The house is finally quiet. Dinner’s done, the TV’s on low volume, and you’re just about to take a breath—when things shift. Your loved one with dementia suddenly becomes agitated. They’re pacing, asking repeated questions, or seem frightened by things that aren’t there. It’s like a switch flipped, and nothing you say seems to bring them back to calm.
This sudden evening change is a common experience for dementia caregivers. It’s called sundowning, and while there’s no single reason why it happens, there is one possible sundowning trigger that is often overlooked: medications.
What Is Sundowning?
Sundowning is the term used for increased confusion, anxiety, or agitation that tends to occur in the late afternoon or early evening. Some people experience irritability. Others become paranoid, restless, or even aggressive. For families, it can be one of the hardest times of the day—especially after everything else you’ve already managed.
Common theories point to tiredness, dimming light, or overstimulation. But many don’t realize how much a person’s medications can influence these changes.
How Medications Might Make It Worse
Medications that are safe—or even helpful—for the general population may behave very differently in someone with dementia. Some to watch include:
- Anticholinergics – Often used in sleep or bladder medications, they can impair cognitive function.
- Benzodiazepines – Prescribed for anxiety or sleep, these can lead to increased confusion or agitation in dementia.
- Certain antidepressants and antipsychotics – These may unintentionally worsen anxiety or restlessness.
- Even over-the-counter sleep aids – Can have lingering effects that increase disorientation as the day winds down.
These medications aren’t necessarily wrong—but for someone with dementia, they can tip the balance at exactly the wrong time of day.
What You Can Do to Help
If your loved one’s sundowning has become more frequent or intense, it’s worth reviewing their medication list. Bring it—prescription and over-the-counter—to their next doctor’s appointment. Ask about side effects that could be increasing late-day confusion.
Sometimes a small change in dosage or timing is enough to help. In other cases, an alternative treatment may be safer and gentler.
More Than Just Medication
It’s also important to look at the full picture. Has your loved one eaten well? Are they hydrated? Has their day included movement and rest in balance? The evening hours are tough on everyone, but even more so for people with dementia—and their caregivers.
That’s why support in the home can make all the difference.
Support That Eases Evenings
At JFS Care, we provide trusted dementia care in West Los Angeles, Santa Monica, Beverly Hills, and throughout Los Angeles County. Our caregivers are trained in recognizing and responding to sundowning behaviors with patience and expertise.
We can help regulate daily routines, monitor for medication side effects, and offer a calm presence when things feel chaotic. Overnight care is also available, so you can sleep knowing someone is there.
Curious about how home care could change your evenings? Call (213) 383-2273 today for a free in-home consultation to learn more about our dementia care services.