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What is Sundowners Syndrome?

Michael Pollick
Updated Mar 03, 2024
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Sundowners syndrome, also known as sundowning, is a type of mood or sleep disorder often associated with the early stages of dementia and Alzheimer's. Patients experience periods of extreme agitation and confusion during the late afternoon or early evening hours, often leading to irritability towards caregivers or hospital staff. While the causes of sundowners are unknown, patients and caregivers can take some useful steps to help reduce the symptoms of the condition.


The exact cause of sundowners syndrome remains a mystery. While the episodes are most commonly found in dementia patients, the symptoms can also appear in those suffering from other conditions, such as degenerating eye conditions. Some medical experts believe the condition may occur because of changes in lighting conditions or sleep disturbances; that the episodes tend to come on around sundown may suggest a link with the body's natural day and night cycles. Some research also raises the possibility of more organic causes such as drug interactions or stress associated with diminishing cognitive function.


The symptoms of this condition may vary from patient to patient. Some people may become extremely restless and refuse to sit or lie down. Disorientation, language problems, and even hallucinating occurs in some patients. Sundowning patients may experience increased fear or anxiety, feel jumpy or unreasonably afraid. In some cases, anger and panic causes patients to verbally or even physically abuse caregivers or visitors.


Some episodes of sundowning are triggered by a specific event or issue. Some patients start growing agitated if they are hungry, for instance, while others may experience distress as the sun goes down, as the changing light creates shadows and makes the environment look different. In nursing homes, a staff change or disruption in the daily routine might also trigger this condition. Identifying triggers and helping patients manage them is a common form of treatment for the condition.


Treatment for sundowners syndrome is generally limited to managing the underlying condition which triggers it, such as Alzheimer's disease. Anti-depressants may lessen the severity of the confusion, while other drugs may improve cognitive function. Melatonin, a hormone that increases sleepiness, is sometimes prescribed to reduce agitation in the evenings. Since sundowners syndrome is also closely associated with sleep disorders and fatigue, sedatives and other sleeping aids may also help. Some caregivers suggest encouraging the patient to take several naps throughout the day and limiting stimulating activities to the morning hours.

Making positive environmental and lifestyle changes is another method of reducing episodes. Limiting caffeine after the morning may prevent feelings of agitation or jitters in the late afternoon. Engaging in outdoor activities in the morning and early afternoon can sometimes help patients feel more tired and less agitated in the evenings. Ensuring a consistent daily routine often helps patients feel more safe and secure in their environment, and may reduce instances of panic or distress associated with sundowning. Providing a snack in the afternoon may also help reduce hunger-related triggers in the evening.

Light is often a big part of treatment for this syndrome. Patients in hospitals and care facilities may not be exposed to very much sunlight during the day, which could upset the body's natural day and night rhythms and lead to sundowning. In addition to making sure that patients get some sunlight during the day, providing extra light in the evening can also help. Since the symptoms can be triggered by the changing light levels at twilight, ensuring that interior lights are turned on or increased before dusk may prevent the shifting light from triggering an episode.

Related Conditions

There are other conditions which closely resemble sundowners syndrome, especially in unfamiliar hospital settings. Some elderly patients may become confused or irritable as a result of the anesthetics used during their surgeries. Others who spend time in the ICU or are connected to noisy medical equipment may experience a condition called hospital psychosis, which may also be especially noticeable during evening hours. One of the major differences between hospital psychosis and sundowning is that psychosis can affect any age group, while sundowners syndrome is generally limited to the elderly population.

The Health Board is dedicated to providing accurate and trustworthy information. We carefully select reputable sources and employ a rigorous fact-checking process to maintain the highest standards. To learn more about our commitment to accuracy, read our editorial process.
Michael Pollick
By Michael Pollick , Writer
As a frequent contributor to The Health Board, Michael Pollick uses his passion for research and writing to cover a wide range of topics. His curiosity drives him to study subjects in-depth, resulting in informative and engaging articles. Prior to becoming a professional writer, Michael honed his skills as an English tutor, poet, voice-over artist, and DJ.

Discussion Comments

By anon354856 — On Nov 11, 2013

My sister is 58. She was born mentally handicapped. Over the past six months, I have watched her change from a sweet child to someone I don't know. She has the mind of a five year old, so the doctors say. Her neurologist says she has Sundowners. She hears people talking to her at all times of the day and night. When she goes to bed, it takes her a couple of hours to get to sleep.

She also has violent episodes. She is on several medications. Also, she stays cold where she used to be hot all the time and her hands shake a lot. Does anyone else know anything about what I need to do to help her?

By anon349732 — On Sep 28, 2013

My husband is about to turn 67. Almost two years ago, he was hospitalized and nearly died from staph pneumonia in his lungs. He was a chronic smoker as well as an alcoholic. Since his recovery he has stopped smoking and drinking. He did it all cold turkey while unconscious in the ICU. He has retired, but now is having severe anger issues with me in the evenings. He is on many medications for blood pressure and type 2 diabetes. He refuses to check his sugar levels. He is sleeping almost 10 hours each night, easily tires and also tires easily from heat. He tries to eat every four to five hours, but this is still not helping to control the anger and memory loss of the rage incidents.

I am at my wits’ end. Help, please. I think he needs to be seen by a neurologist. How do I get that to happen? He is a very smart man, and behaves rationally during the day but the night rages and waking in the morning with no memory of them has me ready to leave.

By anon306809 — On Dec 01, 2012

My father has dementia as well as my mother, she suffered from vascular dementia and has since passed on two years ago.

My sister and I took care of my mother in my parents' home at the time. We both had full time jobs in the nursing field.

My sister left her home to stay and help keep mom at home instead of her being put into a nursing home. I have always lived in my parents' home.

We worked every other weekend, so that schedule worked out great for us because she was off while I had to work and visa versa.

My mother had the services of hospice so, while I worked 7-3 and my sister worked the 3-11 shift, there was an aide who came to my house from 2-4 so that my sister could leave for work and I got home from work.

After nine months, my sister was burned out and could not deal with the stress and I was not that far behind her. There was no other option other than to have my mother put into a nursing home because I could not work and be up around the clock. We could not afford to pay a caregiver to come in while I was at work, as their pay was more than what my hourly wage was. I could not quit my 30 year job. Also at times, it was very hard for my sister and I to find someone to sit with my parents to have time to go shopping or to just have time to yourself.

Then there is my father. Sometimes he has confusion in the late morning, it's usually real bad around 4:30 in the evening. I know what signs to look for, as he will take his wallet out several times to find a card that has his own phone number on it along with his son's, my brother. He gets this card out and asks me to give his daughter, "myself" a call so that she, "myself, can come and take him "up to the house." Where we are! Not a good thing. You can't reason with dementia.

I have to call my brother so that he can tell dad the same thing that I was telling him, "You're home dad". Something else I do is, take dad on short rides in the car and as I pull up in to the driveway I say, "We're back home, safe and sound."

Other times when all else fails, we go outside the house so that he could see the front of the house. This seems to help some days. But, it is getting worse day by day. He has also wandered away at night while I was sleeping. I now have a door alarm that I set every night before I go to sleep.

My father does quirky things like putting a plastic coffee butler on the stove and turns on the burner to heat the coffee in it. He also did this with a coffee mug filled with water. He sometimes confuses the stove as the sink and dumps liquids down the burners; he thinks that turning on the flame and holding his plastic comb over it is water to comb his hair.

I have been out of work for a year due to a bad back injury, so my health is not good, as I am always in a lot of pain.

I am at this point trying to set up adult day care for my dad. I think that this would be a good thing for him as well as for me.

Dealing with dementia of any kind is not easy. It is a very heartbreaking thing for the person who has it and, for the one who is the caregiver.

