Understanding Sundowning and Behaviour Changes

Changes in behaviour are often among the most challenging experiences families face when supporting someone living with dementia or another progressive neurological condition. A loved one who has always been calm and predictable may suddenly become restless, anxious, confused, withdrawn, or emotionally distressed; particularly during the late afternoon or evening. These changes can be unexpected, emotionally difficult, and leave families wondering what has changed or whether they are doing something wrong.

One of the most common patterns families observe is known as sundowning, sometimes referred to as late-day confusion or sundown syndrome. Although it is not considered a disease or a separate diagnosis, sundowning describes a collection of symptoms that often become more noticeable as daylight fades and evening approaches. Individuals may experience increased confusion, agitation, pacing, irritability, anxiety, emotional distress, or changes in communication and behaviour that seem out of character.

While sundowning is frequently associated with Alzheimer's disease and other forms of dementia, it can also affect individuals living with Lewy Body Dementia, Parkinson's disease dementia, vascular dementia, and other neurological conditions that influence cognition and daily functioning. Every person's experience is unique. Some individuals may experience only mild changes, while others may require additional reassurance, environmental adjustments, or increased support during certain times of the day.

Is Sundowning a Normal Part of Dementia?

Not everyone living with dementia experiences sundowning, and the severity of symptoms can vary considerably from one individual to another. For those who do experience it, the changes often develop gradually and may become more noticeable as the condition progresses. While sundowning can be distressing for both the individual and their family, recognizing it as a common behavioural pattern allows caregivers to respond with greater understanding, patience, and confidence rather than fear or uncertainty.

Why Do Behaviour Changes Occur?

Behaviour changes rarely happen without reason. Although dementia affects the brain's ability to process information, behaviour is often a form of communication rather than intentional resistance or difficult behaviour.

An individual may become distressed because they are tired, overstimulated, experiencing discomfort, unable to communicate a need, confused by their surroundings, or struggling to make sense of what they are experiencing. In many situations, the behaviour itself is not the problem; it is a signal that something else requires attention.

Many dementia care professionals encourage families to think of behaviour as they would think of physical symptoms such as pain or fever. Rather than viewing agitation, pacing, or emotional distress as the primary problem, these behaviours can often be understood as outward expressions of an unmet physical, emotional, environmental, or communication need. Looking beyond the behaviour itself frequently leads to more compassionate caregiving and more successful problem-solving.

Understanding behaviour through this perspective allows families to move away from asking:

"How do we stop this behaviour?"

…and instead begin asking:  "What might this person be trying to communicate?"

This simple shift often leads to more compassionate responses and more effective support.

Understanding Before Reacting

It is also important to recognize that behaviour changes are often influenced by multiple factors working together. Fatigue, changes in routine, unfamiliar environments, reduced lighting, pain, dehydration, hunger, medication effects, illness, overstimulation, loneliness, or difficulty interpreting surroundings can all contribute to changes in mood and behaviour.

Because these factors differ from person to person, there is rarely a single solution that works for everyone. Instead, successful support often comes from observing patterns, understanding individual triggers, and making thoughtful adjustments that help the person feel calmer, safer, and more secure.

Although behaviour changes can feel overwhelming at first, many families discover that education, patience, and consistent routines significantly reduce both uncertainty and stress. By understanding why these behaviours occur, it becomes possible to respond with empathy rather than frustration while preserving dignity, strengthening relationships, and improving quality of life for everyone involved.

At Senior Helpers Victoria, we believe that understanding behaviour is one of the most valuable tools families can develop. Through practical, evidence-informed education, our goal is to help older adults and families throughout Greater Victoria better understand sundowning and behaviour changes, recognize common patterns, and develop compassionate strategies that support safety, confidence, and meaningful daily living.

Families throughout Greater Victoria often tell us that behaviour changes are among the most emotionally challenging aspects of supporting a loved one living with dementia. Our goal is to provide trusted local education that helps replace uncertainty with understanding while giving families practical strategies they can confidently apply at home.

Recognizing the Signs and Symptoms of Sundowning and Behaviour Changes

Sundowning does not look the same for every individual. While some people experience only subtle changes in mood or attention during the late afternoon and evening, others may demonstrate more noticeable behavioural or emotional changes that can be confusing or concerning for family members.

These behaviours are often gradual rather than sudden. Families may first notice that their loved one becomes more restless toward the end of the day, asks repeated questions, appears more anxious than usual, or struggles with activities that seemed manageable earlier that morning. Over time, these changes may become more predictable, often occurring around the same time each day.

When Does Sundowning Usually Begin?

Although every individual is different, many families notice behaviour changes beginning during the late afternoon and continuing into the evening. For some people, symptoms may start as daylight begins to fade, while others experience changes closer to dinner time or bedtime. Recognizing when behaviours typically begin can help families prepare routines, reduce unnecessary stress, and create a calmer environment before symptoms become more noticeable.

