Health & Wellbeing > Sundowning


Published: September 26, 2009

Have you ever wondered what makes the elderly become more confused in the evening than any other time? It is a symptom related to Alzheimer's called sundowning. I work at a nursing home, and I see this type of behaviour every day. Around 5:00pm the elderly take on another personality.

One of the elderly ladies I take care of forgets that she has eaten her meals, and that her parents are deceased. She also thinks her husband can just come over and get her when he's housed on the other side of the building. Once when she asked him, "Where's my father?" He told her that her father was dead, but she didn't believe it, so he told her that he was her father.

I've taken pictures of her eating to show her, she gets up and storms out of the eating room, runs to her bedroom, slams the door, then when she cools off she comes back and tells me that we are starving her.

Another of my patients was a doctor (Internal Medicine). He gets upset and won't let me or any of the other nurse aides change him. I guess this is because he thinks he can still do it himself. In order for me to gain his confidence I must talk doctor stuff with him. I tell him that he has a doctors meeting to get ready for, and they won't do anything until he shows up. Or I tell him he has to perform surgery - this usually works. I go out of my way to bring him some made-up doctor/patients files to sign.

Another resident is an elderly blind man who thinks that he can just get up and use the bathroom wherever he's at, such as in the dining room or the hallway. He does not remember where the bathroom is. When we try to re-direct him he tells us, "I'm in the bathroom, leave me alone."

An expert speaks about this type of confusion with Alzheimer's at

"The term sundowning refers to a person who becomes confused at the end of the day and into the night. Sundowning isn't a disease, but a symptom that occurs in people with dementia, such as Alzheimer's disease. The cause isn't known, but factors that may aggravate late day confusion includes:

  1. Fatigue
  2. Low lightning
  3. Increased shadows

Some tips for reducing this type of disorientation in your love one with dementia:

  1. Encourage a mild afternoon nap or quite time.
  2. Keep a night light on to reduce agitation that occurs when surroundings are dark and unfamiliar.
  3. In a strange setting such as a hospital, bring familiar items such as a photograph or a radio from home.

When sundowning occurs in a care facility it may be related to the flurry of activity during the staff changes. Staff arriving and leaving may cue some people with Alzheimer's to want to go home, or check on their children..." or pets.

Trying to convince a sundowning elderly person can be very hard at times.

We all have to remember to be patient with them because one day, if we live long enough, we also will be filling these same shoes.

Any Comments?


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