- Carers Mind Hub
When the difficult part of the day starts at teatime
Perhaps the morning has gone well. You have had lunch together, managed a little shopping and even enjoyed a conversation. Then late afternoon arrives. The person you care for starts pacing, asks repeatedly where they are or insists they need to leave. By bedtime, both of you are exhausted.
Some people living with dementia experience increased distress or confusion later in the day. It is often called sundowning, although it does not happen to everyone and is not always connected to sunset itself. Understanding what might be happening can help you respond without turning every evening into a battle.
Look beyond the clock
There is no single cause. Tiredness, hunger, pain, dehydration, disrupted sleep, changes in light, too much activity or an unfamiliar environment may all contribute. Hearing or sight difficulties can make shadows, television noise and reflections harder to interpret. Some medicines may also affect sleep or behaviour.
Instead of treating every episode as inevitable, notice patterns. Does distress begin before dinner? Is it worse after visitors leave? Does a bright television compete with conversations in the room? A few notes over several days may reveal one manageable trigger.
Make late afternoon feel familiar
Try moving demanding appointments or outings earlier if possible. Offer a drink and a snack before the usual difficult period, and check for discomfort or the need for the toilet. As daylight fades, turn on lights before the room becomes gloomy. Close curtains if dark windows create unsettling reflections.
Keep the evening simple. One familiar programme, a quiet conversation or looking through photographs may work better than a crowded room and several people giving instructions. If the person wants to walk, a short accompanied walk around the house or garden may be more helpful than repeatedly telling them to sit down, provided it is safe.
What to say when they are frightened
Respond to the feeling before correcting the facts. ‘You seem worried. Shall we sit together for a minute?’ is often more useful than explaining for the fifth time that they are already at home. Speak slowly, give one suggestion at a time and allow space for a response. You may need to try a different approach tomorrow; there is no script that works for every person.
If confusion appears suddenly, becomes markedly worse or comes with fever, pain or unusual drowsiness, seek medical advice promptly. Infection, dehydration, medication problems and delirium can cause changes that need assessment.
Evenings affect carers as well
Anticipating several difficult hours every day can make you dread the clock. If this has become a regular pattern, tell the GP or dementia team what is happening and ask about support. Arrange a family rota where
Know someone who is finding evenings difficult? Send them this article. A little understanding can help another carer feel less alone.
