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Every afternoon around half past four, Maureen’s husband Tom would put on his coat.
He had lived in the same Edgemont house for thirty-one years. He would stand in the front hall with his car keys, increasingly agitated, telling her he needed to go home. When she told him he was home, he got angry. Some days he shouted. Some days he cried.
By seven he was usually settled. By nine he was asleep. And in the morning he was gentle and himself again, with no memory of any of it.
Maureen thought she was watching the disease accelerate. What she was actually watching was sundowning, a pattern so common in dementia that it has its own name. Understanding it will not make it disappear, but for most Calgary families it changes how the late afternoon goes.
What sundowning actually is
Sundowning describes a predictable worsening of confusion, agitation, and distress in the late afternoon and early evening in people living with dementia.
It is not a separate condition or a new diagnosis. It is a pattern, and the key word is predictable. Families often notice it arrives at roughly the same time each day, intensifies for a few hours, and then eases.
It is most associated with Alzheimer’s disease, though it occurs across other types of dementia too. Our guide on the types of dementia explains how the conditions differ.
The most important thing to understand early is that a parent or spouse who is calm at breakfast and distressed at five o’clock is not choosing it, and is usually not declining faster. They are running out of the reserves that got them through the day.
Why it happens
There is no single confirmed cause, but researchers point to several factors that likely combine.
Disrupted internal clock. Dementia damages the part of the brain that regulates sleep and wake cycles, so the body’s sense of time becomes unreliable.
Accumulated fatigue. Following conversations, recognising faces, and making sense of a confusing world takes enormous mental effort. By late afternoon the reserves are gone, much as a tired child becomes harder to settle.
Fading light and shadows. As daylight drops, shadows and reflections distort the room. A coat on a hook becomes a person. This matters especially in Calgary between November and March, when it is dark by half past four.
Too much happening. Late afternoon is often the busiest part of a household. Cooking, television, phone calls, people arriving home. The noise and movement overwhelm a brain already struggling to filter.
Physical needs. Hunger, thirst, tiredness, needing the bathroom, or pain can all drive agitation in someone who can no longer identify or express what is wrong.
What it looks like
Sundowning shows up differently from person to person, but families tend to describe the same cluster.
Restlessness and pacing. Wanting to leave, often to go to a home that may be a childhood house rather than the current one. Repeated questions that grow more insistent. Suspicion or accusations that feel out of character. Shouting or tearfulness. Difficulty following conversation that was manageable that morning.
Some people become withdrawn rather than agitated, which is easy to miss. A parent who goes quiet and still at five o’clock may be experiencing the same thing.
Before anything else, rule out the other causes
This is the step families most often skip, and it matters enormously.
A sudden start to sundowning, or a clear worsening of an existing pattern, is not always the dementia. Several treatable things produce the same picture.
Urinary tract infections are the most common culprit and frequently present in older adults as confusion and agitation rather than obvious symptoms. Pain that the person cannot locate or describe is another, as is constipation.
Dehydration is often overlooked, and the signs look remarkably like worsening dementia. Our article on seniors and dehydration covers why.
Medication effects also belong on this list, including the timing of doses. If the pattern has changed recently, it is worth a conversation with the doctor rather than an assumption.
What actually helps in the late afternoon
The approaches below are the ones families consistently report making a difference. None of them fix sundowning, and most need a couple of weeks of consistency before the pattern shifts.
Turn the lights on before dusk, not after. Bright indoor lighting from mid-afternoon reduces the shadows and reflections that trigger confusion. Close curtains before it goes dark outside, so windows do not become mirrors.
Move demanding things to the morning. Bathing, appointments, visitors, and anything requiring cooperation go far better before noon. Scheduling them at four o’clock sets everyone up to fail.
Offer a snack and a drink mid-afternoon. Low blood sugar and mild dehydration make everything harder, and this one change alone sometimes softens the whole evening.
Quieten the environment from about three. Television off or turned down, fewer people in the room, calmer activity. A busy kitchen at five is often the trigger rather than the backdrop.
Protect a predictable routine. Same meal times, same evening sequence, same order of events. Predictability does some of the work that memory can no longer do.
Use familiar music. Songs from a person’s twenties and thirties reach past the damage in a way conversation often cannot, and many families find it the single most reliable tool they have.
Watch daytime naps and caffeine. A long late nap or an afternoon coffee can make both the evening and the night worse.
How to respond when it is happening
What you do in the moment matters as much as any of the preventive steps.
