Watching a loved one become increasingly confused or agitated as daylight fades can be both puzzling and distressing. This phenomenon, known as sundowning, affects many people living with dementia and creates unique challenges for both families and caregivers. At Hovi Care, we understand how these evening changes can impact quality of life for both seniors and their families. Our approach combines thoughtful environmental design, family collaboration, and personalized care strategies to help manage sundowning symptoms with dignity and compassion. Let’s explore what sundowning is and how we can work together to create more peaceful evenings for your loved ones.
What is sundowning syndrome in dementia patients?
Sundowning syndrome refers to a state of confusion, anxiety, agitation, or restlessness that typically occurs in the late afternoon or evening hours in people living with dementia. This behavioral pattern often coincides with the setting of the sun, hence the name “sundowning.” For many families, this can be one of the most challenging aspects of caring for someone with dementia.
People experiencing sundowning may show a variety of behaviors including:
- Increased confusion and disorientation
- Restlessness and pacing
- Heightened anxiety or fear
- Irritability or aggression
- Difficulty following directions
- Shadow chasing or responding to imaginary stimuli
While scientists don’t completely understand why sundowning occurs, it appears to be connected to changes in the brain that affect the body’s internal clock and sleep-wake cycles. As with other changes in memory and behavior, sundowning results from the impact of dementia on the brain. For people living with dementia, these disturbances tend to be more frequent and severe than ordinary age-related sleep changes.
Sundowning can be triggered or worsened by several factors, including fatigue, low lighting, disruption of the body’s internal clock, and increased shadows. At Hovi Care, we recognize that understanding these triggers is the first step toward effective management of evening agitation.
Creating calming environments for evening comfort
At Hovi Care, we believe that thoughtfully designed environments play a crucial role in managing sundowning behaviors. Our nursing homes are specifically designed to be cosy, stimulating, and secure—three elements that are particularly important during the challenging evening hours for people with dementia.
Our approach incorporates elements from nature as part of our Green Care philosophy. These natural elements evoke positive recollections and can significantly reduce agitation during sundowning periods. For instance, gentle nature sounds, natural lighting that mimics the progression of daylight, and familiar scents can all help maintain a sense of place and time when confusion typically increases.
Some environmental strategies we implement include:
- Adjustable lighting systems that gradually change throughout the day, mimicking natural light patterns to minimize the jarring transition from daylight to darkness
- Reducing unnecessary noise and stimulation in the evening hours
- Creating comfortable, familiar spaces with personal items that evoke positive memories
- Incorporating natural elements like indoor plants, nature sounds, or views of outdoor gardens
These environmental adaptations help create a predictable atmosphere that can reduce anxiety and confusion during sunset hours. By designing spaces that feel secure and familiar, we help people living with dementia navigate the transition from day to evening with greater ease and comfort.
Our environments are also designed with clarity and simplicity in mind—features that become especially important during times of increased confusion. Clear pathways, recognizable landmarks, and intuitive design elements help residents maintain their independence while reducing frustration that can trigger sundowning behaviors.
Family-oriented approaches to managing sundowning
At Hovi Care, we embrace a family-oriented philosophy that forms the foundation of our approach to managing sundowning. We believe that elderly services are provided “from a family to a family,” recognizing that both the person living with dementia and their loved ones need support during challenging evening hours.
This approach begins with transparent communication between our staff and families. We work together to understand each resident’s life history, routines, and preferences, which helps us develop consistent evening routines that can reduce sundowning symptoms. When families share insights about what has worked at home—whether it’s a particular activity, music, or approach—we can incorporate these familiar elements into our care strategies.
Some family-oriented strategies include:
- Holding regular family meetings to discuss observations and adjustments to evening care plans
- Encouraging family visits during early evening hours when appropriate
- Teaching families techniques that work in our care settings that might also help at home
- Creating consistent routines across care settings, whether at home or in our facilities
We find that maintaining consistent evening routines is particularly beneficial. Predictable activities, mealtimes, and bedtime rituals provide security and orientation when confusion might otherwise increase. Having familiar faces present during these transitions can also significantly reduce anxiety.