Recognizing these patterns is one of the most valuable tools families can develop. Rather than viewing each episode as an isolated event, identifying when behaviours occur, how long they last, and what may have happened beforehand can help uncover meaningful patterns that support more effective care planning.

Common Signs of Sundowning

Although every person's experience is unique, some of the more commonly observed signs of sundowning include:

• Increased confusion or disorientation during the late afternoon or evening
• Restlessness or an inability to sit comfortably
• Pacing or repetitive walking
• Increased anxiety, nervousness, or fearfulness
• Irritability or unexpected changes in mood
• Repetitive questions or conversations
• Difficulty recognizing familiar people or surroundings
• Wanting to "go home," even when already at home
• Increased emotional sensitivity, tearfulness, or frustration
• Resistance to personal care or evening routines
• Difficulty settling for the evening or preparing for bed
• Changes in sleep patterns or increased wakefulness during the night

Not every individual will experience all of these behaviours, and the intensity of symptoms may vary from day to day. Some evenings may pass with very little change, while others may require additional reassurance and support.

It is also common for the severity of sundowning to fluctuate over time. Individuals may experience periods where behaviours become less noticeable before increasing again during times of illness, fatigue, environmental change, or disease progression. These natural fluctuations do not necessarily indicate that the condition is suddenly worsening but rather reflect the complex way dementia affects the brain.

Behaviour Patterns Often Follow a Routine

One characteristic of sundowning is that behaviours often become predictable over time. Families may notice that certain situations consistently occur before behaviour changes begin.

For example, behaviours may become more noticeable after:

• A busy or overstimulating day
• Physical fatigue
• Missed meals or dehydration
• Changes in routine
• Visitors leaving the home
• Reduced daylight during the evening
• Increased shadows or dim lighting
• Loud television or competing background noise
• Multiple conversations occurring at the same time

Recognizing these patterns allows caregivers to begin anticipating behavioural changes rather than simply reacting to them after they occur.

Changes in Behaviour Are Not Intentional

One of the most important things families can remember is that these behaviours are not deliberate attempts to be difficult, argumentative, or uncooperative.

Individuals living with dementia are responding to changes occurring within the brain, many of which affect their ability to interpret the environment, process information, regulate emotions, and communicate effectively.

When behaviour is viewed through this lens, it becomes easier to replace frustration with curiosity.

Instead of asking: "Why is this happening to us?"

…families often find it more helpful to ask:  "What might my loved one be experiencing right now?"

That simple change in perspective often leads to calmer interactions, stronger relationships, and more compassionate caregiving.

Every Behaviour Tells Part of the Story

Perhaps the most valuable lesson families can learn is that behaviour rarely occurs without meaning.

Agitation may reflect fear.  Pacing may reflect restlessness or uncertainty.  Repeated questions may reflect anxiety rather than forgetfulness.  Resistance to care may reflect confusion, embarrassment, discomfort, or a desire to maintain independence.

When families begin looking beyond the behaviour itself, they are often able to better understand the individual's experience and respond in ways that reduce distress rather than unintentionally increasing it.

Keeping a simple journal of when behaviours occur, what happened beforehand, and how the individual responded can sometimes help families identify meaningful patterns over time. Sharing these observations with healthcare providers may also contribute to more informed discussions about care planning and individualized support strategies.

Understanding these signs is not about learning to predict every behaviour.

It is about developing the confidence to recognize patterns, respond thoughtfully, and create an environment where the individual feels safe, understood, and supported.

Understanding What Can Trigger Sundowning and Behaviour Changes

One of the most common questions families ask is, "Why does this seem to happen every evening?" While there is no single answer, researchers and healthcare professionals believe that sundowning is often influenced by a combination of physical, emotional, environmental, and neurological factors that gradually build throughout the day.

For someone living with dementia, the brain is already working harder to process information, interpret surroundings, communicate needs, and adapt to everyday experiences. As the day progresses, mental and physical fatigue can make these tasks increasingly difficult. By late afternoon or evening, even small challenges that may have been manageable earlier in the day can begin to feel overwhelming.

Understanding these contributing factors helps families move away from searching for a single cause and instead recognize that behaviour often reflects the combined effect of several influences occurring at the same time.

Multiple Triggers Often Work Together

In many situations, there is not one single trigger responsible for a behavioural change. An individual may be physically tired, slightly dehydrated, experiencing increased confusion because of fading daylight, and feeling overwhelmed by a busy household; all at the same time. Recognizing that several contributing factors may occur together helps families respond with greater flexibility rather than becoming frustrated when there is no obvious explanation.