By anon300371 — On Oct 29, 2012

For the caregivers, if your loved ones can still take care of bodily functions (pulling up and down briefs,and other stuff) check out adult day care programs. The hours are usually 7 a.m.-5 p.m.

Also, local transit can be arranged. Check with county Senior Citizens or Council on Aging organizations. Also, nutrition programs are available for those age 60 or older. It is a federal program where they come to a central location for a meal. And do not forget Meals on Wheels. Some of these programs provide respite for the caregiver, even for a few hours.

As time progresses, you will need them. In later stages of the diseases, you will not be able to use them because they will get more dependent. I am also going through the process. Hope this helps.

By anon294672 — On Oct 02, 2012

They believe my father-in-law has sundowners. He is having these episodes only at night time. It doesn't happen every night, maybe a month apart and now it has been within two weeks apart. He lives alone.

There have been times I have gone over there to take him to the doctor and he will be in his bedroom and he has thrown clothes all over the floor and it is like he doesn't know what he is doing. He has been in that bedroom for hours and I ask him what he is doing and he says he doesn't know, and he has a very blank look on his face.

As the day goes on he seems to become more alert. Now, after a year and a half of having these spells, the doctors say it could be sundowners. Se just don't know what to do. Any suggestions?

By amypollick — On Sep 20, 2012

@anon292506: It doesn't sound like Sundowners to me. It sounds like hospital psychosis, in my opinion. Sundowners is mostly associated with Alzheimer's Disease.

Or, this may be a result of your father hitting his head, or he could have another UTI, and I know from experience with my mom that a UTI will cause confusion, acting out, you name it, in an older person.

Hospital psychosis can set in when an elderly person, especially, is in the hospital or rehab for a period of time, and becomes confused. There are a lot of causes for it, but getting the person in his or her normal environment usually resolves the issue.

If I were you, I would talk to his doctor ASAP and ask for a head X-ray and a complete blood workup, to check for a UTI, and also for a skull fracture.

When you have elderly parents, as I'm sure you've found out, sometimes you have to be a noisy advocate for their health. Good luck.

By anon292506 — On Sep 20, 2012

My father had brain surgery six months ago. He has been through three rehab facilities and was at home for a few months and making good progress.

He continued to suffer repeat urinary tract infections, along with C-Dif and MERSA. He had to be re-hospitalized and is now in rehab again. He is beginning to show signs of hostility, anger, fear, confusion and does not sleep at night. He can only be calmed by family. He yells and anything he speaks about does not make sense.

This is all happening since he was left alone in the rehab bathroom and fell last week and hit his head. Do you think this is sundowners?

By anon282063 — On Jul 27, 2012

I have m.s. and suffer from these symptoms. I am 46 and do not know what is wrong. I panic and have anxiety about stupid stuff, but at the time it is very serious. I can no longer drive because at night I panic and want to get out of a moving car. Tell me is this what I have. Am I losing my mind?

By anon275696 — On Jun 19, 2012

I came to visit mother and daddy in Oklahoma from Alabama in November, only to find out that she was starting to get very sick. She is 88 and my dad is 91. Several months later, I am still here. Mother has sundowners, diabetes, CHF and blood clots. Daddy has COPD, heart problems and messed up nerves from World War II. He is very controlling, argumentative and demanding, (always has been) and now that mom is so sick, he is even worse. I am the only one to take care of them since my husband is in Alabama, keeping our business going (he is a trucker). So he can’t come here and I can’t go home. If I leave, they will have to go to a nursing home. They have had such a sad life. My two younger sisters have died over the years and now this!

I do know that God is good and he will help us through this! I believe that there are angels out there that God has sent to do a job that only a very few people will even attempt. God has reasons for this, and maybe we won’t see it until we get to heaven, but I believe that when my parents go there, they will be at peace, will see my sisters and their own parents and our heavenly father.

Yes, it is too hard for me sometimes. One minute mother is sweet, and the next she is accusing me of sleeping with a man under the bed, and tells daddy she wishes she never had married him (they’ve been married 65 years). It is breaking his heart. Because of the way I was brought up, I won’t give up on keeping them together. If I can’t, I will live with leaving them in a nursing home. God help me when that time comes!

By anon261173 — On Apr 14, 2012

My sister is 71 years old and is in her 20th year of parkinsons. She is now becoming very disabled, is showing signs of dementia and very recently entered a nursing home. She has begun calling me every evening to come see her, because she says she is dying and doesn't want to die alone or the staff is trying to harm her in some way. Finally, someone told me of sundowning. I'm sure this is her problem.

By anon246298 — On Feb 08, 2012

My father, now 92, experienced sundowners when he was in the ICU. At that time, I was unaware of this syndrome, so I was extremely alarmed when he told me that the nurses were trying to kill him. Fortunately, my daughter is a nurse, and was able to explain my dad's behavior.

Once he returned home, he went back to normal. In fact, his cognitive functions have been better than ever. He was recently hospitalized with an infection that requires him to spend time in a facility for physical rehab. He was being given Oxycondin CR, a narcotic for pain relief, twice daily. This was keeping him quite dopey, so this was changed to Oxycondin IR, which is a shorter acting pain reliever. Now, the effects of the Oxy end at around 16:30. At 18:30 we noticed that he was starting to see and hear things that were not there. This got progressively worse, ending with me and my mother being accused of planning his painful finish.

We have found that there is very little that can be done when he gets like this, other than to be as kind and calm as possible. If we engage in whatever mania he happens to be focusing on, we find that this actually makes it worse. We also find it best not to tell him about his behaviors, until after he returns to normal (upon return to his home). If we confront him with his accusations the following morning in the hospital, we find that this really upsets him, and actually sets the stage for a more aggravated episode in the evening. The bottom line is that the best thing you can do is to stay calm, and very objective throughout the entire episode. We sometimes even get a good laugh from the stuff that my dad comes up with.

Hope this helps those of you with elderly parents in the same situation.

By anon243009 — On Jan 25, 2012

Although it is so disheartening to read all your posts, you have provided a valuable education to me. My 86 1/2 year old mother has lived with us for three years now and in that time, I have seen a great change. I am now surmising that it may well be sundowners. She suffers from COPD, has had three heart attacks, has just been diagnosed with breast cancer for which she had a mastectomy, then broke her foot two weeks after the surgery. The part that hit home for me was you all mentioning the strange delusions these folks have. My mother has asked who was banging downstairs, saying she smelled vinegar, the neighbours have another new car, nobody is home next door so they've gone on vacation, yes, you can buy 12 tea biscuits instead of one, she heard a cat crying this morning and it woke her up, etc., but the worst one was one summer night when she told us that she smelled marijuana and if she discovered who of us it was she was reporting it to the police. I had to call a family meeting with my husband, two daughters and myself and my mother, after which she apologized for her accusations.

Whenever something of hers goes missing, which it invariably does every other day or so, then the baby (my granddaughter) took it; if she makes a stain on the carpet it must have been one of the pets. She will have you turn the house upside down to find something which she has forgotten that she herself put away and doesn't recall doing it. She completely ruined a brand new set of my expensive bath towels thinking they were "rags.” She is always judging, commenting, criticizing and accusing and yes, it gets worse at night.

If no one brings the baby up to see her, she sits in bed with arms crossed and her mouth set. Because she "helps" all of us then she expects royal treatment. If you suggest that she has done something wrong she denies it and has ruined many a confidence. It's never her fault.

I am very concerned but she had an MRI last year which showed nothing. It's very hard for me to be kind as she was very abusive to me during my growing-up years and it is a losing battle to try and fight someone who is so clever at manipulating and lying and blaming.

I pray for all of us on this site and hope that God will somehow send us help in whatever form. For now, I just carry on every day the best I can, knowing and believing I'm doing the right thing.

