Dementia Worse in the Evening? Why It Happens, and What Helps

If your mum or dad’s dementia seems worse in the evening, you’re not imagining it. For many people living with dementia, late afternoon and early evening are the hardest part of the day: more confusion, more restlessness, sometimes real distress. It’s common enough to have a name, sundowning, and there is a lot that can make those hours easier.

It isn’t anyone’s fault, and it isn’t a sign you’re doing something wrong. Here’s why it happens, what families tend to see at home, and what helps.

Why is dementia worse in the evening?

Nobody can point to a single cause, and it’s usually a mix of things building up through the day.

• Tiredness. Making sense of the world takes a lot of effort when you’re living with dementia. By teatime there’s much less left in reserve.
• The light changes. As it gets dark, shadows grow and windows turn into black mirrors. A coat on a door or a reflection in the glass can easily be misread, and that can be frightening.
• A muddled body clock. Dementia can blur day and night, so someone may doze through the afternoon and then feel wide awake and unsettled as the evening goes on.
• A busier house. Tea is being made, the telly’s on, people are coming home. More noise and more movement at the very time someone has least capacity to cope with it.
• Needs they can’t put into words. Hunger, thirst, pain, needing the loo, being too hot or too cold. If they can’t tell you, it often comes out as agitation instead.
• Old routines. For decades, late afternoon meant finishing work, collecting the children or getting the tea on. That pull to be somewhere else can stay long after the routine has gone.

What does it look like at home?

Every person is different, but families often describe the same few things. Pacing, or not being able to sit still. Asking to go home, even when they’re sitting in the house they’ve lived in for forty years. Following you from room to room. Packing a bag, or looking for someone who isn’t there.

Some people become tearful or frightened. Others get cross, which can be hard to take from a parent who was always calm. It’s worth remembering that this is the illness, not the person, and not a judgement on you.

If this sounds familiar and it’s starting to feel like more than one person can manage, our guide to what to do when dementia behaviour becomes too much at home goes through the options.

What helps in the late afternoon and evening?

Small changes to the shape of the day tend to help more than any one big fix. Try a few and see what works for your mum or dad.

• Keep the day active, with daylight. A walk, time by a window or a bit of pottering in the morning helps the body clock. Short rests are better than a long nap late in the afternoon.
• Put the lights on before it gets dark. Close the curtains early, so the windows don’t turn into mirrors, and keep rooms evenly lit.
• Bring the pace down. Turn the telly down or off, keep visitors to earlier in the day, and do one thing at a time.
• Switch to decaf after lunch. A proper cuppa can still be part of the evening. It just doesn’t need the caffeine.
• Have something calm and familiar ready. A favourite record, a radio programme they’ve always liked, a photo album, folding towels, a hand massage. Familiar things settle people.
• Check the basics. Hungry, thirsty, in pain, needing the toilet? An earlier, lighter tea suits a lot of people.
• Answer the feeling, not the words. “I want to go home” often means “I feel unsettled”. Arguing or correcting rarely helps. Sitting together, a gentle hand and a chat about home usually does more.

When should you talk to the GP?

If evenings change suddenly, over a day or two rather than a few months, mention it to the GP. A sudden change can be a sign of an infection (a urine infection is a common one), pain, constipation, or a side effect of a new medicine, and these can often be treated. It’s also worth asking for a medicines review if things have been getting steadily harder.

Talk to the GP too if evenings are becoming unsafe, for example if your mum or dad is trying to leave the house at night or has had a fall.

What about you?

Evenings are when carers are most worn out too. If you’re running on empty, that matters. A short stay can give you both a break, and our page on respite care at Laurel Bank explains how one works.

How does a good care home handle evenings with dementia?

If you’re starting to look at homes, ask each one what late afternoon looks like. A home that understands dementia will plan the end of the day around the person: calm, familiar faces, a settled routine, and someone who knows what helps that particular resident when things get hard.

At Laurel Bank, in Gee Cross, Hyde, we care for people at every stage of dementia, including advanced dementia and behaviours that challenge. We’re known locally as the home that says yes when others say no. Calm, familiar routines and a consistent team help residents feel settled, and we take time to learn the small things, like a favourite radio show or how someone takes their tea, that can turn an unsettled hour into a calmer one. There’s support day and night, and we’re rated Good by the Care Quality Commission.

You can read more about our specialist dementia care for families in Stockport and Hyde, or our guide on how to choose a dementia care home. And if you’d like to talk it through, get in touch with our team or come and see us for a brew and a chat.

Frequently asked questions

What is sundowning in dementia?

Sundowning is the name for the confusion, restlessness or distress that many people living with dementia feel in the late afternoon and evening. It can include pacing, asking to go home, following people around or becoming upset more easily.

Does sundowning happen every evening?

Not always. It tends to come and go, and it’s often worse after a busy, tiring or unusual day. Keeping days calm and predictable usually makes evenings easier.

Should I stop my mum or dad napping in the afternoon?

A short rest is fine and can help. A long sleep late in the afternoon can make evenings and nights harder, so many families find a shorter rest after lunch works better.

Is dementia worse in the evening a sign it’s getting worse?

Not necessarily. Sundowning can happen at any stage. A sudden change, though, is worth a word with the GP, as it can be a sign of an infection, pain or a medicine side effect.

Can a care home help with sundowning?

Yes. A home with a consistent team, a calm routine and support through the night can plan evenings around each person. At Laurel Bank we care for people at every stage of dementia, including those other homes have turned down.