Physical Factors That May Contribute

Changes in physical well-being are among the most common contributors to behavioural changes.  For example, an individual may become more confused or agitated because they are:

1. Physically tired after a busy day
2. Hungry or dehydrated
3. Experiencing pain or discomfort
4. Recovering from illness
5. Constipated or experiencing urinary discomfort
6. Sensitive to medication timing or medication changes
7. Experiencing poor sleep or interrupted sleep patterns

Because dementia may affect a person's ability to recognize or communicate these needs, behaviour sometimes becomes the only outward sign that something is wrong.

Environmental Factors Can Influence Behaviour

The environment itself can also play an important role.

As daylight fades, changing shadows, reduced lighting, increased background noise, unfamiliar surroundings, or busy household activity may become more difficult for the brain to interpret accurately.

For some individuals, environments that once felt comfortable may suddenly seem unfamiliar or confusing.  Common environmental contributors may include:

• Dim lighting
• Busy family gatherings
• Loud televisions or radios
• Multiple conversations occurring simultaneously
• Cluttered living spaces
• Frequent interruptions
• Changes to familiar routines
• New caregivers or unfamiliar visitors

Reducing unnecessary stimulation does not mean creating a silent environment. Rather, it involves creating predictable surroundings that help the individual feel calm, secure, and oriented.

Emotional Needs Matter Just As Much

Behaviour is often influenced by emotions that the individual may no longer be able to express clearly.  An individual may experience:

• Anxiety
• Loneliness
• Fear
• Frustration
• Embarrassment
• Grief
• Boredom
• A desire for reassurance

Although these emotions may not always be communicated verbally, they remain very real. Recognizing emotional needs allows caregivers to respond with empathy instead of assuming the behaviour is intentional.

Sometimes the most effective response is not solving a problem but helping someone feel safe, heard, and understood.

Dementia Changes How the Brain Processes the World

Perhaps the most important factor to understand is that dementia changes how the brain interprets information.

As the disease progresses, the brain may have greater difficulty processing visual information, filtering background noise, maintaining attention, regulating emotions, or making sense of unfamiliar situations.  By evening, after an entire day of processing people, conversations, sounds, and activities, the brain may simply become overwhelmed.

This neurological fatigue often explains why behaviours become more noticeable later in the day, even when nothing obvious appears to have changed.  Understanding this concept helps families recognize that the individual is not choosing these behaviours.

Their brain is working differently.

Looking for Patterns Instead of Searching for One Cause

Every individual experiences sundowning differently.  For one person, fatigue may be the primary trigger.  For another, overstimulation may play the largest role.

Someone else may respond primarily to changes in lighting or disruptions to their routine.

Rather than searching for a single explanation, families often find greater success by observing patterns over several days or weeks. Small observations frequently become valuable clues that help identify which situations consistently precede behavioural changes.

When these patterns become clearer, caregivers are often able to make thoughtful adjustments that reduce stress while helping the individual feel calmer and more secure.

Over time, many families discover that making small adjustments before behaviours begin; such as maintaining consistent routines, reducing unnecessary stimulation, offering reassurance, or planning quieter evening activities - can often lessen the intensity of behavioural changes. While these strategies cannot eliminate sundowning, they frequently help create a calmer and more supportive environment. The following section explores these practical approaches in greater detail.

Understanding triggers is not about preventing every episode of sundowning.

It is about increasing confidence, improving communication, and creating an environment where individuals living with dementia feel supported, respected, and understood.

Practical Strategies for Responding to Sundowning and Behaviour Changes

Once families begin recognizing the patterns and contributing factors associated with sundowning, the next step is learning how to respond in ways that reduce stress for everyone involved. Although there is no single approach that works in every situation, many individuals living with dementia benefit from calm, consistent, and person-centred strategies that help them feel safe, understood, and supported.

The goal is not to control behaviour or eliminate every episode of sundowning. Rather, it is to reduce distress, preserve dignity, and create an environment where the individual feels secure despite the challenges they may be experiencing.

Often, small changes in how caregivers respond can have a meaningful impact on the overall experience.

Begin with Calm Reassurance

When behaviour changes begin, family members naturally want to explain what is happening or quickly correct misunderstandings. While these responses come from a place of love and concern, lengthy explanations or repeated attempts to reason with someone experiencing confusion may unintentionally increase frustration.

Instead, a calm voice, reassuring presence, gentle eye contact, and simple communication often provide greater comfort than detailed explanations.  Sometimes reassurance sounds as simple as:

• "You're safe."
• "I'm here with you."
• "Let's do this together."
• "Everything is okay."

Although these phrases may seem simple, they often communicate far more than lengthy conversations during periods of confusion or anxiety.

Reduce Stimulation Rather Than Increasing It

When individuals become overwhelmed, adding more activity rarely improves the situation.

