{"id":7718,"date":"2026-09-26T23:59:28","date_gmt":"2026-09-26T23:59:28","guid":{"rendered":"https:\/\/www.visiting-angels.co.uk\/cheshire-east\/?p=7718"},"modified":"2026-09-27T00:06:05","modified_gmt":"2026-09-27T00:06:05","slug":"sundowning-dementia","status":"publish","type":"post","link":"https:\/\/www.visiting-angels.co.uk\/cheshire-east\/sundowning-dementia\/","title":{"rendered":"Why does dementia get worse at night? Sundowning"},"content":{"rendered":"\t\t<div data-elementor-type=\"wp-post\" data-elementor-id=\"7718\" class=\"elementor elementor-7718\" data-elementor-post-type=\"post\">\n\t\t\t\t<div class=\"elementor-element elementor-element-2607b910 e-flex e-con-boxed e-con e-parent\" data-id=\"2607b910\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t\t<div class=\"e-con-inner\">\n\t\t\t\t<div class=\"elementor-element elementor-element-d2e8bff elementor-widget elementor-widget-text-editor\" data-id=\"d2e8bff\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\t<h3><b>Quick summary<\/b><\/h3><p><span style=\"font-weight: 400;\">Late afternoon and evening are when dementia often gets hardest, and it has a name: sundowning. The exact cause is not fully understood, but tiredness, fading light, hunger, pain and a disrupted body clock all seem to play a part. A steady routine, daylight early in the day and a calm evening tend to help more than anything else.<\/span><\/p><p>\u00a0<\/p><h3><b>What is sundowning?<\/b><\/h3><p><span style=\"font-weight: 400;\">A pattern where someone with dementia becomes more confused, anxious, agitated or restless in the late afternoon and evening. Alzheimer&#8217;s Society describes it as behaviour that can be difficult to understand in the late afternoon or early evening, and notes that people may become intensely distressed or agitated and may have hallucinations or delusions (<\/span><a href=\"https:\/\/www.alzheimers.org.uk\/about-dementia\/stages-and-symptoms\/dementia-symptoms\/sundowning\"><span style=\"font-weight: 400;\">Alzheimer&#8217;s Society, Sundowning<\/span><\/a><span style=\"font-weight: 400;\">).<\/span><\/p><p><span style=\"font-weight: 400;\">It is not a separate condition. It is a set of symptoms that tends to cluster at a particular time of day. Estimates of how many people with dementia experience it vary widely between studies.<\/span><\/p><p>\u00a0<\/p><h3><b>What does it look like?<\/b><\/h3><p>\u00a0<\/p><ul><li style=\"font-weight: 400;\" aria-level=\"1\"><b>Restlessness and pacing<\/b><span style=\"font-weight: 400;\">, often around the same time each day.<\/span><\/li><li style=\"font-weight: 400;\" aria-level=\"1\"><b>Wanting to leave<\/b><span style=\"font-weight: 400;\">, &#8220;to go home&#8221;, sometimes from the home they have lived in for decades.<\/span><\/li><li style=\"font-weight: 400;\" aria-level=\"1\"><b>Increased confusion<\/b><span style=\"font-weight: 400;\"> about where they are or who people are.<\/span><\/li><li style=\"font-weight: 400;\" aria-level=\"1\"><b>Anxiety, irritability or tearfulness.<\/b><\/li><li style=\"font-weight: 400;\" aria-level=\"1\"><b>Suspicion<\/b><span style=\"font-weight: 400;\">, including believing things have been taken.<\/span><\/li><li style=\"font-weight: 400;\" aria-level=\"1\"><b>Seeing or hearing things<\/b><span style=\"font-weight: 400;\"> that are not there, particularly as the light fades.<\/span><\/li><li style=\"font-weight: 400;\" aria-level=\"1\"><b>Difficulty settling to sleep<\/b><span style=\"font-weight: 400;\">, or waking and wandering at night.<\/span><\/li><\/ul><p>\u00a0<\/p><h3><b>Why does it happen?<\/b><\/h3><p><span style=\"font-weight: 400;\">Nobody knows for certain, and it is probably several things at once.<\/span><\/p><p>\u00a0<\/p><table><thead><tr><th><p><b>Possible factor<\/b><\/p><\/th><th><p><b>What it means in practice<\/b><\/p><\/th><\/tr><\/thead><tbody><tr><td><p><b>Tiredness<\/b><\/p><\/td><td><p><span style=\"font-weight: 400;\">Getting through a day takes a great deal of effort with dementia, and by evening there is less left<\/span><\/p><\/td><\/tr><tr><td><p><b>Fading light<\/b><\/p><\/td><td><p><span style=\"font-weight: 400;\">Shadows and dim rooms are harder to make sense of, and ordinary objects can look threatening<\/span><\/p><\/td><\/tr><tr><td><p><b>The body clock<\/b><\/p><\/td><td><p><span style=\"font-weight: 400;\">Dementia can disrupt the internal clock, so the difference between day and night blurs<\/span><\/p><\/td><\/tr><tr><td><p><b>Unmet