By anon238246 — On Jan 02, 2012

I got this in the winter months at about 5-6:30pm as a teenager. Now it started up again. I don't get it every night in the winter, just once in a while. Obviously this can't mean alzheimers since I experienced it as a teen?

By anon237919 — On Jan 01, 2012

My Mum has dementia/Alzheimer's. After she refused to eat and drink for weeks, we had her hospitalized and eventually an ACAT assessment recommended she go into 'home' with high level nursing care. A week and a half after Mum was hospitalized, Dad had a massive heart attack and died.

We have watched Mom deteriorate rapidly over the last four months. Sundowning is a term I have always used as something that occurs to Mum as the day goes on. She is most lucid in the morning but as the day progresses and the sun goes down, her lucidity flies out the window.

I'm in Australia and have only heard it used in this way with dementia patients. Good luck and my thoughts and prayers are with all families and caregivers who have loved ones suffering from this truly horrendous disease.

By anon228427 — On Nov 08, 2011

I met a psychiatrist at a rehab facility who does not believe in sundowners. He believes it is anxiety that the elderly are experiencing and it tends to get exacerbated as the sun goes down. I think this makes a lot of sense because when I am experiencing anxiety, the most difficult time of the day for me is when the sun goes down. I think some of these nursing homes are so horrible and anxiety producing in and of themselves.

I recommend that if someone with you is experiencing these signs, pull the shades down, speak softly to them and try your best to reassure them. Sometimes meds are necessary, but doctors are too quick to throw drugs at the elderly. These drugs often make things worse. It's shocking how many drugs contraindicated for elderly people are prescribed.

As for the teens on this site who are worried about their forgetfulness, stress can cause a lot of mental strains. If there is someone you trust that you can talk to, go ahead. See a doctor if the problem continues.

By anon228282 — On Nov 07, 2011

I don't know if this is even humanly possible, but I'm 14 years old and for some reason, snapped into this phase where it seems like I'm forgetting what my emotion was earlier and it feels like I know I did something earlier, like take a shower, but it doesn't feel like I was there.

I've never done drugs and it's gotten worse lately. I never get angry midday or at night, but that does seem to be around the time that the confusion sets in and I really need some help.

Is there any advice out there for me because I seem to be unrealistically young for this but I seem to hit most of the symptoms. Please help.

By anon211874 — On Sep 04, 2011

My name is joy and I am the sole caregiver of my sweet mom. I am also on 24 hours with no sleep!

My mom suffers from some dementia that is always worsened by a chronic uti! I have a prescription for antibiotics at all times and when the signs start to show, put them on the antibiotic!

Of course, discuss this with your doctor, and if they do not agree, get another one. It works! God bless all! It is so hard but the rewards are endless!

By anon206395 — On Aug 16, 2011

I want to echo, from experience, what anon113057 wrote. Getting extremely agitated people who are not on an IV to take medication is a real challenge. But the rehab center where our relative lives chops the meds up and puts it into ice cream. Very few turn that down. Whatever works.

By anon206277 — On Aug 15, 2011

I have these symptoms and I am only 20. How is this possible? I've had these symptoms all my life. Does that mean I have the body of a 20 year old, but the mind of a 70 year old?

By anon178529 — On May 21, 2011

Many thanks to all who posted. I read all and they will help me make it through the day. My husband, 82 years old is confused, talks about the past constantly, interested only in his physical problems, anxious, nervous, verbally abusive around 5 p.m., restless, likes to go for a walk around dusk before dinner, but after eating he is calmer sometimes.

He refuses to take meds the doctors give him, and watches me like a hawk when I am preparing food. I wish I had some answers for you but I am struggling every hour when I am with him because of the unknown. Thank you for all your suggestions.

By anon174067 — On May 09, 2011

I am reading these posts and concerned for many of you who seem to be trying to figure all of this out with very limited information, and help, especially those of you who are caregiving. Please contact your local Area Agency on Aging - you can look them up on the federal government's Administration on Aging website. Then contact your local Alzheimer's Association. They deal with many types of mental disorders, not just Alzheimer's.

any things can cause these episodes: medication interactions or improper doses - the list goes on. There is help out there, and not all doctors are as informed as they should be. Please call these organizations to get assistance and more information. --Mary

By anon169892 — On Apr 23, 2011

I decided to look up "sundowning" as this is what I'm told my father is suffering from. He was diagnosed several years ago with Alzheimer's and was in a clinical trial for a year. During that time he did not decline and my mother was very pleased. Unfortunately, my mother (who had three bouts of breast cancer) began to get very sick. Her cancer had spread to her lower intestines, and she was recently sent home on Hospice. She died in March. Just before that my father, while my mother was home, began to fall constantly. He had to go to the hospital 911 and never came home to see my mother before she died.

He has been in rehab for about a month and is about to come home. I think he knows she died, but it is hard to be sure. He has these episodes of sundowning and the nursing home just can't deal with it. They send him to the emergency room for "behavioral." He comes back the next day and sleeps for two days. I saw this sundowning last week for the first time and we had just seen him have one of his best days ever. He calmed down when we came and finally went to sleep. But yesterday we went to see him and, again, he was pretty lucid. They called us a short time later and said if we didn't come right away they were going to have to send him back to the hospital. We did go back, but could not calm him down. And again, he had to go to the hospital. He is back in rehab but sleeping the drugs off.

This is so difficult, especially after just losing my mother. Thank you all for your stories. It is comforting to know that I am not going through this alone. By the way, he is 88 and not physically well at all.

By anon160166 — On Mar 14, 2011

I am a 51 year old who is bringing a 52 year old home with sundowners who is adamant that he is going to drive. We have already had to have law involved and has now been in a mental hospital for detox. Please give me any advice or help with the verbal abuse that progresses as the sun goes down.

By anon156479 — On Feb 27, 2011

I may be able to help some of you!

I take care of an 85 year old man who suffered a stroke three years ago. He was recovering slowing until July 2010. He started suffering from Sundowning and it would take all his energy. After six months of doctors and medication, nothing helped! He was going downhill fast.

As a last resort, I took him for an acupuncture treatment. After one treatment, his sundown symptoms were gone and he is now stronger than ever. I take him once a week for acupuncture. He is off all his medication and does not have sundowning episodes at all!

I recommend anyone struggling with sundowning to at least try it.

By anon154315 — On Feb 20, 2011

My wife is 70 years old and exhibits some of the symptoms of sundowners. She has chronic UTIs, sleep apnea (but does not use her machine), wakes at night and does puzzles until gets sleepy again, leaves the bedroom light on all night, forgets her morning meds 50 percent of the time and is getting more forgetful in short term memories.

For years (but now getting worse) she has had violent outbursts of rage cursing (which is not like her)threats of violence at me or suicide. During these episodes she is totally irrational and will not tolerate any attempts to conversation with me. (most of the time I have to take her to the psych ward of the VA for five to seven days). If not, I usually I leave her alone without talk or interaction for two or three days and she finally comes back down to "normal". I think several things are going on. Help.

By anon153522 — On Feb 17, 2011

I work in a longterm care hospital and we have a few Dementia patients. some are over 85 years of age and some are 70 -85 and we have noticed the sundowning effect they get around supper time around 5-5:30 p.m. One gentleman snorts and makes animal noises and upsets the other patients in the room.

We have a couple of women volunteers who come in to help out at lunch and supper, and when the one gentleman starts his noises, she yells at him to quit upsetting everyone. I would love to go over and give her a shake, but she doesn't listen to us and keeps yelling at them. i am thinking of reporting her to the hospital. she is only making things worse for this man. Thanks.