Instead, many families find success by gradually reducing unnecessary stimulation.  Helpful strategies may include:

1. Lowering the television volume
2. Reducing background noise
3. Closing curtains to minimize confusing reflections
4. Turning on additional lighting as daylight fades
5. Limiting multiple conversations occurring at once
6. Moving to a quieter room if the environment becomes overwhelming

The objective is not silence; it is creating an environment where the brain has fewer competing demands.

Keep Communication Simple and Supportive

As dementia progresses, complex conversations may become increasingly difficult to follow, particularly during the evening when cognitive fatigue is greater.  Simple communication often works best.  Consider:

• Speaking slowly and calmly
• Offering one instruction at a time
• Asking simple questions rather than presenting multiple choices
• Allowing extra time for responses
• Avoiding arguments or repeated corrections
• Using reassuring facial expressions and body language

The way something is communicated often becomes just as important as the words themselves.

Redirect Rather Than Correct

One of the most effective strategies during periods of confusion is gentle redirection.

If someone insists they need to "go home," repeatedly explaining that they are already home may unintentionally increase distress because their emotional experience remains unchanged.

Instead, caregivers may find greater success by acknowledging the underlying feeling before gently redirecting attention toward another familiar activity, conversation, photograph, favourite snack, music, or calming routine.

Validation followed by redirection often preserves dignity while helping reduce anxiety without creating confrontation.

Remember That Every Individual Is Different

The strategies that help one individual may not be equally effective for another.  Some people find comfort in quiet conversation.

Others respond positively to music, a short walk, familiar household routines, looking through family photographs, folding towels, holding a favourite blanket, or simply sitting quietly with someone they trust.

Learning which approaches provide comfort often becomes one of the most valuable forms of individualized care.  Successful caregiving is rarely about finding one perfect solution.

It is about remaining flexible, observing what works, and adapting support to the person's unique preferences, personality, and changing needs.

When a Strategy Does Not Work

It is perfectly normal for a strategy that worked yesterday to be less effective today. Dementia affects the brain in ways that can cause needs, emotions, and responses to change over time. Rather than viewing this as a setback, families are often encouraged to remain curious, make small adjustments, and continue observing what helps the individual feel calmer and more secure. Flexibility is one of the most valuable caregiving skills that can be developed throughout the dementia journey.

Compassion Is Often the Most Effective Strategy

Families sometimes worry they are not doing enough when behaviour changes continue despite their best efforts.  It is important to remember that sundowning cannot always be prevented.

What caregivers can influence is how the individual experiences those moments.

Responding with patience instead of urgency, reassurance instead of correction, and understanding instead of frustration often helps create a calmer environment for everyone involved.

Sometimes the greatest comfort we can provide is simply being present.

Many families also discover that the most successful responses begin long before behavioural changes develop. Establishing consistent evening routines, reducing unnecessary stimulation before sunset, and creating predictable daily rhythms often provide an important foundation for calmer evenings. The next section explores how thoughtful routines can help support comfort, familiarity, and emotional well-being.

Although behaviour may change, the person's need to feel safe, respected, and connected remains constant.

Creating Supportive Evening Routines

While sundowning cannot always be prevented, many families find that establishing calm, predictable evening routines helps reduce confusion, anxiety, and emotional distress. Consistency provides familiarity, and familiarity often creates a greater sense of comfort for individuals living with dementia.

As the day progresses, the brain gradually becomes fatigued from processing conversations, decisions, sounds, visual information, and daily activities. Evening routines help reduce these demands by replacing uncertainty with predictable patterns that the individual begins to recognize and expect.

Rather than viewing an evening routine as a strict schedule, it can be helpful to think of it as creating a calm transition from the activities of the day to the restfulness of the evening.

Consistency Creates Confidence

Individuals living with dementia often benefit from knowing what comes next.

When meals, personal care, quiet activities, medications, and bedtime occur at approximately the same time each day, the brain has fewer unexpected changes to process. This consistency may reduce anxiety while providing a greater sense of security and orientation.

Even when daily schedules need to change occasionally, maintaining the overall rhythm of the evening can often help reduce unnecessary stress.

Small moments of predictability frequently make a meaningful difference.

Create a Calm Environment Before Behaviour Changes Begin

Many families naturally wait until behaviours become noticeable before making adjustments to the environment; however, some of the most effective strategies begin before signs of sundowning appear.  Helpful approaches may include:

1. Turning on lights before natural daylight begins to fade
2. Closing curtains to reduce confusing reflections
3. Lowering background noise during the evening
4. Finishing stimulating activities earlier in the day
5. Offering a light snack or beverage if appropriate
6. Encouraging quiet conversation or relaxing activities
7. Limiting unnecessary interruptions during the evening

These proactive adjustments often help reduce environmental stress before it begins affecting behaviour.

