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Post No 70...Dementia care and sundowning – what is it?

Posted on 23rd April 2025 at 07:00
 
Introduction 
 
Sundowning is a term used to describe a behavioural change in a person who is living with dementia. Sometimes, these changes in behaviour can be challenging for the carer, or perhaps for the care home staff, because they can come on quite suddenly and not always at the same time of the day. 
The reasons for sundowning are not fully known, but within this post we will break down some of the reasons why people may experience sundowning, and discuss the impact it can have on those living around them. 
 
It is worth quickly noting that not everyone with dementia will experience sundowning, there are over 100 types of dementia, every person is different and dementia affects people in different ways. 
 
So, why does it happen? 
 
According to The Alzheimer’s Society, sundowning can occur at any stage of a person’s dementia journey, but is perhaps more likely to manifest in the mid to latter stages. Reasons for sundowning can vary, but the charity note the following reasons on their website: 
 
• tiredness, hunger, pain or other unmet physical needs 
• not enough exposure to sunlight during the day 
• overstimulation during the day, such as from a noisy or busy environment 
• disturbance to the person’s ‘body clock’ caused by damage to the brain 
• disturbed levels of hormones that vary over the course of the day 
• sensory impairment, such as hearing or sight loss 
• tiredness in other people causing the person with dementia to become upset 
• mood disorders, such as anxiety or depression 
• fewer carers around to look after the person (in a care home) 
• side effects of prescribed drugs. 
 
As you can see the reasons a person may experience sundowning can be very varied, and although the term sundowning suggests these changes happen in line with the setting of the sun / ending of the day these changes can happen at any time, although more cases do occur during the afternoon compared with the morning. 
 
What happens when a person experiences sundowning? 
 
When folks experience sundowning their behaviour changes, for some people this can lead into moments of high anxiety, confusion, agitation, delusions, or hallucinations. This not only is distressing for the person, but this can have a huge impact on the primary carer who then experiences their loved one in this dreadful state, making it both physically and mentally very draining. 
 
During my time in care homes, I have seen many examples of residents who are sundowning; sometimes this can go on into the night which further complicates the persons night routine, making them tired and potentially more agitated the next day. 
Equally, sometimes the behaviours can pass after a shorter period and although the latter is of course preferable, it still does not make it easy for the person, or their carer, to go through. 
 
At the extreme end, some people who experience sundowning can become violent through their confusion, and this can present a very big problem to the persons family. To start, this behaviour may be too risky for the family and they may seek a care home placement, however care homes are not always inclined to accept a person who is expressing violent behaviour due to the safety of the other residents. 
 
If you are in a position where a loved one is becoming aggressive during periods of sundowning, it would be advisable to request an urgent referral to the Older Persons Mental Health team who can be accessed through your GP. 
 
Ways of reducing sundowning 
 
Reducing sundowning is unfortunately not an easy fix; with so many different variables that can cause a person to experience sundowning, it takes some very close attention to detail to try and understand why. However, if you can determine the reason then measures can potentially be put in place to reduce the risk or perhaps the severity. Below, there are a few things that you can consider: 
 
• If the person is tired, is there a new night routine that could be introduced, included the use of a weighted blanket to help the person to sleep. Use of a therapeutic lap blanket may also help during periods of sundowning. 
 
• Medication – is the persons pain relief being affectively managed? Do they, or their carer, need support with this? 
 
• Overstimulated - this is an interesting one, I am a big believer that we should work hard to ensure folk with dementia are stimulated, but there is a delicate balance and sometimes too much stimulus can simply overbear a person living with dementia. Reducing stimulus in the afternoons could therefore potentially help the person. 
 
• A bad experience that day – in all my dementia training one thing remains constant, that is that ‘the feeling lasts longer than the memory.’ This means a person with dementia can still have a bad day, or be sad, they may just not know why. Trying to reduce these experiences and keeping the person in a positive mindset could therefore be an effective way of reducing the risk of sundowning. 
 
• Sensory impairment – getting regular hearing and vision check-ups are important and may reduce the risk of sundowning. Hearing loss can also be linked to memory loss, so using appropriate hearing devices are also an important element of dementia care. 
 
Conclusion 
 
Sundowning can be a very difficult element of the dementia journey and can cause carers to not want to go out due to the fear of dealing with the behavioural changes outside of the house, leading to further isolation of the carer. In the extreme, it can also lead to high anxiety for the carer and a potential challenge when finding a care placement. 
 
If you are concerned about a loved one who is sundowning, its best to approach your GP for a referral to Older Persons Mental Health as well as trying some of the tips highlighted in this post, but ultimately getting advice from professionals and those around you will help. Do not let the stigma get in the way of speaking with someone about sundowning… 
 
Lap Blanket
£115.00

Say farewell to Sundowning!

