Sundowning: what actually helps at four in the afternoon

Lights on before it starts, not after

Every lamp, by half past three, before the light starts going.

"Sounds too simple to matter and it cut ours by about half." It is the single most repeated piece of advice on this, and it costs nothing to try tonight.

Feed him at three

"Ours crashes at four because he has not eaten since noon. A snack at three changed our evenings."

Not a cure. But hunger and tiredness stack on top of the confusion, and those two you can actually do something about.

Do not argue with where he is going

If he is trying to leave for work he retired from in 2004, telling him he is retired starts the fight. Caregivers describe the same move again and again: give him a reason it is canceled rather than a reason he is wrong.

"Ask what he has got on today. Let him tell you. Then it is raining, or the truck is in the shop, or the office called and said tomorrow."

One person answers to a dead sister’s name all afternoon and has decided that is fine. Another stopped correcting entirely: "When he says my mother is coming to visit, I ask what she is bringing. He said a lemon cake. We had a lovely ten minutes about a cake that will never arrive."

Something for the hands

"Ours was better with a job. Folding towels, matching socks, sorting a tin of buttons."

Not to occupy him. To give the agitation somewhere to go that is not the front door.

Move dinner earlier

"I have no idea if this was right but we moved dinner to four thirty and it helped more than anything else."

That hedge is doing real work. Nobody in these rooms claims to know why things work. They report what happened.

And the clock, if nights are the problem

A dementia clock that shows the words rather than the hands, about thirty dollars, stopped the 2am phone calls for one family entirely. It says IT IS NIGHT TIME.

Two warnings from people who bought one. Put it where she cannot reach it, because the first thing several people did was cover it with a scarf or a towel. And expect her to read it aloud like she is discovering it, every single time.