Meaningful Activities Can Provide Comfort

The hours leading up to bedtime do not need to be filled with inactivity.  Many individuals continue enjoying calm, familiar activities that provide both comfort and purpose.  Depending on personal interests, this may include:

• Listening to favourite music
• Looking through family photographs
• Reading together
• Folding towels or completing simple household tasks
• Gentle stretching or a short walk
• Watching familiar television programs
• Enjoying a favourite beverage while talking quietly with family

The activity itself is often less important than the sense of familiarity, accomplishment, and connection it provides.

Balance Activity with Rest

Although maintaining engagement is important, overexertion can sometimes contribute to evening fatigue and increased behavioural changes.

Families often find success by balancing periods of activity with opportunities to rest throughout the day. Planning appointments, errands, social visits, or more demanding activities earlier in the day may leave greater energy available during the evening when the brain is naturally becoming more fatigued.

Learning this balance often requires observation and flexibility, as every individual's energy patterns are unique.

Small Adjustments Often Have the Greatest Impact

One of the most encouraging aspects of creating supportive evening routines is that dramatic changes are rarely necessary.

Instead, many families discover that small, thoughtful adjustments gradually create evenings that feel calmer, more predictable, and less stressful.  There is no perfect routine that works for everyone.

Allow Routines to Evolve Gradually

As dementia progresses, routines may naturally need to change to reflect the individual's abilities, energy levels, health, and personal preferences. Whenever possible, introducing small adjustments gradually rather than making several changes at once can help reduce confusion and allow the individual time to adapt. Maintaining familiar elements while thoughtfully adjusting routines often provides the greatest sense of comfort and stability.

The most successful routines are those built around the individual's lifelong preferences, personality, habits, and daily rhythms.

As needs evolve over time, these routines can continue evolving as well, always with the goal of helping the individual feel safe, respected, comfortable, and supported within the familiarity of home.

Supporting Family Caregivers During Challenging Evenings

For many families, the late afternoon and evening can become the most emotionally demanding part of the day. After balancing work, household responsibilities, appointments, and caregiving throughout the day, caregivers often find themselves supporting their loved one just as fatigue begins affecting everyone involved.

These moments can feel overwhelming.

When behaviour changes become more noticeable each evening, it is natural for caregivers to question whether they are doing enough or wonder if they are responding the "right" way. It is important to remember that supporting someone living with dementia is not about finding perfect solutions. It is about responding with patience, compassion, and a willingness to adapt as circumstances change.

Just as individuals living with dementia benefit from understanding and reassurance, family caregivers deserve the same support and encouragement throughout the caregiving journey.

It Is Normal to Feel Emotionally Tired

Providing care during periods of confusion, anxiety, or emotional distress requires considerable emotional energy.  Many caregivers experience feelings such as:

• Frustration
• Sadness
• Uncertainty
• Helplessness
• Guilt
• Mental fatigue
• Emotional exhaustion

Experiencing these emotions does not mean someone is failing as a caregiver.

In fact, recognizing these feelings is often an important step toward maintaining resilience and ensuring caregiving remains sustainable over the long term.

Give Yourself Permission to Pause

When evenings become particularly difficult, caregivers sometimes feel they must immediately solve every problem or prevent every behavioural change.  In reality, one of the most valuable things a caregiver can do is pause.

Taking a slow breath. Speaking calmly.  Allowing a few extra moments before responding.

These simple actions often help both the caregiver and the individual feel calmer.

Responding thoughtfully rather than reacting quickly frequently creates more successful interactions while reducing stress for everyone involved.

Caring for Yourself Supports the Person You Love

One of the greatest misconceptions about caregiving is that focusing on personal well-being somehow takes attention away from the person receiving care.  The opposite is often true.

Caregivers who prioritize adequate sleep, healthy nutrition, regular medical care, meaningful social connections, and opportunities for rest are generally better equipped to provide calm, compassionate, and consistent support.

Self-care is not selfish.  It is an important part of providing sustainable care.  Looking after your own well-being allows you to continue looking after someone else's.

You Do Not Have to Navigate This Journey Alone

Supporting someone living with dementia was never intended to be a responsibility carried by one person alone.  Many families benefit from gradually building a circle of support that may include:

• Family members
• Friends
• Neighbours
• Healthcare professionals
• Community organizations
• Dementia support groups
• Professional home care providers

Seeking additional support is not a sign that you are giving up.  It is often one of the most thoughtful decisions a caregiver can make.

Sharing responsibilities allows caregivers to preserve their own health while continuing to enjoy meaningful time with the person they love.

Compassion Includes Yourself

Family caregivers naturally extend extraordinary compassion to those they support.  Remember that same compassion should also be directed inward.  There will be evenings that go well.  There will be evenings that feel more difficult.

Neither defines your success as a caregiver.

Measuring Success Differently

One difficult evening does not erase the progress that has been made over weeks or months of compassionate caregiving. Dementia is an evolving condition, and even the most experienced caregivers encounter challenging days. Rather than measuring success by whether every evening goes smoothly, it is often more helpful to look at the overall pattern of care, the strength of the relationship, and the continued commitment to responding with patience, dignity, and understanding.