Do not correct or argue. Telling someone they are already home, or that their mother died years ago, does not resolve the confusion. It adds fresh distress to it, and it will not be remembered anyway.
Answer the feeling, not the facts. “You want to go home” usually means “I feel unsafe and I want to feel settled.” Responding with “I know, it has been a long day, let’s sit down for a minute” addresses what is actually wrong.
Keep your own voice low and slow. Agitation is contagious, and so is calm. People with dementia read tone and body language long after words have become difficult.
Redirect rather than refuse. A walk to the end of the street and back, a cup of tea, a photo album, or a small task to help with will often reset the moment where a flat no escalates it.
Give it time. Sundowning passes. The goal in the moment is getting through it safely, not winning the exchange.
Step away if you need to. If the person is safe and you are losing patience, a few minutes in another room is a legitimate choice, not a failure.
When the nights stop being safe
For many families sundowning is difficult but manageable. For some it crosses into something that cannot be handled alone, and it usually happens gradually enough that nobody notices the line being crossed.
The signs worth taking seriously are a person trying to leave the house at night, wandering within the home in the dark, falls during night-time movement, and a family caregiver who has not slept properly in weeks.
Night wandering in particular is the point at which many Calgary families start looking at overnight senior care. A caregiver who is awake through the night means the person can move around safely, be gently redirected back to bed, and be supervised without the family lying awake listening for footsteps.
Our article on overnight home care in Calgary explains what that support involves, and our guide on live-in care versus 24-hour care covers an important distinction. Where nights are genuinely active, live-in care is usually the wrong fit, because it assumes the caregiver sleeps.
The part nobody warns families about
Sundowning does not only exhaust the person living with dementia. It exhausts whoever is with them at five o’clock every single day.
It arrives at the hour when the family caregiver is already tired, often while trying to make dinner, and it repeats daily for months or years. Sleep deprivation on top of it wears people down in a way that is hard to see from inside.
Our article on caregiver burnout in Calgary covers the warning signs families miss in themselves. Arranging respite care for the late afternoon specifically, rather than at a random time of day, is one of the most practical decisions a family can make.
A caregiver who arrives at three and stays through the hardest stretch changes the shape of the whole day. Our dementia care and Alzheimer’s care services are built around exactly this kind of consistency, and our complete family guide to dementia care at home covers the wider daily picture.
Frequently asked questions
What time does sundowning usually start?
Most families describe it beginning somewhere between mid-afternoon and early evening, often around four or five o’clock, and easing after a few hours. The exact timing varies by person, but it tends to be consistent for each individual, which is what makes it possible to plan around.
Does sundowning mean the dementia is getting worse?
Not by itself. Sundowning is a pattern within the day rather than a marker of overall progression, and many people experience it for a long period without a corresponding decline. A sudden start or a clear change in the pattern is worth reporting to the doctor, since infections, pain, and dehydration can all produce the same picture.
Should I correct my parent when they say they want to go home?
No. Correcting rarely resolves the confusion and usually adds distress, and the correction will not be retained. Responding to the feeling behind the request works better. Acknowledging that they want to feel settled, then redirecting gently to something calming, tends to defuse it faster than any explanation.
Can medication help with sundowning?
Doctors usually start with environment and routine changes, since those carry no side effects and often help considerably. In some situations medication is considered, and a doctor may also review existing prescriptions, since some can worsen confusion. That conversation belongs with the physician who knows the full history.
Why is sundowning worse in winter?
Shorter days mean the light fades much earlier, and in Calgary it can be dark before half past four in midwinter. Less daylight exposure during the day also disrupts the sleep and wake cycle further. Bright indoor lighting from mid-afternoon helps, and getting some daylight earlier in the day supports the body clock.
When should we consider overnight care?
When night-time movement has become unsafe, when there is any attempt to leave the house after dark, when falls are happening at night, or when the family caregiver is no longer sleeping. Many families wait longer than they needed to, and look back wishing they had arranged it sooner.
The afternoons can get easier
Maureen started turning the lights on at three. She moved Tom’s shower to the morning, gave him a snack and a cup of tea at half past three, and put on the Johnny Cash records he had played for forty years.
Tom still looked for his coat most days. But he looked for it a little later, and he settled a little faster, and after a few weeks she stopped dreading four o’clock quite so much.
Sundowning rarely disappears. It does, with some patience and a few changes, usually become something a family can live alongside.
If the late afternoons or the nights have become difficult in your family and you would like to talk through what support might help, the Compassion Senior Care team is here. You can learn more on our dementia care page, or reach out whenever you are ready.
