May 20, 2025 by
You’ve finally made it through the day. Dinner’s done, the dishes are drying, and just when you’re hoping for a quiet evening, things start to unravel. Your family member with dementia becomes anxious. Restless. Confused. Maybe even combative. You’re watching a switch flip right before your eyes, and no matter how calmly you speak or how many times you reassure them, nothing seems to help.
This late-day shift in behavior is something many people with dementia experience. It’s called sundowning, and while there’s no single cause, one surprising factor might be hiding in plain sight: their medications.
What Is Sundowning, Really?
Sundowning refers to a pattern of confusion, agitation, or anxiety that tends to worsen in the late afternoon and evening. For many families, it’s one of the most challenging parts of caring for someone with dementia. You may start the day in a relatively calm place and end it feeling like you’re caught in a whirlwind of pacing, worry, agitation, or fear.
And while it’s often attributed to things like fatigue, overstimulation, or changes in light, certain medications can quietly intensify those symptoms, without you even realizing it.
Medications That May Make Sundowning Worse
Some common medications, especially those often prescribed to older adults, may actually contribute to confusion or agitation:
- Anticholinergics, often found in sleep aids or medications for incontinence, can interfere with memory and mental clarity.
- Benzodiazepines (like Valium or Xanax), used for anxiety or sleep, may cause increased agitation or disinhibition.
- Certain antidepressants and antipsychotics may lead to restlessness or even worsening confusion in some individuals.
- Even sleep medications or over-the-counter remedies that seem harmless can have side effects that become more pronounced in the evening.
None of these medications are inherently “bad,” but in someone with dementia, the side effects can show up in unexpected and overwhelming ways.
What You Can Do
If you’re noticing that sundowning behaviors have worsened, or started after a new prescription, it’s worth asking questions. Bring a full list of medications to their next doctor’s appointment, and don’t hesitate to ask whether any could be contributing to the symptoms you’re seeing.
Sometimes a simple adjustment in timing or dosage can make a world of difference. Other times, switching to an alternative medication might bring relief.
The Bigger Picture
Of course, medications are just one piece of the puzzle. Sundowning can also be made worse by poor sleep, hunger, dehydration, or too much or too little stimulation. And let’s be honest; by the end of the day, everyone is more tired and less patient, yourself included.
That’s why having specialized dementia care support in the home can be so helpful, both for the person you’re caring for, and for you, too.
Let Home Care Be Your Lifeline to Restored Peace
We understand what it feels like to dread the evenings. At Home Independent Living is supporting your neighbors in Syracuse, Salina, Clay, and throughout Central New York with experienced dementia care professionals who know how to respond to sundowning behaviors with calm, reassurance, and empathy.
We can help monitor medication effects, keep the person engaged during the day to reduce late-day agitation, and create a soothing environment when things start to shift. We even offer overnight support, to allow you to get the rest you need.
Want to learn how home care could ease the weight of sundowning? Give us a call at (315) 579-HOME (4663) to schedule a free consultation, right in the comfort of home.