By anon153246 — On Feb 16, 2011

I read your stories while my 97 year old grandmother is dying from Sundowners (Acute Dementia) in a hospice. Less than a month ago she went into the hospital for shingles. While in the hospital, she became very uncooperative, ripping out her IV and ripping off her oxygen and trying to get up out of bed to leave and go home. It got to the point where the nurses had to restrain her with straps and big mittens on her hands. She would have horrible nightmares of being chased. The doctors told us her behavior was from being in the hospital. We took her home, hoping that her familiar surroundings would return her to her personality and state of mind.

The sun went down and the agitation started. Up and down, shaking, crying, ripping her clothes and bed sheets. She even managed to relocate her hospital bed that she has at home. My father came home from work to find her shaking uncontrollably and took her back to the hospital. She continued to cry and try and rip out her IV and whatnot. The nurses had to strap her to the bed again to keep her safe. She cried and screamed and didn't understand what was wrong.

Finally, the doctors took an MRI and a doctor told us that her brain was the size of an orange and that she was dying from dementia and that she would live probably another three to four days. My father called a Hospice and made arrangements. They started my grandmother on morphine and she is finally sound asleep. Her body is shutting down by the minute but at least she is no longer suffering.

To all who are reading this article, take your loved one to get an MRI and contact hospice for information who can tell you how much time your loved one has and can guide you with proper information, especially with what to expect. Seeing someone suffer is horrible. There are doctors and nurses who handle these situations and know how to treat a person with severe Sundowners or dementia.

By anon141351 — On Jan 10, 2011

I am betwixt and baffled. My mom of 86 has been slowly going down hill, but now is on a fast track to who knows where.

The doctors have done all kinds of tests and said that she does not have Alzheimer's, but she shows all the symptoms and most of her family died of it.

During the day she is somewhat okay, but in the evening she calls and tells my family that someone is ringing the door bell, banging on the house, whispering under her window about kidnapping her and much more. I have tried to convince her that these things are not happening, i.e., look in the snow for footprints, open the door when the bell rings etc. She always has an excuse for why she cannot catch this person. What makes it worse is that she thinks that it is someone from her past when she was in high school. Logic does not seem to work, and being there does not help because she says they only come when no one is there. "They are smart and have listening devices and can tell if she is alone or not" or "they have things that can turn her lights off or control her television."

I am actually scared that one day I will walk in and find her dead of fright. I know about the sundowners now, thanks to a semi-retired doctor who informed me of this disease.

Has anyone had any luck with Aricept? I am taking her to the doctor today and looking for drug interactions and have her tested for a UTI since she is really susceptible to them. This information has been really helpful and reading all the posts certainly has helped me know that I am not alone in this! Thank you for sharing!

By amypollick — On Nov 17, 2010

@anon127859: Maybe I can give you some hope. There is an article on this site called "What is Hospital Psychosis?" I strongly recommend you read it.

With any condition that affects the blood, especially something like a urinary tract infection, where toxins can build up in the blood, these toxins can also affect the brain. Also, older people are especially prone to suffering from hospital psychosis and many doctors have no idea what it is.

My mother is 82 and tends to get h.p. when she is in the hospital. It was especially bad when she was admitted earlier this year for a severe kidney infection. These will cause confusion in elderly people anyway and that, plus the h.p. made her a complete basket case. She was in rehab for five weeks after and was pretty confused the whole time, until we got her home.

If your mother has had no other symptoms of dementia before now, it's a pretty safe bet she will recover her faculties when she's back home and feeling better. Just being back in their familiar environment can work a change which can seem little short of miraculous. I've seen it first-hand.

Get your mom home and in a couple of days, she will probably be back to her old self. If not, then you may have other issues to deal with, but in my personal experience, getting her home will probably do the trick. Best of luck and God bless you both!

By anon127859 — On Nov 17, 2010

My mom recently went into the hospital for blood disease. She became very confused at times while in the hospital, often thinking that she was at church or at a store. At other times she seemed fine. The doctor has said she is experiencing Sundowners. This is very scary and we don't know what to do. Will Sundowners ever go away? Will it continue to get worse and lead to full on dementia?

By anon127025 — On Nov 14, 2010

Wow, I am a long long way from the top but I wanted to drop in my comments as I am currently involved with my mom in hospital at 87 and on a downhill slide.

Until a month ago she was at home and having these horrific emotional blowouts and now she is having them on a daily basis. The doctor called a little while ago and said to look up 'sundowner syndrome' and here I am.

My mom is one of those people who wouldn't use a foul word period, no matter what. Last night she called my sister, who has power of attorney, a b-word a bleep liar, a thief, and a cheat, for not telling her that she had been in the hospital for a month when she figured she had been there maybe two days. So she was telling a lie, go figure.

It is difficult in the extreme for family members to see their loved ones completely lose it like this, and so hard to not take it personally when in fact they won't even remember.

So it says above that this is only the early stages of dementia. I don't even want to ask what to expect next. Day at a time.

By anon119646 — On Oct 19, 2010

Sundowners does exist in a lot of us -- we just don't know what we want to call it.

I have been told that I am crazy, which I might be, but this is not crazy. I have panic attacks so severe I have tried to jump out of the car. I get this overwhelming feeling and nothing or nobody can help me at this time.

Medications are addictive and I never in my life want to take something that is addictive. Lord please don't let anyone put me in restraints. Walking and being kept busy is the best medication for me.

I look for reasons why I have this disease, like working nights and missing out on daylight. I get worse in the fall, like in October.

By anon117835 — On Oct 11, 2010

I feel bad for your husband. I would never choose my mother over my husband. My mother was a lovely, caring, honest woman who loved her children. When I said "I do", I was committing myself to my husband and our "new life". Your husband must be feeling the choice that you have made.

By amypollick — On Oct 10, 2010

@Kim: You and your mom are in my prayers. Bless you both.

By anon117431 — On Oct 10, 2010

In 2007 my mother had a valve replaced in her heart. 24 hours after surgery she went in to respiratory distress and they had to open her up again, at which time she suffered a stroke. It took quite a while for her to recover, but she slowly got much better and was able to live by herself, with me caring for her during the day.

I moved her to the town where I live so she would be much closer. Two years after getting her here, I was staying with her during the night because she was having trouble with her legs. I woke one morning to find her on the floor in her bedroom. After a month in the hospital, I took her home and moved in with her. She is now hospital bed bound in the living room, and in the evenings she slips in to what must be sundowners. She gets extremely weepy and cries at anything and nothing.

I tell her I'm going to brush her teeth and she covers her eyes with her hands and weeps. She's terrified I'm going to leave her, and 15 minutes later, she tells me I should go home before it gets dark. A lot of the time she doesn't recognize her house, and more than once she has asked me "What's your name?" as if she doesn't recognize me.

She is never violent or condescending, just sad and extremely confused. From 5:00 p.m. until 4:00 a.m., she calls a name, usually not mine, and asks me if I'm cold or if I have enough blankets. And her dreams are frightening. She woke me one night, frantically telling me about the dog on fire in the tree under my truck. That's a quote.

During the day while she's awake, she seems to be okay, except for word salad and mild confusion. It's only when she gets sleepy that she slips into this mode. I've desperately tried to get her doctor out here because she cannot be transported, then have to sit in his office for an hour. So far, no such luck.

I have been reduced to taking certain matters in to my own hands. It's been over six months now, and luckily I've managed to keep her bedsore free. I've contacted a service for help and got a very quick response.

I now have a girl that comes in from 10:00 a.m. and stays until 6:00 p.m. the next day. When mom is comfortable with her, I will be able to go home for at least 24 hours and visit my husband. That's only if she accepts it.

My mother is the most important person in my life. She brought me in to this world, then treated me with nothing but love and respect ever since. I figure the best way to repay her for that is by being the best daughter I can and take care of her for the rest of her life. A very small price to pay for all the love she's shown me my entire life.