The goal is not perfection.  The goal is creating as many moments of comfort, connection, and dignity as possible; both for the individual living with dementia and for yourself.

When caregivers feel supported, informed, and encouraged, they are better able to provide the steady reassurance that helps individuals living with dementia feel safe and understood throughout each stage of the journey.

When to Consider Additional Support

Many families begin their caregiving journey with the intention of managing everything on their own. For a period of time, this may work well. As routines become established and family members learn more about dementia, they often develop confidence in supporting their loved one through everyday challenges.

Over time, however, dementia changes and caregiving naturally changes with it.

Behaviour changes that once occurred occasionally may begin happening more frequently. Evenings may become increasingly unpredictable, caregivers may feel more physically or emotionally fatigued, and balancing caregiving alongside work, family, and personal responsibilities may become more difficult.

Recognizing these changes is not a sign that someone has failed.  It is often a sign that additional support may help everyone involved continue living more comfortably and confidently.

Support Is Most Effective Before a Crisis Occurs

One of the most common misconceptions about home care is that it should only be considered when a family reaches a crisis.  In reality, many families find the opposite to be true.

Introducing support before caregiving becomes overwhelming often allows everyone to adjust gradually. The individual living with dementia has an opportunity to become familiar with a consistent caregiver, while family members gain additional reassurance knowing they are not carrying every responsibility alone.

Building trusted relationships early frequently creates a smoother transition as care needs evolve over time.

Signs That Additional Support May Be Helpful

Every family's situation is unique, but some common indicators that it may be beneficial to explore additional support include:

• Behaviour changes becoming more frequent or more difficult to manage
• Increased caregiver fatigue or emotional exhaustion
• Difficulty maintaining consistent evening routines
• Concerns about safety within the home
• Frequent sleep disruption affecting the caregiver's well-being
• Balancing caregiving with employment or other family responsibilities becoming increasingly difficult
• The individual requiring more assistance with personal care, mobility, or daily activities.
• Family members feeling isolated or unsure where to turn for guidance

Experiencing one or more of these situations does not necessarily mean immediate comprehensive care is required. Instead, they may simply indicate that additional assistance could help preserve everyone's quality of life.

Support Can Begin Gradually

Introducing professional home care does not require an immediate transition to extensive services. Many families begin with only a few hours of companionship, respite care, or assistance during the times of day that feel most challenging. Starting gradually allows everyone to become comfortable with additional support while preserving established routines and maintaining the individual's sense of independence.

Professional Home Care Supports the Entire Family

Professional home care is often misunderstood as replacing family involvement.  Our philosophy is exactly the opposite.  The goal is to strengthen the support already being provided.

Depending on each family's circumstances, professional caregivers may assist with:

• Companion care and meaningful engagement
• Personal care delivered with dignity and respect
• Meal preparation and light housekeeping
• Evening companionship and reassurance
• Respite care that allows family caregivers opportunities to rest and recharge
• Assistance following hospitalization or changes in health
• Flexible care plans that evolve alongside changing needs

When families share practical responsibilities, they are often able to spend more meaningful time together while reducing the stress associated with managing every aspect of care alone.

Asking for Help Reflects Strength, Not Failure

One of the most compassionate decisions a caregiver can make is recognizing when additional support would benefit both themselves and the person they love.  Seeking help does not diminish the commitment families have to one another.

Instead, it often allows caregivers to preserve their own health, strengthen relationships, and continue providing the emotional connection that only family can provide.

Support is not about replacing family.  It is about helping families remain families.

Every Family's Journey Is Different

There is no single moment when every family should introduce professional support.  Some families begin with just a few hours of companionship each week.

Others seek assistance following a hospitalization, during periods of caregiver fatigue, or as dementia gradually progresses.  The right time is the time that reflects the individual's needs, the caregiver's well-being, and the family's overall goals.

The most successful care plans are those that evolve thoughtfully, preserve dignity, and continue adapting as life changes.

How Senior Helpers Victoria Supports Families Living with Sundowning and Behaviour Changes

At Senior Helpers Victoria, we understand that supporting someone experiencing sundowning or behavioural changes requires far more than simply following a checklist of caregiving tasks. Every individual experiences dementia differently, and every family develops its own routines, relationships, and ways of providing care. For that reason, we believe the most effective support begins by understanding the individual; not simply the behaviour.

Our approach is built upon person-centred care, relationship-building, and education. Before recommending any support, we take time to understand the individual's history, daily routines, personal preferences, strengths, challenges, and the goals that matter most to both the individual and their family.

Behaviour is never viewed in isolation.

Instead, we work to understand what the behaviour may be communicating while helping create practical strategies that preserve dignity, reduce unnecessary distress, and support quality of life.

