside in the continental US (no shipping to Alaska or Hawaii)
As the days get shorter, we’re turning to fall and winter: shorter daylight, slick steps, cold-and-flu season, and how to get the house (and yourself) ready before the weather turns.
Got a topic you wish someone would just explain plainly? Leave us a comment or drop us a note. This newsletter gets better when it’s shaped by the people reading it.
Take care of yourself this week. You’re doing more than enough.
— The Heart of the Home team
This content is for educational purposes only and is not a substitute for professional medical advice. Always seek the advice of a physician or qualified health provider regarding any medical condition or treatment.
Want issues like this in your inbox every week? Join the Heart of the Home mailing list →
Leave a comment