But I'm not going to lie to you: it's been the most difficult time of my life, and by far the most heartbreaking. Thanks for for lending an ear. --Kim

By anon113057 — On Sep 22, 2010

Sundowners as I have experienced it through a family member is like an extreme psychotic episode or psychosis. It is like they are on a bad acid trip with extreme paranoia and extreme rage thrown in the mix.

After the episode my family member remembers little if anything of the event. It is a funny name for a very not so funny problem. The best thing you can do is let the episode work itself through or get the person a good dose of a tranquilizer.

No amount of coaxing or reasoning gets through to a person having an irrational episode due to misfiring nerves or brain chemical imbalance you just have to wait for the episode to run it's course.

By anon108446 — On Sep 02, 2010

Reading these posts have helped tremendously. I know know that I am not the only one going through this problem.

My mom is 72 and was diagnosed one year ago, even though we noticed something different about five years ago. She went though a personality change from my dear, sweet, loving mom and wife to my dad to a mean-spirited, accusing, hurtful woman. We could not understand it and took her to a doctor, who diagnosed her with Alzheimer's.

It was heartbreaking. My dad died nine months later from grief (they were married 53 years). Now that I stay with her, I feel my dad suffered much and kept it away from us and endured too much stress (he was diabetic). In my research, I know that there is no cure and no meds can stop this ugly disease.

I am accepting my role as caretaker, and simply walking her home, in a comfortable fashion. Whatever works to keep her calm, I do it. When the time comes, I must be able to let go, no matter how hard it is. I don't talk much, I do let her go on and on and on and agree to everything or try to think myself if it is grossly wrong and then tell her I don't remember myself.

I'm learning enough from her childhood to write a book. I don't write it down. I've heard it 1,500 times and counting. My prayers are with each and every one of you angels caring for a loved one in this condition.

By amypollick — On Aug 30, 2010

@Phil: Is there a compounding pharmacy in your area? If there is, they can often compound medications into other forms that might be easier for your mom to take, like in a sweet-tasting syrup suspension, or even in a lollipop. Good luck. You and your mom are in my prayers.

By anon107338 — On Aug 29, 2010

my mom is 86 and has been diagnosed with the "disease" (Alzheimer's) for 14 years and she now recently starting severe signs of sundowning.

I hadn't heard of it until recently. I told her doctor that it was becoming very difficult getting her to take her night meds and this is when he told me she was experiencing sundowning and suggested giving her medicine before six. Morning meds are no problem. I'm having to crush medicine that's not to be crushed and I know that lessens the effectiveness of the medication and I read it will increase the side effects as well. Are there any suggestions about the night meds?

thanks. --Phil

By anon95615 — On Jul 13, 2010

my husband has picks disease or ftd. he is 62 and was diagnosed four years ago, he does not speak now, which is very lonely for me. i was talking to a carer in his day center about him getting very restless about six in the evening and she said it was one of the symptoms of dementia called sundowners. Up until now i had never heard of this. thanks for your time. --chris

By anon92892 — On Jun 30, 2010

My father just celebrated his 86th birthday. He has been one of the most smartest people I have ever known. We started to see changes around six years ago. Just small changes in the beginning. Last year he was officially diagnosed with Alzheimer's. Sometimes he cannot remember where we live.

He lives alone and has a woman that comes in on Monday, Wed, and Fri. She cooks, cleans and does his laundry. The other days it is up to me to try to feed and entertain him.

He has mood swings that are extreme, he does not want to bathe or change his clothes and becomes very abusive when I try to encourage him to bathe.

He had a caregiver get him to sign checks and took well over $5,000 in two months time. (She is being prosecuted) I now co-sign most of his checks.

Be careful when hiring a caregiver. Dad does not realize he is 86 and had entertained thoughts of marrying this one. She told that she had given him a "new lease on life".

He has come onto his new caregiver but she was forewarned and was prepared.

He has been on Aricept for over a year and a nurse has suggested that we try him on low dose

Haldol, .5 mg. every morning. She vows that it has helped so many of their patients. Have any of you ever used this combination? I am leery of anything and hopeful of all.

By anon81815 — On May 03, 2010

Alzheimer's Disease is a devastating illness which robs families of their loved ones. By losing the relationship with their loved ones and the individual losing sense of self.

One of the hardest decisions is knowing when to get help or place your loved ones in a facility. When the level of care had progressed beyond your ability, it is time -- especially if you are by yourself.

I know the feelings of guilt fill our minds and our hearts because we promised we would never place them. People, please realize no one can care for your families better than you. Caregivers die at an alarming rate due to ignoring their illnesses and stress. If you can't take care of yourself, how can you take care of others?

I encourage you to have someone not involved evaluate the situation to be more objective. When we are involved or it is our families we tend not to see the big picture. Yes, I do have someone who I dearly love who is age 90 and living with alzheimer's.

By anon80548 — On Apr 27, 2010

My mother is 95 and lives in an independent facility. We have moved her four times in the building because of her complaints regarding her neighbors making noise and stealing from her.

It is terrible. She calls the police and security all night long. I have a lovely aide who stays with her all night and someone who visits in the day as I work. She is become very abusive to everyone involved in her life and has been prescribed Seroquel, but mostly refuses to take it.

I am at my wits' end. Her behavior is isolating her from all the other residents and management. She is very astute when not having her episodes, so the doctors cannot prescribe other medications as she refuses to take them and fights with anyone who doesn't believe her tales.

It's just terrible.

By anon79677 — On Apr 23, 2010

Thanks to everyone of you who posted a story on

this website.

I have an 87 year old mother in an assisted living facility. She has dementia and now is showing signs of Sundowners Disease. Wow! I cannot believe how awful this disease is.

Sometimes I visit my Mother and she is fine, happy and joking with me. Other times I go and she does not even know me.

I appreciate the advice you have given me. I definitely will e-mail the director of the facility and tell the some of the nice suggestions you have made that may be helpful to my Mother.

Today she was nasty to the nurses and director. She told them she had a gun and would shoot anyone who tried to make her do anything. They politely advised her that no guns were allowed on the premises.

She told them the cops had told her she had the right to keep a gun in her house to protect her from robbers. Again they told her that no guns were allowed on the premises.

So with the recommendations: a simple nap or two a day in the afternoon, keeping a small night light on in her room by her bed, having her do calming repetitive tasks during the morning, perhaps take a small dosage of a sleeping aid to help her sleep and calm her nerves, and to not disagree or argue with her will help.

God bless all of you dealing with the disease.

By anon70958 — On Mar 16, 2010

my roommate's boyfriend is freaking out. he spilled some gas on himself and since then he's been weird.

he thinks someone broke into his house and spilt gas all over the rug so he had to have the rug replaced and he says he smells gas all the time. he's been to the hospital several times and they can't find anything wrong.

he's called the police so much that they turned him over to protective services. now she is going to be his caregiver at night. he's 81 years old and he really believes all of this.

he's up most of the night either taking showers or being outside looking for someone who's not there. no one is really trying to kill him.

what to do?

By anon70808 — On Mar 16, 2010

My mom noticed something was not right with my dad a few months earlier. I have recently been told that my dad, age 76, has sundowning.

He hallucinates and to him they are real. He also had a stroke about a month ago and he underwent surgery to have a stent put in, but he still is not out of the woods. He has to stay in hospital because he cannot walk yet. The stroke left him with right side not working properly.

He has good days but he also has has very bad days in which he becomes very mean to everyone including my mom and my sister. He will push them away.

