How to deal with agitation in the evening (sundowning)?

My husband gets very agitated every afternoon, from 5 pm onwards. He walks around the house, repeats the same questions, and sometimes shouts. Is this normal?

What you describe is called "sundowning syndrome" and it is one of the most common and difficult symptoms of dementia. It is estimated to affect about 20-45% of people with Alzheimer's. It's not a whim — it has neurological causes and it's possible to reduce its frequency.

Why it happens

A brain with dementia has difficulty regulating the circadian rhythm (the internal "biological clock"). At the end of the day, accumulated fatigue, reduced natural light, and increased shadows can intensify confusion and anxiety.

Practical strategies

• Light: Keep the house well-lit from early afternoon. Open curtains, use warm spectrum bulbs.
• Predictable routine: Establish a calm activity at 4-5 pm — listening to favourite music, looking through photos, having a cup of tea.
• Reduce stimulation: Turn off the television. News and loud sounds increase confusion.
• Movement early in the day: Physical activity in the morning improves night-time sleep and can reduce evening agitation.
• Early meal: A light dinner at 6 pm instead of 8 pm can help.

"I found that playing classical music at 4:30 pm worked wonders. Not every day, but many days."

During agitation

• Don't contradict. Say "I understand you're worried" instead of "you have no reason to be".
• Offer a simple task: folding towels, organising buttons.
• Go out briefly to the garden or balcony — a change of scenery can interrupt the cycle.

When to talk to the doctor

If the agitation is frequent and intense, speak to the GP. There are medication adjustments and melatonin supplements that can significantly help.