Why evenings are harder, and what families do about it

What it looks like

The pattern is strikingly consistent between families. It begins as the light changes, it peaks in the hour or two after dark, and it passes. Common versions are pacing, wanting to leave, asking the same question every few minutes, sudden suspicion about somebody in the house, or an urgent need to be somewhere for a reason that made sense forty years ago.

It is not defiance and it is not aimed at you, although at seven in the evening on a bad day it can feel like both.

What tends to help

None of this is a cure and none of it works every day. Families report that the same small levers help more often than not, and that the largest of them is making the late afternoon dull on purpose.

• Turn the lights on before dusk, not after. The change in the light is often the trigger.
• Move the demanding parts of the day earlier: the bath, the visitors, the outing.
• Keep the evening meal at the same hour, whatever else moves.
• Cut the news and anything loud after four. A quiet room is doing real work.
• Watch caffeine and long afternoon naps, both of which push the trouble later.
• Give them something for their hands. Folding, sorting, shelling peas, anything with no wrong answer.

What to say when they want to go home

Arguing with the geography does not work, because the home they mean is usually not a place you can drive to. It is often a house from childhood, or simply the feeling of being where they belong.

Families get further by answering the feeling. Agree that it is late, that the road is bad, that you will go in the morning, and then offer tea and the next small thing. It feels like lying and it is closer to kindness. The alternative, explaining again that this is their home, restarts the distress from the beginning.

Plan for your own evening too

These hours are also when the person doing the caring is most tired and least supported, which is why this part of the day is the part that ends careers and marriages. If there is any help to be had at all, put it here rather than in the middle of the morning.

If you are the one abroad, this is the hour when a call is worth the most, and the hour when it is hardest to be awake for it.

When to ring the doctor

A sudden change over a day or two is different from a slow pattern over months. Families are usually told to mention the ordinary things first: pain, constipation, a urinary infection, poor sleep, a new medicine or a changed dose. All of those are for a doctor and none of them are for a website.

If your parent is at risk of walking out of the house, or becomes frightened in a way that does not settle, that is a conversation to have with their doctor this week rather than next.

Where else to look

These are other people’s pages, not ours. Our own published work and the neurologist who reviews it are on the research page.

• Cultural adaptation of Alzheimer’s disease assessment scale-cognitive subscale for use in India and validation of the Tamil version for South Indian population.
  The cultural adaptation of the same questionnaire for use in India.
• Hindi Version of Addenbrooke’s Cognitive Examination III: Distinguishing Cognitive Impairment Among Older Indians at the Lower Cut-Offs.
  A Hindi memory questionnaire validated for older adults in India.
• Alzheimer’s and Dementia Support, India
  The Alzheimer’s Association’s own pages for families in India.