Memory Loss
Visit sheetPractice a conversationStart assessment

Danger first. If anyone may be hurt, call 911 now.

Call 911Call or text 988

988 is the Suicide & Crisis Lifeline: any hour, by call, text or chat. This page cannot see or answer an emergency.

Daily routine and sundowning

Most restlessness happens for a reason. Check physical and room causes first, shape the day around when they are most alert, and print a one-page daily plan on this phone.

What this page is

1. Check treatable causes before blaming dementia

The National Institute on Aging notes that agitation and restlessness usually happen for a reason. Look for these first, and tell the doctor what you find. Source: NIA

  1. Pain, constipation, or illness. Untreated pain or constipation can make a person restless or upset when they cannot explain what hurts. Ask a doctor to check for physical problems. Source: NIA
  2. Too little rest or sleep, or late-day exhaustion. Mental and physical exhaustion from a full day makes late-afternoon and early-evening confusion worse. Source: NIA Source: Alzheimer's Association
  3. Too much noise or too many people in the room. Loud television, chores, or a busy room can overwhelm someone living with dementia. Source: NIA Source: Alzheimer's Association
  4. Low lighting and evening shadows. Dim light increases shadows, which can cause confusion about what the person sees or trigger hallucinations. Keep the home well lit in the evening. Source: Alzheimer's Association
  5. Being pushed to do something that has become too hard. Pushing someone to bathe, dress, or recall events or people when dementia makes the task hard often brings on distress. Source: NIA
  6. Certain medicines or interactions between two medicines. Ask the doctor or pharmacist to review every medicine, especially if restlessness started after a new prescription or change. Source: NIA

2. Shape the day to calm late-afternoon upset (sundowning)

When confusion, anxiety, pacing, or restlessness start or get worse from dusk through night, it is called sundowning. A steady daytime rhythm helps. Source: NIA Source: Alzheimer's Association

  1. Keep waking, meals, bathing, and bedtime at regular times each day. A predictable routine leaves less time trying to figure out what comes next. Source: NIA Source: Alzheimer's Association
  2. Schedule doctor appointments, trips, and bathing in the morning or early afternoon when the person living with dementia is most alert. Source: Alzheimer's Association
  3. Get outdoor sunlight and gentle physical activity each day. Go outside or sit by a window in the daylight, and balance activity with rest so they do not get overtired. Source: NIA Source: Alzheimer's Association
  4. Offer a larger meal at lunch and keep the evening meal lighter. Source: Alzheimer's Association
  5. Avoid caffeine (such as coffee or cola) and alcohol late in the day, and discourage long late-afternoon naps. Source: NIA
  6. Slow down, count to 10, and reassure them that they are safe. Noticing stress or frustration in those around them can make a person living with dementia more stressed too. Source: NIA Source: Alzheimer's Association

3. Build a one-page daily routine for your refrigerator

Answer three questions about your real day first. The sheet below updates right on this page so you can print it for family helpers. Nothing is saved or sent.

Daily routine and calm-down plan

Best window for visits and bathing: Pick when they are most alert above to fill this line.

How we handle the hardest hours: Pick the hardest part of the day above to fill this line.

What helps them settle: Pick what helps them settle above to fill this line.

Check first if restless: pain, constipation, too little sleep, a room too loud or dim, or a recent medicine change (NIA; Alzheimer's Association).

Emergency: Call 911 if anyone is in danger or for sudden stroke signs. Call or text 988 in a crisis. Alzheimer's Association 24/7 Helpline: 1-800-272-3900.

Next stops

In a hard moment right now?Short steps for a refused bath, a refused outfit, night waking, the same question, and the end of your rope.Worried about wandering?What to do if they go missing (911 after 15 minutes), how to prepare, and a wallet card to print.Bring this to the doctor visitTurn what you noticed into a one-page sheet so the clinician can check reversible causes and medicines.Alzheimer's Association Helpline: 1-800-272-3900Answers 24 hours a day, every day. Run by the Alzheimer's Association, not by this site.

Sources