Hand sewn in Europe, our high quality lap blankets are a fantastically versatile product, they are weighted to provide the calming therapy of the other blankets but can be used 'on the go' during the day as well as at the night time.

These products can be of great help to those living with dementia who are experiencing Sundowning. They can be used to calm the person either in a chair, sofa, bed or wheelchair.

Because the lap blankets mainly cover peoples waist, legs and feet, they can potentially be used by those living with vascular conditions for shorter periods, but we would still recommend speaking with your doctor if you are unsure.

Size:
Weight:
Colour:
Quantity:

This weighted lap blanket is filled with high-quality glass microbeads closed in small pockets, which evenly distributes the weight across the body.

The weight provides a pleasant and nurturing sense of well-being, with the evenly distributed pressure helping you to peacefully calm your mind in moments of anxiety (including Sundowning), to sit quietly and relax on the couch, chair, bed or wheelchair.

Thanks to the pleasant pressure the body calms down more quickly, importantly, their use does not lead to side effects like those associated with pharmacological treatments.

The deep pressure created by the therapeutic weight of our lap blankets relaxes joints, muscles and tendons. This effect is also known as “Deep Pressure Stimulation” because of its gentle but potent and even pressure that is applied to the body. This helps you relax both physically and mentally. In addition, it causes the release of the serotonin hormone, and at the same time lowers the level of cortisol (the stress hormone).

Breathable fabric

The blanket is made of 100% cotton

Weight Layer

The filling contains high-quality fine-grained glass beads in small chambers that give the blanket the necessary weight.

The gentle movement of the beads within the chambers allows the blanket to better conform to the user.

Sustainability

The weighted lap blanket is made exclusively in Europe, the cotton used is certified and comes from sustainable plantations. The tiny glass balls inside the blankets are manufactured in Europe in a perfectly safe environment.

Getting the correct weight is important because it ensures the benefits of the blanket are provided but also comfort and safety as well, particularly in children or older adults.

Which weight is best for me?

It is suggested that users of weighted blankets chose a weight that is 10% of their body weight. For older or more frail people, you can consider reducing the weight by perhaps 1kg or 2kg. For example, if 10% of your body weight = 6kg, you might want to consider a 5kg or 4kg blanket. Please see more info in the table below.

Weight Blanket Weight Reduced Weight for Frailties
30-49kg 4kg 3kg
50-69kg 6gk 4-5kg
70-89kg 8kg 6-7kg
90-109kg 10kg 8-9kg
110+kg 12kg 10-11kg

The recommended weight of the blanket is about 10% of the user’s body weight. However, if you experience discomfort during the initial phase of using the blanket, follow these guidelines to help adjust to the weight:

Days 1-3 - 15 minutes per day
Days 4-10 - 1 hour per day
Days 11-20 - 2 hours per day
Day 21 and beyond - as often as required

The effects of using a weighted blanket depend on the individual characteristics of your body, so the differences may be felt at varying rates. In some cases, the first positive effects may be noticeable within a few days, but this time frame can extend to several weeks.

It is important to note that certain health conditions may prevent older people using weighted blankets. If you have a health condition such as one of those listed below, please consult with your doctor before trialling a weighted lap blanket:

  • Asthma
  • Vascular dementia
  • Osteoporosis (bone fragility)
  • Cardiovascular conditions (e.g., individuals with a pacemaker)
  • Respiratory system disorders
  • Hypertension
  • Obstructive sleep apnea

It is worth noting that unlike traditional weighted blankets that you sleep under, the lap blankets can potentially be used by those with certain respiratory conditions. This is because they cover your lower body and not your chest, however it is always advisable to consult your with your doctor if you are unsure.

All of our weighted blankets and pillows are hand sewn to order before being shipped for delivery to our customers. We aim to fulfil all of our orders within 10 business days.

We will provide you with a tracking number, and will always be available to speak with you should you experience any delays or issues with our service.

If you need to return one of our blankets, please contact us within 14 days of delivery to initiate a full refund. Kindly note we can only refund blankets that are not damaged in any way.

This product is covered by a one-year manufacturers warranty. If the product is faulty please return it to us for either repair or replacement, depending on the issue or defect.

The blanket can be easily washed in the washing machine. We recommend that you wash the blanket at a temperature of 30°C on a low spin cycle.

The blanket should not be tumble dried. After washing, hang up or spread out and leave until dry.

Do not iron the blanket.

Tagged as: Dementia Care, Dementia Care Homes, Weighted Blankets
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