Restless behaviour in the afternoon

Restless behaviour in the afternoon

Dementia affects people in different ways and changes in the behaviour or emotional state of a person living with dementia are common.

People living with dementia may become more confused, restless or insecure in the late afternoon or early evening (when the sun is going down). This behaviour can increase after a change in their routine.

They may become more:

  • demanding
  • restless
  • upset
  • suspicious
  • disoriented.

They may also see, hear or believe things that are not real, especially at night. Their attention span and ability to concentrate may be reduced. Sometimes, they can become more impulsive and place themselves at risk.

Some doctors or medical specialists may refer to this behaviour as sundowning.

Possible causes

The exact cause of restless behaviour in the late afternoon is unknown. It seems to result from changes in the brain.

The behaviour may be related to:

  • Sleep disruptions. People living with dementia get tired easily and can become more restless and their behaviour may change when tired.
  • Lack of sensory stimulation after dark. Dim lights and an absence of daytime noises can make it harder for the person to know where they are.
  • Restlessness due to hunger, discomfort, pain or a need to use the toilet.

Some people with more progressed dementia can become frantic to restore a sense of familiarity or security. Many families and carers say the person becomes anxious about ‘going home’ or ‘finding mother’ late in the day. This may indicate a need for security and protection. They may be trying to find an environment that is familiar to them, particularly one from an earlier time in their life.

What to try

Always discuss concerns about changes in behaviour with the person’s doctor. They will be able to provide a thorough medical examination.

  • Medications should be discussed with the doctor. Sometimes symptoms can be relieved by changing the dose or time a medication is given. They can also discuss the possible side effects of medication and medications that may help with restless behaviour in the late afternoon.
  • Assess the environment and if possible, increase exposure to natural light.
  • If fatigue is making the behaviour worse, resting after lunch might help. Plan activities in the morning and encourage rest and relaxing activities in the afternoon.
  • Reintroduce familiar early evening activities previously engaged in. This may be closing the curtains, helping prepare dinner or setting the table.
  • Let your loved one pace in a safe place, as they need. A walk outdoors can help reduce restlessness.
  • Offer activities and things that provide a sense of calm and comfort. This could be:
    • a favourite pastime
    • pets or soft toy animals
    • familiar songs
    • warm milk.
  • Consider whether bright lights and noise from televisions and radios could be causing their confusion and restlessness.
  • If baths or showers tend to be upsetting, have them in the early afternoon. However, if these activities are soothing, time a bath or shower for before bed.
  • A nightlight or radio playing softly may help with sleep.
  • Monitor dietary intake. Try to reduce sweets and caffeine from the afternoon onwards.
  • Take care of yourself. Make sure you get plenty of rest and seek help if needed.

(Based on ‘Care of Alzheimer’s Patients’ by Lisa Gwyther).

Where to get help

  • Discuss with the person’s doctor your concerns about changes in behaviour, and the impact on you and the person you care for.
  • Call the National Dementia Helpline on 1800 100 500 to learn about support services and education programs, including carer support groups, counselling, and services and programs to assist you to understand and respond to changes and maintain your health and wellbeing.
  • Call the Dementia Behaviour Management Advisory Service on 1800 699 799. They support people living with dementia who experience changes in behaviour that impact their care or the carer.

Additional reading and resources