By involving families in developing these routines, we ensure that care approaches align with each resident’s lifetime habits and preferences. This collaborative approach helps create a sense of security that can significantly reduce sundowning behaviors while strengthening the bonds between residents, their families, and our care team.
Technology solutions for sundowning safety
At Hovi Care, we thoughtfully incorporate technology into our care environments to enhance safety while preserving dignity for people experiencing sundowning. Our approach to technology focuses on creating secure environments without intrusive monitoring that might cause additional stress or confusion.
Our memory-friendly designs incorporate various technological solutions that help monitor and manage sundowning behaviors discreetly. These technologies are carefully integrated into the living environment to maintain a homelike atmosphere while providing necessary safety monitoring during evening hours when risks may increase.
Some of the technology solutions we implement include:
- Gentle motion sensors that alert staff to unusual nighttime activity without disturbing residents
- Circadian lighting systems that automatically adjust to support natural sleep-wake cycles
- Acoustic monitoring that recognizes distress sounds while respecting privacy
- Orientation aids such as digital clocks with day/night indicators to reduce time confusion
These technologies help create safety without restriction, allowing residents to maintain their independence while still receiving the support they need. This balance is particularly important during sundowning episodes when increased supervision may be necessary without making the person feel controlled or confined, which could worsen agitation.
By integrating these solutions into our care environments, we help ensure that residents experiencing sundowning can move safely within their surroundings while maintaining their dignity. This approach aligns with our commitment to creating environments that are simultaneously stimulating, secure, and respectful of each individual’s need for autonomy.
Personalized evening care strategies
At Hovi Care, we recognize that each person experiences dementia and sundowning in their own unique way. Our approach to evening care is built on the foundation of respecting individuality—one of our core values. We carefully tailor evening care plans to match each senior’s specific needs, preferences, and established routines.
This personalized approach begins with detailed observation and documentation of when sundowning symptoms typically appear, what seems to trigger them, and which interventions prove most effective. By identifying patterns specific to each individual, we can often anticipate needs before agitation escalates.
Some personalized strategies we employ include:
- Scheduling meaningful activities during typical sundowning hours to provide positive engagement
- Adapting the timing of meals and medications to avoid hunger or discomfort during vulnerable evening periods
- Creating personalized music playlists that evoke positive memories and emotions
- Developing individualized relaxation routines based on lifetime preferences
- Adjusting staffing patterns to ensure familiar caregivers are present during difficult transition times
We find that meaningful activities during potential sundowning periods can be particularly effective. These might include simple tasks that provide a sense of purpose, gentle exercise to reduce restlessness, or reminiscence activities that connect to positive memories. The key is ensuring these activities match the individual’s abilities and interests while providing appropriate stimulation without overwhelming.
Our personalized approach extends to how we communicate during evening hours. We train our staff to recognize each resident’s unique communication style and adapt accordingly—using simpler language, maintaining a calm tone, or employing reassuring touch when appropriate and welcomed.
By honoring each person’s unique preferences and adapting our care strategies accordingly, we help minimize sundowning triggers while supporting overall well-being. This individualized approach reflects our commitment to respecting the dignity and personhood of each resident in our care.
Managing sundowning requires patience, creativity, and a deep understanding of each person’s needs. At Hovi Care, we combine environmental design, family collaboration, appropriate technology, and personalized care strategies to help make evenings more peaceful and comfortable for people living with dementia.
We recognize that supporting someone through sundowning can be challenging for families. Our family-oriented approach means we’re here to partner with you, sharing strategies that work and learning from your insights about your loved one. Together, we can create evening routines and environments that reduce anxiety and promote greater well-being for people living with dementia.
If you’re caring for someone experiencing sundowning and would like to learn more about how our elderly care services might help, we invite you to reach out. At Hovi Care, we’re committed to enhancing quality of life for seniors and their families through personalized, compassionate care—from our family to yours.