needs<\/b><\/p><\/td><td><p><span style=\"font-weight: 400;\">Hunger, thirst, pain, constipation or needing the toilet, which may not be put into words<\/span><\/p><\/td><\/tr><tr><td><p><b>Activity at the end of the day<\/b><\/p><\/td><td><p><span style=\"font-weight: 400;\">Visitors leaving, carers changing, tea being made, the television on. A lot happens at once<\/span><\/p><\/td><\/tr><tr><td><p><b>Old routines<\/b><\/p><\/td><td><p><span style=\"font-weight: 400;\">Late afternoon was when people collected children or came home from work, and that pull can remain<\/span><\/p><\/td><\/tr><\/tbody><\/table><p>\u00a0<\/p><h3><b>What helps during the day<\/b><\/h3><p>\u00a0<\/p><ul><li style=\"font-weight: 400;\" aria-level=\"1\"><b>A regular routine.<\/b><span style=\"font-weight: 400;\"> Getting up, meals and bedtime at similar times each day.<\/span><\/li><li style=\"font-weight: 400;\" aria-level=\"1\"><b>Daylight in the morning.<\/b><span style=\"font-weight: 400;\"> Time outside, or sitting by a window, helps the body clock.<\/span><\/li><li style=\"font-weight: 400;\" aria-level=\"1\"><b>Activity earlier in the day.<\/b><span style=\"font-weight: 400;\"> Appointments, bathing and outings in the morning when people are usually more alert.<\/span><\/li><li style=\"font-weight: 400;\" aria-level=\"1\"><b>Not too much napping<\/b><span style=\"font-weight: 400;\"> late in the day, which makes night-time sleep harder.<\/span><\/li><li style=\"font-weight: 400;\" aria-level=\"1\"><b>Less caffeine and alcohol<\/b><span style=\"font-weight: 400;\"> in the afternoon and evening.<\/span><\/li><li style=\"font-weight: 400;\" aria-level=\"1\"><b>A bigger meal at lunchtime<\/b><span style=\"font-weight: 400;\"> and a lighter evening meal.<\/span><\/li><\/ul><p>\u00a0<\/p><h3><b>What helps in the evening<\/b><\/h3><p>\u00a0<\/p><ul><li style=\"font-weight: 400;\" aria-level=\"1\"><b>Put the lights on before it gets dark<\/b><span style=\"font-weight: 400;\">, and close the curtains, so the change from day to evening is less stark and reflections in windows do not confuse.<\/span><\/li><li style=\"font-weight: 400;\" aria-level=\"1\"><b>Keep it calm.<\/b><span style=\"font-weight: 400;\"> Less noise, fewer people, and the television off if it is adding to the confusion.<\/span><\/li><li style=\"font-weight: 400;\" aria-level=\"1\"><b>Something familiar to do.<\/b><span style=\"font-weight: 400;\"> Folding towels, looking at photographs, music they know.<\/span><\/li><li style=\"font-weight: 400;\" aria-level=\"1\"><b>Check the basics.<\/b><span style=\"font-weight: 400;\"> Hungry, thirsty, in pain, too hot or cold, needing the toilet.<\/span><\/li><li style=\"font-weight: 400;\" aria-level=\"1\"><b>Do not argue.<\/b><span style=\"font-weight: 400;\"> Reassure, respond to the feeling, and redirect gently.<\/span><\/li><li style=\"font-weight: 400;\" aria-level=\"1\"><b>Let them walk<\/b><span style=\"font-weight: 400;\"> if it is safe. Stopping someone who needs to move usually escalates things.<\/span><\/li><\/ul><p>\u00a0<\/p><h3><b>Keep a diary<\/b><\/h3><p><span style=\"font-weight: 400;\">For a week or two, write down when the difficult time starts, what happened just before, what they had eaten and drunk, and what helped. Patterns often show up that are not obvious day to day, such as distress always following a particular visitor leaving or a missed afternoon drink.<\/span><\/p><p><span style=\"font-weight: 400;\">It is also useful to take to the GP or memory service.<\/span><\/p><p>\u00a0<\/p><h3><b>When it is not sundowning<\/b><\/h3><p><span style=\"font-weight: 400;\">If evening confusion comes on suddenly, or is much worse than usual over a day or two, it may be delirium rather than sundowning. Delirium has causes that often need treatment, such as an infection.<\/span><\/p><p><span style=\"font-weight: 400;\">The NHS advice is to go to A and E or call 999 if someone suddenly becomes confused (<\/span><a href=\"https:\/\/www.nhs.uk\/symptoms\/confusion\/\"><span style=\"font-weight: 400;\">NHS, Sudden confusion<\/span><\/a><span style=\"font-weight: 400;\">). The key difference is the pattern. Sundowning tends to follow a similar shape most evenings. A sudden change from their usual is a medical question.<\/span><\/p><p>\u00a0<\/p><h3><b>What about medication?