I know this is draining on my two sisters and my mom. I live eight hours away so I try to get to them when I can. Any suggestions will be of great help. -- JM

By anon70255 — On Mar 12, 2010

I take care of an elderly couple in my home. He is 90 and pretty much has all his faculties. She is 89 with dementia. Her main problem is not being able to discern between day and night.

She sits in her chair asking if it is time to go to bed yet, often for several hours before it is time. She just can't wait to go to bed, claiming that she is tired. (and she does fall asleep in her chair regularly).

However, ten minutes after she goes to bed she gets up again and thinks that it is time to get up. She dresses and comes out of her room. She gets extremely agitated if we tell her that it isn't morning yet and that she needs to go back to bed.

I have finally just told her that she can go to bed whenever she wants to and get up whenever she wants to. It doesn't make any difference if she sleeps in her bed or in her chair. She will sleep if she gets tired enough.

She doesn't wander and doesn't get into anything that she shouldn't be. She just wants to be in control and gets upset if we don't let her do what she wants.

She doesn't take any meds and I would rather not put her on any, but I am curious to know if anybody else out there has had to deal with this problem and how?

By anon64622 — On Feb 08, 2010

Please help me! My Grandmother will be 90 years old in July. She has always been a super strong woman and still has all her memory short and long term, etc.

Starting about a year ago she said her neighbor was playing loud, offensive music. My stepfather called the police several times, but they never found anything. She got better for a while and starting about three months ago she said that the man that lives two houses down was screaming at her, saying he was coming into her house to rape her.

My parents live about 1/4 mile from her and she has been staying with them at night for the past month. She will ask to go home during the day but every night she comes back, and she has even started saying he has taken her keys so she can't drive to their house and he breaks her phone so she can't call for help. Last night she woke them up in the middle of the night with the alarm going off in the house. She said he was in the house and was hiding under the couch. When my little brother told her no he wasn't she was just hallucinating she screamed and cursed at him, she has never done this before!

I don't know what to do. She refuses to go to the doctor to get help. My Stepdad and Mom are in bad health themselves so they can't force her to go. Any advice on what to do would be great!

By anon64353 — On Feb 06, 2010

My 87 year old mother lived in a assisted living due to a fall that left both shoulders shattered. One year later she was admitted to the hospital with swelling of mouth and throat (cauliflower reaction) with massive doses of steroids given to reduce the swelling.

It worked but now two weeks later she is totally not herself. She still knows some things in the present but talks about life 75 years ago, quotes {correctly} nursery rhymes to bible verses. Will sing up to two hours at a time with the right tune and words. Cries and laughs, body moves constantly, moans aloud.

The medical people saying maybe steroid psychosis since CT scans of the head, UT, and Mri are all normal. Any suggestions?

By anon63320 — On Feb 01, 2010

My name is Christine. My Mother is 89 years of age, and is suffering from vascular dementia. She has exhibited all the symptoms that everybody has discussed on this forum!

It is a terrible disease, and people don't understand it, not until you have watched your loved one go through the terrible hallucinations and thinking that all the terrible things that are happening to them are so real to them.

We have nightmares, and wake up from them - they can't--how horrendous is that! I nursed my Mother for five years after she broke her hip, which is when it all started.

I and everybody on this site know how hard it is to be a caregiver to somebody with this awful disease.

Mum is in a lovely Dementia Care home now, with wonderful people to care for her. I would give up everything in my life if I could get my Mum back the way she was before. I miss her so much.

Good luck to each and every one of you who care for a loved one with this awful, awful disease. God bless.

By anon59281 — On Jan 07, 2010

First, I want to thank everyone for their stories, they have been so very helpful.

My mother in law is 86 years old and she has mid to moderate dementia and I also think she has Sundowners. The dementia has been there for about two years and she now lives with her daughter, but she also has spent time at the other daughter's and also my house.

I've worked in a memory care community for a few years and the family thinks she responds to me the best, but let me tell you, her most aggressive time, i've noticed, is right before dark or if I turn the lights down in the early afternoon. She starts up about nobody cares, and everyone is stealing from her.

The other night i thought i was going to lose my own mind. I needed a few minutes to myself. I had been keeping her engaged all day, and well, about 10 minutes after that (oh it was also about 5 p.m.) she started ripping here purse apart and she was yelling "someone stole my money." Well i knew it was there (i saw the money earlier) so we went through it together. I even went through her luggage --every inch -- and she started yelling to call the cops.

I said, "Bea, we don't need to do that, you have hidden your money somewhere in this room." Within 10 minutes, she stopped ranting and she said, "Oh that's o.k. we'll look tomorrow." Wow. The next morning she new nothing of that night and the money was back in her wallet, but she does this with all kinds of things.

She's not on meds yet, but I'm doing footwork to take her to the doctor. I just want to share our story and say thank you to everyone.

Please I would love to communicate with others. maybe we can ease each other and help our loved ones. Thanks again, Debbie

By anon59062 — On Jan 06, 2010

my mom, 87 recently moved to assisted living. She lived for a year between my sister and I. We decided it would be best, since we both had children, (13-15, 6 and 9) because we could not leave her alone, and we switched with our days off.

She has been there one month, and we take her out every day for lunch, dinner etc. The health care manager told us to leave her alone two weeks so she could settle in. She has vascular dementia. She often thinks things are happening that are not, worries about the kids, where are they? did we put them inn jail? etc. Tonight, I'll get a call at 1 a.m., to come get her. "she's beating up residents". She told me a man came after her with a knife. another hallucination. she has taken ativan a few times to sleep. Should we do this every day? We are nervous because she wears diapers, and frequently gets up to go to the bathroom. Don't know if she will ever settle in there. She is very strong willed, doesn't like it, and too many "old people"! please give me ideas, thanks! anne

By anon57175 — On Dec 20, 2009

"Where are my babies? Give me back my babies! You are a liar, you are trying to poison me! You are stealing my money. I hate you, I hate you, I hate you! Get out of my room! You are nothing to me! If I had known that you made me this dinner I would have puked on it!"

These comments are from my 84 year old mother. I am 54. She is convinced I am her sister, not her daughter and I have been lying to her for all these years. Her three babies are all over 50 and we are blown away by what she has been saying. If this is Sundowner Syndrome then it sucks!

I love my Mom but she doesn't believe me or my brothers. This came on very sudden so we are having the Hospice nurse check for a UTI and trying to get some pointers on how to turn this around. The comments I have read have given me some hope. Thanks. Good luck to everyone that is dealing with this.

By anon56672 — On Dec 16, 2009

My mom is 81 years old and has severe sundowners. I've hired a companion to be with her during the day because of the stress. She will tell me all day long "Why do I feel you're putting me to bed?", when I'm not. She is confused and looks at her watch all day and says "she can't do anything".

I pray for her every day and hope for the best. Is there anyone out there with these same questions being asked and if so what can I do? She is on Lexapro for depression and Seroquel for nightmares. Thank you. Christine

By anon55559 — On Dec 08, 2009

My dear mother has just been diagnosed with Sundowners. Two weeks ago she had a fall and was

taken to the hospital. That night she went crazy!

Because she was incontinent when the ambulance

arrived they handed this over at the hospital.

Mum has been diagnosed with dementia for two years. She was self caring in all ADL'S and was not previously incontinent. She was diet controlled. Diabetic? Vascular dementia. She told me the reason she went off because someone came in the dark putting their hands down her pants.

She was physically and verbally aggressive, smacking the nurse in the face. My sister works in a Dementia Unit and was familiar with this.

I am General trained and even though I had seen patients go off after surgery or with UTIS etc.

This was really distressing to hear of this as it was not how my mother would normally be. This has been very interesting reading these stories.

I must say I feel for the family and caregivers, as it is indeed a heart-wrenching time for all. But most of all it must be frightening and frustrating for the patient.

My heart goes out to each and every one of you.