Supporting Individuals Through Familiarity and Consistency

One of the most valuable aspects of home care for individuals experiencing sundowning is consistency.

Whenever possible, we strive to build familiar caregiver relationships that encourage trust, reduce uncertainty, and create predictable routines. Over time, these relationships often become an important source of reassurance during periods of confusion or anxiety.

Care is individualized and may include support with:

• Companion care that encourages meaningful engagement and conversation
• Personal care delivered respectfully and at the individual's pace
• Meal preparation and light housekeeping
• Assistance establishing calm evening routines
• Mobility support and safe supervision when appropriate
• Medication reminders within our non-medical scope of practice
• Flexible scheduling that evolves as needs change

Every recommendation is guided by one simple question:  "What will best support this individual today?"

Partnering With Families, Not Replacing Them

Families know their loved ones better than anyone else.  Their knowledge, experience, and observations are invaluable.

Rather than replacing family involvement, we work collaboratively with family members to understand behavioural patterns, identify routines that provide comfort, and adapt care as circumstances evolve.  Open communication allows everyone involved to learn together, share observations, and develop thoughtful approaches that continue supporting the individual's well-being over time.

The strongest care plans are built through partnership.

Education Is Part of Every Care Plan

Providing exceptional home care involves more than assisting with daily activities.  Education is equally important.

Helping families understand why behaviours occur, recognizing changing patterns, and building confidence in responding compassionately often improves the caregiving experience for everyone involved.

Whether support begins with companionship a few hours each week or evolves into more comprehensive assistance over time, education remains an essential part of helping families navigate the dementia journey with greater confidence.

Care That Evolves Alongside the Journey

No two dementia journeys unfold in exactly the same way.  Needs that are appropriate today may naturally change months or years from now.

Because of this, care plans should remain flexible.  As routines, health, mobility, communication, and behaviour evolve, support can evolve as well.

Continual Observation Supports Better Care

As behaviour changes over time, ongoing observation and communication help ensure that care continues reflecting the individual's current needs rather than assumptions based on earlier experiences. Small changes in routines, communication, preferences, or behaviour often provide valuable insight that allows care plans to be adjusted thoughtfully while preserving consistency, dignity, and quality of life.

Rather than asking individuals to fit into predetermined services, we believe services should adapt to the individual's changing needs, personal goals, and preferred way of living.

This flexible approach helps preserve dignity while supporting independence for as long as possible.

More Than Providing Care

At Senior Helpers Victoria, our goal is not simply to respond to behavioural changes.

Our goal is to help individuals continue living meaningful lives within the comfort and familiarity of home while giving families the confidence that they are supported throughout every stage of the journey.  Every interaction is guided by patience, compassion, respect, and the understanding that behaviour is communication.

When families feel informed and supported, and when individuals feel safe, understood, and respected, everyone benefits. 

That is the philosophy that guides every relationship we build.

Frequently Asked Questions About Sundowning and Behaviour Changes

What is sundowning?

Sundowning is a term used to describe behavioural and emotional changes that often become more noticeable during the late afternoon or evening in some individuals living with dementia. These changes may include increased confusion, anxiety, restlessness, pacing, agitation, or difficulty settling for the night. Although sundowning is common, not everyone living with dementia will experience it, and the severity of symptoms varies from person to person.

Why does sundowning usually happen in the evening?

Researchers believe several factors contribute to sundowning. As the day progresses, physical and mental fatigue can make it more difficult for the brain to process information. Reduced daylight, changes in routine, overstimulation, hunger, dehydration, discomfort, and environmental changes may also contribute to increased confusion or behavioural changes later in the day.

Is sundowning a normal part of dementia?

Sundowning is a common behavioural pattern associated with many forms of dementia, but it is not experienced by everyone. Some individuals may have only mild changes in mood or attention during the evening, while others experience more significant behavioural changes. Every dementia journey is unique, which is why individualized observation and care are so important.

How long does sundowning usually last?

The duration of sundowning varies considerably between individuals. Some episodes may last only a short period, while others continue throughout the evening before gradually improving. The intensity and frequency of symptoms may also change over time as dementia progresses or as routines, health, and environmental factors change.

Does Sundowning Happen Every Day?

Not necessarily. Some individuals experience sundowning most evenings, while others have behavioural changes only occasionally. The frequency and intensity of symptoms often fluctuate depending on factors such as fatigue, physical health, environmental changes, daily routines, and the progression of dementia. Keeping track of patterns over time may help families better understand what contributes to behavioural changes and when additional support or routine adjustments may be helpful.

Can sundowning be prevented?

There is no guaranteed way to prevent sundowning completely. However, many families find that maintaining consistent routines, reducing unnecessary evening stimulation, encouraging meaningful daytime activity, supporting good hydration and nutrition, and creating a calm environment may help lessen the intensity of behavioural changes.

