1. Stick to a Consistent Routine:

Keeping things predictable can help reduce confusion and anxiety. When the person knows what to expect at certain times of the day, they feel more secure. Routine gives them a sense of control, and that consistency is especially important in the late afternoon and evening when sundowning can happen.

*Set up regular times for meals, baths, and bedtime. Even small things like watching a favorite show or having a specific time to read can add structure to the day. Try to avoid big changes to the routine, which might unsettle them.

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2. Create a Calming Environment:

The atmosphere in the home plays a big role in how the person feels. Bright lights, loud noises, and clutter can make things worse, especially in the evening when sundowning tends to peak.

*As the day winds down, lower the lights and keep the noise levels down. Avoid playing loud music or having the TV on too loud. Clear away clutter to help the space feel more peaceful. The goal is to make the environment as soothing as possible.

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3. Encourage Daytime Activity:

Getting some exercise or keeping active during the day can help prevent restlessness in the evening. When the person has used up some energy, they’re more likely to feel ready for bed when night comes.

*Encourage walks, light stretching, or even hobbies they enjoy, like knitting or gardening. Make sure any physical activity is appropriate for their abilities and aim to do it earlier in the day, so they don’t get too tired later.

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4. Limit Naps During the Day:

Taking long naps or sleeping too late in the day can mess with their sleep cycle and make sundowning worse. If they nap too long, they might not be tired enough at bedtime, which only increases confusion and agitation.

*Keep naps short (15-30 minutes), and ideally before 3 p.m. This way, they can recharge without it interfering with their sleep later on. If they’re feeling sleepy in the afternoon, encourage light activities to help them stay alert.

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5. Avoid Stimulants:

Caffeine and nicotine can make sundowning symptoms worse, leading to increased anxiety and difficulty falling asleep. These substances can overstimulate the nervous system, which is exactly what you don’t want as the day comes to a close.

*Avoid caffeine, nicotine, and sugary snacks in the late afternoon and evening. Instead, offer a caffeine-free herbal tea or a glass of warm milk, which can help soothe and relax.

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6. Offer Comfort and Reassurance:

People with dementia can become scared or agitated as sundowning sets in. Offering comfort and reassurance can help them feel safer and less anxious.

*Use a calm and soothing voice when they seem upset and gently hold their hand or offer a soft touch. Sometimes they just need to know that everything is okay. It’s important not to argue or correct them if they’re confused—just reassure them with simple words.

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7. Redirect Their Attention:

If they start to get upset or fixated on something, try redirecting their focus to a different activity or topic. This can help take their mind off the stress and make them feel more settled.

*If they’re getting agitated, suggest a calming activity like listening to music, looking at old photos, or doing a puzzle together. Gently steer the conversation away from anything that seems to be causing distress.

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8. Keep Evening Visits and Activities Minimal:

Evening is a vulnerable time for someone with dementia. Too many visitors or complicated activities can overwhelm them, which increases the risk of sundowning.

*If you have visitors, try to schedule them earlier in the day. If people stop by in the evening, keep the visit brief and low-key. Try to avoid doing anything that might be too stimulating or confusing.

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9. Get Plenty of Natural Light During the Day:

Natural light helps regulate the body’s internal clock, which in turn helps with sleep. When people get outside or even sit by a sunny window during the day, it can reduce the severity of sundowning.

*Try to get outside for a walk or simply sit by a window during daylight hours. Keep the blinds or curtains open to let in as much sunlight as possible. If the weather is nice, try opening a window for some natural Vitamin D

In the evening, use soft lighting to make the room feel more calming.

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10. Make Sure They Get Enough Sleep:

A good night’s sleep is crucial in managing sundowning. If the person isn’t sleeping well, sundowning symptoms can get worse. Creating a peaceful bedtime routine is one way to help them settle down for the night.

* Create a consistent sleep schedule with relaxing bedtime rituals like reading or listening to soothing music. Make sure their bedroom is comfortable—dark, quiet, and not too hot or cold. And try to avoid anything stimulating (like TV or phone screens) right before bed.

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11. Try Soothing Music or Aromatherapy:

Music and certain scents can have a calming effect, helping the person relax when they start to feel agitated. Music that’s familiar or calming can be especially effective in bringing comfort.

*Play soft music in the background, perhaps songs they enjoyed in the past. You can also try essential oils like lavender or chamomile, which are known to have calming effects. A diffuser in the room can help create a peaceful atmosphere.

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12. Stay Calm and Patient:

It can be tough to deal with sundowning, especially when the person becomes distressed, but staying calm yourself can help de-escalate the situation. Your patience and composure are reassuring and can help the person feel more at ease.

*If you’re feeling overwhelmed, take a break when you can. Find support from other family members, friends, or professional services. Remember, you can’t do everything on your own, and taking care of yourself is just as important as caring for the person with dementia.

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By implementing these strategies, caregivers can create a more peaceful environment that helps manage sundowning. It might take a little trial and error, but with time, you’ll find what works best for your loved one. Remember, patience and consistency are key!