By lynnkevin — On Nov 01, 2009

our father is 74 years old and has been in two hospitals in the psychiatric wards trying to get his medication for bipolar under control. Both times dad was diagnosed with alzheimers/dementia along with his bipolar. Ever since our mom passed away just over two years ago, we have been seeing very unusual behavior that mom used to tell us about but we used to disregard it as her overreacting. Reading all the above posts has convinced us that sundowners is exactly what our dad as well as his mother (our grandmother) has had all these years. It is of great comfort reading our many of you have shared what has worked best in your situations. Please keep up the stories and suggestions as we will be posted with all eyes/ears open to help with our current challenges. Diane and Lynn

By anon49027 — On Oct 16, 2009

My 93 year old father was very self sufficient and very smart. He had a passion for computers and could take them apart and put back together with no problem. He had emergency surgery in the spring of 2009, a dead gallbladder, and they cut him all the way down his stomach to find it. He was never the same again. He was alert during the day, but panicked at night, cried out all night long, "got to get up" or "get me out of here". He wanted lights on all night, so please anyone out there taking care of a loved one who is experiencing Sundowners, let them have as much light as they need. They are really afraid of the dark with good reason. My father lasted only four months after surgery. I really believe he was in touch with others on the other side and was not ready to join them. I miss him so much and looking back on it now, I wish someone had informed me earlier about Sundowners. I would have turned enough lights on for him that would have lit up the heavens.

By anon47173 — On Oct 02, 2009

My mother had hip replacement surgery in the spring and exhibited the symptoms of either sundowner's or hospital psychosis. She has been on Lorazepam .5 for years to help her sleep; the hospital gave her Ativan (we did not realize it was supposed to be basically the same thing) but it upset her because it did not look the same to her; they finally allowed her to have "her" medication. She had a catheter (but also was on medication - a prophylatic) to prevent bladder infection although nothing was ever mentioned about that possibly causing the symptoms. Actually the hospital never seemed concerned at all and her primary was aware of the meds - she got them from a specialist - another reason for keeping your primary in the loop, though she sees no reason to, so all this came when she was in the hospital because they informed him. anyway she was not supposed to get out of bed but she would and tried to pull the catheter out. They finally took it out because of that. Her primary is the one who told me what was going on and it would have been bad had she pulled it out on her own. I was not aware there is a balloon at the top that could have really messed her up. However, I could not get a nurse to come and I did not know how to handle it at the time; she was agitated with me. It was a very hard time. Reading these has been helpful - wish I'd known before

By anon45155 — On Sep 14, 2009

Never ever use Haldol on a Parkinson's patient. I would be reluctant to use it on any elderly. It affects the brain, and those with Parkinson's, Alzheimer's, etc. already have brain issues. My fathers Parkinson's doctor was livid when he found this had been given to my dad, prolonging his hospital stay by weeks.

By anon44077 — On Sep 04, 2009

My Mother was on Lorazepam .5 mg for years to help her sleep. She recently has come off of this medicine because of dizziness and being unsteady. When she was taking it she remembered everything. Now she is having memory loss and a short attention span. Health care professionals are saying she can't live on her own. I looked up the withdrawal symtoms of this drug and they are everything she is going through right now. The health care professionals don't seem to know anything about addiction and the fact that even though the doctor prescribes medicine it doesn't make the withdrawal any different than if she had gotten the drugs somewhere else. This is very frustrating and makes me wonder how many people are misdiagnosed and in nursing homes because of this and doctors' mistakes. I work in the field of addiction and when people come off of drugs (prescribed or not) they have short term memory loss, anxiety and short attention spans. Why can't anyone at this nursing home realize this?

By anon42833 — On Aug 24, 2009

My mother has had Sundowners symptoms first in a hospital setting, and not a few months later while at home. Both times she was also found to have urinary tract infections, which were considered incidental, while the doctors tested brain scans, MRIs, etc, and gave meds for that created even more difficulty. We read in your forum about the link with UTIs and it was a great insight into what is probably a *very* significant link between infections or disease in the elderly and the array of Sundowning symptoms! Please help spread this important connection to others, including the need expressed by anon36396 for follow ups to ensure infection is gone!

By anon39517 — On Aug 02, 2009

hello, my mom had a short run of sundowners a while back and the doc explained to us what brought it on (a stressful period with her health as I recall). Here's what we did to get through it. Hope it helps someone.

First, mom and I discussed what it is and what it isn't. We talked about if she knew it was happening and how she felt while it was going on.

Then we implemented the doctor's advice. I personalized a small lamp that we placed near her bed. We agreed she would do a relaxing activity in her bedroom beginning around sunset. We turned on the lamp and spoke of it as her guiding beacon to help her through the darkness. I tried to be as unintrusive as possible with her relaxing task without leaving her to feel unaided. If I needed to ask her a question or give information, I always tried to remember to enter the room gently, get her attention gently, give her a chance to process it was me who entered before I spoke. I don't remember how long it took before she felt well again, but she always kept the lamp at her bedside from then on.

By anon39177 — On Jul 30, 2009

my name is chris and i work in home health. the local hospital is releasing a patient to me who has sundowners. a friend of mine who works with him told me that he bites, growls, and punches and gets really agitated. he is fine when family is there but once they leave he turns hostile and aggressive. what should i do if he gets agitated and hostile?

By anon37799 — On Jul 21, 2009

I recently started working in an assisted living/memory care community and absolutely love it. It is hard for me though because I am younger and have never dealt with seniors, especially those with dementia/Alzheimer's. I started a workshop at the Alzheimer's Association this week and found it incredibly informative and helpful. For all of those writing and looking on here, I would strongly suggest that you contact them. Their services are free and they are extremely helpful. They can help answer many of your questions, help you understand and cope with what is going on with your loved one and with yourself. It is also very helpful on how you care for those who are suffering from this disease, how you communicate with them, the stages, the affects it has on your loved one, and much, much more. Please, the most helpful thing you can do for yourself and all others affected is to inform yourself and get the appropriate help, treatment, and placement for your loved one.

By anon36396 — On Jul 12, 2009

I read several of the above comments. I have worked for a psychiatrist that services several nursing homes, as well as many geriatric patients. If you have a loved one that has done a 360 in a short amount of time, such as showing signs of paranoia, auditory and visual hallucinations, or possible a complete personality change. Always get a simple urine screen to check for UTI. This is a very common problem in the elderly and will have them really disoriented very quickly. One they have been diagnosed as having a UTI, please *always* go back after taking the antibiotic and have a follow up urine screen done. Many times it may take 2-3 rounds of antibiotics to get rid of the infection. Just some FYI.-- Darlene

By anon35027 — On Jul 01, 2009

Hi, i am a CNA at nursing home in maine specializing in dementia. I have experienced all phase of dementia and sundowning, so i am very familiar with how it works. Sundowning or sundowner's syndrome can be very challenging for care givers and loved ones. There are many theories as to what causes it but no medical experts can agree. The range of symptoms are just as endless. It can even begin before the sun goes down. there are many ways to help lessen the symptoms but no way to cure it. Having a simple afternoon and evening routine seem to be helpful. Environment is also extremely important. Keeping the home well lit with little stimuli is helpful. Using pharmaceutical drugs can have long lasting effects on your loved one. Carefully weigh the risk of side effects with your loved one's physician. A gentle sleep aid may be just as effective. However, Psychotropic drugs can be very useful when all other alternatives have been tried. Calming repetitive tasks may also be soothing to your loved one.

By anon32355 — On May 20, 2009

My hubby has just been diagnosed with pancreatic cancer. He is 60. I have noticed since they told him that he has been forgetting several things. I find myself repeating something I told him the night before or something we discussed the previous night.