Should I correct my loved one when they become confused?

In many situations, repeated correction or lengthy explanations may unintentionally increase frustration or anxiety.

Instead, responding with reassurance, calm communication, and gentle redirection often helps preserve dignity while reducing emotional distress. The goal is not to win an argument—it is to help the individual feel safe, understood, and supported.

When should we consider professional home care?

Many families begin exploring home care before caregiving becomes overwhelming.

Professional support may be helpful when behavioural changes become more frequent, caregivers begin experiencing fatigue, routines become increasingly difficult to maintain, or additional assistance would improve quality of life for both the individual and the family.

Introducing support gradually often allows everyone to build trusting relationships while adapting comfortably as care needs evolve.

Can someone experiencing sundowning continue living at home?

Many individuals experiencing sundowning continue living safely at home for years.

Success often depends on individualized care planning, home safety, consistent routines, family involvement, and introducing appropriate support as needs change. Every situation is different, and care should always reflect the individual's unique circumstances, abilities, and goals.

How does Senior Helpers Victoria support families experiencing sundowning?

Senior Helpers Victoria provides personalized, non-medical home care that helps individuals continue living safely and comfortably in the familiarity of home.

Depending on each family's needs, support may include companion care, personal care, respite care, meal preparation, evening companionship, assistance establishing supportive routines, and collaborative care planning that evolves alongside changing needs.

Our philosophy always begins by understanding the individual first, recognizing that behaviour is often a form of communication and that meaningful care starts with compassion, consistency, and relationships.

Understanding Behaviour Changes Begins with Understanding the Person

Behaviour changes associated with dementia can be some of the most emotional and challenging experiences families encounter. Moments of confusion, anxiety, restlessness, or agitation often leave caregivers wondering what they should do differently or whether they are providing enough support.

The most important message to remember is this:  Behaviour is rarely random.

More often, it is the brain's way of communicating a need that can no longer be expressed easily through words.

Approaching behaviour with curiosity instead of frustration, patience instead of urgency, and understanding instead of judgment can transform the caregiving experience for both the individual living with dementia and the family members supporting them.

Although sundowning may never disappear completely, many families discover that education, consistency, thoughtful routines, compassionate communication, and individualized support can make evenings feel calmer, more predictable, and less overwhelming.

Small Changes Often Lead to Meaningful Improvements

One of the most encouraging aspects of supporting someone living with dementia is recognizing that meaningful improvements often begin with small adjustments.

A calmer evening routine.  A quieter environment.  A familiar face. A reassuring conversation. A moment of patience before responding.  Individually, these changes may seem modest.  Together, they often create a greater sense of comfort, security, and confidence for everyone involved.

Progress is rarely measured by having a perfect evening.  It is measured by continuing to learn, adapt, and preserve the dignity of the person at the centre of care.

You Do Not Have to Face This Journey Alone

Every family's experience with dementia is unique.  Some families begin seeking information shortly after diagnosis.  Others begin looking for guidance only after behaviour changes become more challenging.

Regardless of where you are in your journey, asking questions, learning more about dementia, and building a trusted network of support are all important steps toward creating a more sustainable caregiving experience.

At Senior Helpers Victoria, we believe every individual deserves care that recognizes the person before the diagnosis and every family deserves access to compassionate, practical, and evidence-informed guidance.

Whether you are beginning to explore behavioural changes, looking for practical caregiving strategies, or considering additional home care support, our team is here to provide education, guidance, and personalized assistance that reflects your family's unique circumstances.

Supporting Families Throughout Greater Victoria

Families across Victoria, Saanich, Oak Bay, Sidney, Esquimalt, Langford, Colwood, View Royal, Central Saanich, North Saanich, and communities throughout the Capital Regional District share many of the same questions when behaviour changes become part of the dementia journey. Our commitment is to provide trusted local education, compassionate guidance, and personalized support that helps families make informed decisions with confidence, wherever they may be on that journey.

Every Behaviour Has Meaning. Every Person Deserves Understanding.

Behaviour changes may become part of the dementia journey.  They should never become the defining characteristic of the person.

Behind every behaviour is an individual with a lifetime of experiences, relationships, accomplishments, memories, preferences, and values that continue to shape who they are.

By responding with compassion, preserving familiar routines, supporting family caregivers, and adapting care as needs evolve, it is possible to continue creating meaningful moments of comfort, dignity, and connection throughout every stage of the journey.

If you would like to learn more about sundowning, discuss your family's unique circumstances, or explore personalized home care options throughout Greater Victoria, we invite you to contact Senior Helpers Victoria for a complimentary, no-obligation consultation.

Together, we can help create an approach that supports understanding, preserves dignity, and strengthens confidence; one evening, one relationship, and one meaningful moment at a time.

Because every behaviour tells part of the story.  And every person deserves to be understood.