<\/b><\/h3><p><span style=\"font-weight: 400;\">Non-drug approaches are usually tried first. Sometimes medication is considered where distress is severe and other approaches have not helped. That is a decision for the GP or specialist, who will weigh up benefits and risks, including the risk of falls and drowsiness. Do not start, stop or change any medicine without speaking to them.<\/span><\/p><p>\u00a0<\/p><h3><b>Looking after yourself<\/b><\/h3><p><span style=\"font-weight: 400;\">Sundowning tends to arrive exactly when a family carer is most tired, and it can go on into the night. Broken nights, week after week, wear anyone down.<\/span><\/p><p><span style=\"font-weight: 400;\">You are entitled to a carer&#8217;s assessment from the council. Support is available from Alzheimer&#8217;s Society on 0333 150 3456, and from Cheshire East Carers Hub for family carers in Cheshire East. Evening or overnight support, even a few nights a week, can make the difference between managing and not.<\/span><\/p><p>\u00a0<\/p><h3><b>Frequently asked questions<\/b><\/h3><p><b>Why is dementia worse at night?<\/b><\/p><p><span style=\"font-weight: 400;\">The cause is not fully understood. Tiredness, fading light, a disrupted body clock and unmet needs such as hunger or pain all seem to contribute.<\/span><\/p><p><b>Does sundowning mean the dementia is getting worse?<\/b><\/p><p><span style=\"font-weight: 400;\">Not necessarily. It can happen at different stages. A sudden change from someone&#8217;s usual pattern should be checked, because it may be delirium.<\/span><\/p><p><b>My mum keeps saying she wants to go home, but she is home. What do I do?<\/b><\/p><p><span style=\"font-weight: 400;\">&#8220;Home&#8221; often means a feeling of safety or a time in life rather than a place. Arguing that she is already home rarely helps. Asking about the home she means, and offering comfort, usually works better.<\/span><\/p><p><b>What if she wanders at night?<\/b><\/p><p><span style=\"font-weight: 400;\">Make the route to the toilet safe and lit, and think about door sensors or other technology. If night-time wandering is regular, it is worth talking to the GP and looking at overnight support.<\/span><\/p><p><b>Does sundowning stop?<\/b><\/p><p><span style=\"font-weight: 400;\">It varies. For some people it eases as dementia changes. Routine and a calm environment help many people, even if they do not stop it completely.<\/span><\/p><p>\u00a0<\/p><h3><b>About Visiting Angels Cheshire East<\/b><\/h3><p><span style=\"font-weight: 400;\">Visiting Angels Cheshire East provides care at home across Macclesfield, Wilmslow, Knutsford, Congleton, Alsager and the surrounding villages, along with Buxton, Whaley Bridge and the Staffordshire Moorlands towns.<\/span><\/p><ul><li style=\"font-weight: 400;\" aria-level=\"1\"><b>Evening, overnight and live-in care available<\/b><span style=\"font-weight: 400;\">, where the late afternoon and nights are the hard part.<\/span><\/li><li style=\"font-weight: 400;\" aria-level=\"1\"><b>Carers trained in dementia<\/b><span style=\"font-weight: 400;\">, alongside Parkinson&#8217;s, stroke recovery and complex care.<\/span><\/li><li style=\"font-weight: 400;\" aria-level=\"1\"><b>You see the same faces.<\/b><span style=\"font-weight: 400;\"> Our carer turnover is 12 per cent, against a sector figure of 23.7 per cent (<\/span><a href=\"https:\/\/www.skillsforcare.org.uk\/\"><span style=\"font-weight: 400;\">Skills for Care, 2025<\/span><\/a><span style=\"font-weight: 400;\">). A familiar person at the difficult time of day helps.<\/span><\/li><li style=\"font-weight: 400;\" aria-level=\"1\"><b>You choose your caregiver.<\/b><span style=\"font-weight: 400;\"> You meet them before care starts, and if it is not right you say so and we send someone else.<\/span><\/li><li style=\"font-weight: 400;\" aria-level=\"1\"><b>No visit is ever shorter than an hour.<\/b><span style=\"font-weight: 400;\"> There is no such thing as a fifteen minute call here.<\/span><\/li><\/ul><p><span style=\"font-weight: 400;\">David&#8217;s mother in law is becoming increasingly confused:<\/span><\/p><p><i><span style=\"font-weight: 400;\">&#8220;Visiting angels have been a massive help in the care for my mother in law, who is getting increasingly confused. They provide companionship and support every day proving to be very reliable and consistent. They are there at times we can&#8217;t be, due to all the commitments of work and grand children.