Restlessness

Some people with dementia become more confused, anxious or restless in the late afternoon or early evening.

This is sometimes called “sundowning”. When it happens, the person may:

• become more demanding, upset or suspicious
• find it harder to concentrate or pay attention to things
• see, hear or believe things that aren’t real
• believe they’re in the wrong place, and want to “go home” or “find Mum”
• become more impulsive.

These are some common causes, and some things you can try if someone close to you with dementia experiences restlessness in the afternoon.

Causes of restlessness in the afternoon

It’s not clear exactly what causes restlessness in the afternoon. However, it seems to occur as a result of changes in the brain caused by dementia.

There are a few things that can lead to afternoon restlessness:

• tiredness or lack of sleep
• feeling uncomfortable, hungry or needing to go to the toilet
• a change in routine
• a lack of light or daytime noises, which can make it harder for the person to know where they are
• a need for security, particularly for people in later stages of dementia.

What you can do

If someone close to you with dementia is restless in the afternoon, there are things you can do to help.

Planning the day

• Try to schedule activities in the morning, and use afternoons for relaxing.
• If tiredness is making the person’s restlessness worse, encourage them to have a rest after lunch.
• If baths or showers are upsetting, plan them for the early afternoon. If they are soothing, however, time them so they happen just before bedtime.
• Try to limit sweets and caffeine in the afternoon and evening.

Helpful activities

• Create a familiar evening routine, such as closing the curtains, helping prepare dinner and setting the table.
• Find activities that are comforting to the person. These could include a favourite hobby, cuddling a pet or soft toy, singing familiar songs or having a drink of warm milk.
• Go for a walk outdoors or provide them with a safe place to pace.

A comforting environment

• Provide plenty of natural light.
• Turn bright lights down, and reduce noise from TVs and radios.

Their doctor can also help identify health issues that might be contributing to the restlessness, and check whether any medications might be having an impact. They may be able to reduce the restlessness by making changes to the time or dose of the medication.

It’s okay to take care of your own health and happiness. If you're struggling as someone who cares for a person with dementia, contact the free, confidential National Dementia Helpline on 1800 100 500, any time of the day or night, for information, advice and support.