You made it through the day. Meals were handled, the house is quiet, and you’re hoping for a few peaceful moments. But then, out of nowhere, things start to shift. Your loved one with dementia becomes uneasy. They’re pacing, questioning, maybe even lashing out. You try to stay calm, offer comfort, repeat answers—but nothing seems to land.
This common late-day disruption has a name: sundowning. And while it often feels like it comes out of nowhere, there could be a hidden trigger for sundowning you haven’t considered—medication side effects in dementia.
Sundowning: Why It Happens in the First Place
Sundowning refers to a pattern of restlessness, confusion, or agitation that tends to spike in the late afternoon or evening. It’s one of the more difficult aspects of dementia care. The person you love may start the day relatively stable but become increasingly disoriented and upset as night approaches.
Many factors can play a role—like fading light, tiredness, or too much activity. But medication side effects in dementia are actually quite common, quietly intensifying symptoms without obvious warning.
Medications That May Be Playing a Role
Some prescriptions—especially those commonly used by older adults—can heighten confusion or anxiety. These include:
- Anticholinergics – Found in sleep aids and bladder control meds, they can impact memory and cognition.
- Benzodiazepines – Medications like Ativan or Xanax, meant to calm, may have the opposite effect in dementia patients.
- Certain antidepressants and antipsychotics – These may trigger agitation or worsening disorientation.
- Over-the-counter sleep remedies – Even these can carry cognitive side effects, especially in the evening hours.
While these drugs aren’t wrong or unsafe across the board, in people with dementia, side effects can be amplified.
What Should You Do to Counteract Medication Side Effects in Dementia?
If sundowning has started to get worse—or began after a new medication—it’s time to ask questions. Take a full list of medications (including OTC and supplements) to your loved one’s next medical appointment and ask whether adjustments could help.
Even small changes—like moving a dose to earlier in the day—can make a significant difference. And in some cases, there are safer alternatives worth exploring.
The Broader Picture
Of course, medication is only part of the story. Sundowning may also be made worse by hunger, dehydration, lack of routine, or simple exhaustion. And as a caregiver, you’re often running on empty by that time of day, too.
That’s why bringing in help can be such a game-changer.
Home Care Can Change the Way Your Evenings Feel
At Home Health Companions, we’ve supported countless families across Westlake, Lakewood, and Southlake, and the surrounding areas who are struggling with sundowning behaviors. Our dementia care professionals are trained to handle these situations with calm, empathy, and confidence.
We can help structure the day to reduce triggers, monitor the effects of medications, and keep things peaceful when the sun starts to go down. We even offer overnight care—so you don’t have to go it alone.
Ready to find out how home care could restore peace to your evenings? Call 214-295-8213 to schedule a no-cost consultation in your home.