&#8221;<\/span><\/i><\/p><p><span style=\"font-weight: 400;\">David Figg, Google review<\/span><\/p><p>\u00a0<\/p><h3><b>Not sure what you need yet? Start with a free assessment<\/b><\/h3><p><span style=\"font-weight: 400;\">Our free home care assessment is a visit at a time that suits you, with no obligation afterwards. In it we will:<\/span><\/p><ul><li style=\"font-weight: 400;\" aria-level=\"1\"><b>Work out when the difficult times are<\/b><span style=\"font-weight: 400;\">, which for sundowning is usually late afternoon and evening.<\/span><\/li><li style=\"font-weight: 400;\" aria-level=\"1\"><b>Talk through a realistic package<\/b><span style=\"font-weight: 400;\">, including evening or overnight support, and what it would cost.<\/span><\/li><li style=\"font-weight: 400;\" aria-level=\"1\"><b>Look at the money with you<\/b><span style=\"font-weight: 400;\">, including Attendance Allowance and the Council Tax disregard.<\/span><\/li><li style=\"font-weight: 400;\" aria-level=\"1\"><b>Tell you honestly if you do not need us yet<\/b><span style=\"font-weight: 400;\">, or if someone else is a better fit.<\/span><\/li><\/ul><p><span style=\"font-weight: 400;\">If the evenings and nights have become the hardest part, call us on 01625 720157. You can also <\/span><a href=\"https:\/\/www.visiting-angels.co.uk\/cheshire-east\/enquire-now\/\"><span style=\"font-weight: 400;\">send an enquiry<\/span><\/a><span style=\"font-weight: 400;\">, and you can see <\/span><a href=\"https:\/\/www.visiting-angels.co.uk\/cheshire-east\/services\/home-care-services\/\"><span style=\"font-weight: 400;\">what our services cover<\/span><\/a><span style=\"font-weight: 400;\">.<\/span><\/p><p><span style=\"font-weight: 400;\">Authored by Dr Niall Jawad, Director, Visiting Angels Cheshire East.<\/span><\/p><p><span style=\"font-weight: 400;\">Published 21 September 2026. Last updated 21 September 2026.<\/span><\/p><p><i><span style=\"font-weight: 400;\">This article is general information about sundowning, not medical advice, and no substitute for advice from the GP, memory service or a dementia specialist. Do not start, stop or change any medicine on the basis of this article. If someone becomes suddenly confused, go to A and E or call 999. The author is a director of the company and is not acting in a clinical capacity, and Visiting Angels Cheshire East provides personal care at home rather than medical or nursing care. To the fullest extent permitted by law, GB Care at Home Ltd accepts no liability for any loss or injury arising from reliance on this article.<\/span><\/i><\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t","protected":false},"excerpt":{"rendered":"<p>Quick summary Late afternoon and evening are when dementia often gets hardest, and it has a name: sundowning. The exact [&hellip;]<\/p>\n","protected":false},"author":81,"featured_media":7731,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"inline_featured_image":false,"site-sidebar-layout":"default","site-content-layout":"","ast-site-content-layout":"default","site-content-style":"default","site-sidebar-style":"default","ast-global-header-display":"","ast-banner-title-visibility":"","ast-main-header-display":"","ast-hfb-above-header-display":"","ast-hfb-below-header-display":"","ast-hfb-mobile-header-display":"","site-post-title":"","ast-breadcrumbs-content":"","ast-featured-img":"","footer-sml-layout":"","ast-disable-related-posts":"","theme-transparent-header-meta":"default","adv-header-id-meta":"","stick-header-meta":"default","header-above-stick-meta":"","header-main-stick-meta":"","header-below-stick-meta":"","astra-migrate-meta-layouts":"set","ast-page-background-enabled":"default","ast-page-background-meta":{"desktop":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"tablet":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"mobile":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""}},"ast-content-background-meta":{"desktop":{"background-color":"var(--ast-global-color-4)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"tablet":{"background-color":"var(--ast-global-color-4)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"mobile":{"background-color":"var(--ast-global-color-4)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""}},"footnotes":""},"categories":[35,36],"tags":[],"class_list":["post-7718","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-funding","category-blog"],"acf":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v28.8 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Why does dementia get worse at night? 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