Another example we went shopping at Lowe's on Tuesday I need to go back and said I need to go back to Lowes. He said Lowe's when were we at lowe's? I don't recall what did we buy?? Help!

By anon29970 — On Apr 11, 2009

No No No never use haldol for the elderly. None of the drugs work. Anesthesia is usually the main culprit along with UTI's and constipation and dehydration. Keep the same routine and get through with all the stimulating care before the sun goes down.

The other side of Sundowner's is the inability to even walk after the sun goes down. One is not always combative,but merely just can't function after sun goes down.

By CaroleJean — On Apr 01, 2009

This sounds like my husband. *How* does the caregiver deal with it? I have been caring for my husband 24/7 for 5 years and *never* a full nights sleep.

Especially the last 2 years. He wakes me 8 times a night at least. I even sleep in the guest room now with an intercom for him. But the lack of sleep is affecting our relationship. Wonderful all day and bad at night. I cannot go on like this. I am even considering a nursing home, but don't want that if I can avoid it. He is 85 and I am 70. *help* me with any ideas, Please. Say a prayer for us. I am at my wits end.

By anon29264 — On Mar 30, 2009

My dad has been diagnosed with dementia and takes Razadyne 4mg bid. He does fairly well until around 11pm and then he starts calling names of his siblings and does this until the next morning. Sometimes he is asleep when he does this, but most of the time he is awake. This will go on for 6-8 hours. I can go in his room at night and tell him they are not there and he will say okay "I'm sorry I bothered you." He will start again as soon as I leave the room. He was on Namenda, but became very combative with it and that has greatly improved since stopping taking it.

Does anyone have any suggestions. Ambien and Elavil have been tried, but did not help at all.

By cram1862 — On Mar 22, 2009

My 85 year old mother is suffering from severe dementia. She tells me everyday that there are people singing outside at night and they are taunting her by calling her name. She also has told me that on occasions someone is knocking on her door in the middle of the night. I have spoken to her neighbors and they don't hear anything. Is this a symptom of Sundowners Syndrome? My sister who has worked in nursing facilities says it is--how do we treat this?

By anon23410 — On Dec 23, 2008

My 82 yo mother started exhibiting Sundowners several years ago while in the hospital. I thought it was because of the unfamiliar location. She has been diagnosed with vascular dementia. Turns out, she gets sundowners at home. When I was home for Thanksgiving it lasted until she went to bed.

She's at my home for Christmas and sundowners set in this evening. I answered her questions with honesty, i.e. is so-and-so dead? yes.

She went into Sundowners and then came out of it about an hour before she went to bed. I've never seen that before.

By anon21635 — On Nov 18, 2008

I have spent considerable time, over the last 3 years, with people in nursing homes while taking care of my parents. I have learned that "home" is related to how far they have regressed in their life. Home to my mom started as the home before moving into assisted living and right before she died it was the farm where she was born.

By anon20039 — On Oct 24, 2008

I believe my 70 year old mother has sundowners, because she usually calls us at night complaining about family members. She just recently has surgery and she was combative with the nurses in the evening and she was fine during the day and this still goes on. She is presently rehabbing in a nursing home but continues to call me complaining that we are trying to keep her there and telling family members that my husband and I are trying to keep her there, we have no say so. It is disheartening because I work in the health care field and didn't see it coming. It harder when the person in close to you. I am working with the nursing home to take a look at what is happening with my mom.

By anon19865 — On Oct 21, 2008

Hello, my dad passed away a few months ago. My mother had never spent a night alone in 25 years. Now that he is gone, she is experiencing seeing people that are not there and having conversations with them. She said she asked why they were there to hurt her but they told her they were there to watch over her. She claims people are living in her house but no one else can see them. She says people are stealing from her, and then bringing things back. I believe she has misplaced things. She accuses everyone of stealing off of her and they are starting to stay away from her, thus, leaving her more alone and making things worse. Do you think she might have this Sundowners Syndrome? I wasn't sure if it was signs of Dementia. I'm just really worried about her. She takes quite a few different medicines and now her doctor gave her sleeping pills. I hate the idea of putting her in a nursing home or facility, but don't know what to do. Any suggestions?

By deeann — On Jul 05, 2008

My Mom definitely had symptoms of Sundowners Syndrome when she was in her 40s. She is now in her 70s and suffers from Alzheimer's. She would hallucinate and become paranoid at night and then the next morning she would act like nothing happened. Was this possible?

By anon13220 — On May 22, 2008

I lost my mother when she was 80 years old. Various complications due to diabetes, hypertension, stroke etc made her bed ridden. In the last few months she became disoriented and failed to recognize people and generally irritable.

We couldn't believe the change in her personality. I also witnessed these changes in some other older relatives also. It made made me convinced that it is not worth living like that. Eat, Drink, be merry and die young with no regrets and no misery to others.

By anon12630 — On May 11, 2008

Hi, to you all! I run a 24 bed intermediate care home and I would like to pass on a helpful tip to you all. I would suggest that you contact your local Alzheimer's Society. They should be able to provide you with information on Sundowner's.

Now just because someone experiences Sundowner's it does not mean that they have Alzheimer's. Furthermore Alzheimer's cannot be truly diagnosed until death. However the Alzheimer's Society, holds information on most neurological conditions. I encourage you to look up your local chapter.

By anon12265 — On May 03, 2008

My mother is 67 years old and has been in a skilled nursing facility for the past three years. She was taken to the hospital originally due to a botched angioplasty. She was diagnosed with Tuberculosis in the bone (rare form of tb), double pneumonia, Sepsis and TB Meningitis. She has recovered from most of the incident and has no recollection of 2005 and the first half of 2006. In the past three years, she has battled C-Dif 14 times and UTI's 35 times. She is unable to walk due to severely atrophied legs. During the later part of the day...after dinner and a snack, usually, she will wake from a sleep or nap calling out for me or another family member. My dad has been deceased for 15 years now and she swears he is outside knocking on her window. She will then call out for me as if I was a child needing to finish my homework (I'm now 32). I had never heard of sundowners until a nursing home aide had mentioned it to me. She will awake in the evening and attempt to get out of bed on her own, and apparently, on one occasion, got out of bed and was standing and leaning on her desk. How do I know if this is sundowners or just another reaction to something? Its been a long road for her and hate to see her suffer like this so much. She's been through enough in her life. I will try a few items mentioned in earlier posts. Thank you---

By beenthere — On Apr 06, 2008

I hope I can give you hope as you read this. My dad had broken his arm at 83 years old. He was anesthetized to set the arm; and the sundowners began. His personality changed - his face - his eyes. He was in a wheel chair for 6 wks. He did not recognize his loved ones and talked and acted with little regard for his family. After 6 wks, he began to walk, but his gait was as though he had been drinking. I fought for the man who had been my wonderful dad for three months showing him pictures of the family and reminding him of his former activities. I was exhausted from his night walking and different personality. But, miraculously, after much attention and prayer, my dad came back like someone had switched on a light in his head. He had no memory of his behavior. He was able to return to his home, and my mother had him for 3 years until he suffered a stroke that took him. This was my experience of giving him total care for three months with sundowners, and I wish you and your loved one peace and good health. Take time to care for yourself.

By Casey — On Mar 27, 2008

My 88 year old great grandmother is showing signs of sundowners syndrome. She is in excellent physical condition and has never had to have any help with anything in her entire life. Recently her son decided that the best thing for her would be to put her in a nursing home with constant care. It seems the symptoms have worsened now that she has been taken from her home and thrown into a totally new environment. It is so hard to see her struggling everyday. I have depended on her my whole life, now it seems she is the one depending on me. I'm just having trouble coping with the confusion, the agitation, and constant worry that my grandmother has never had before.

By anon9935 — On Mar 16, 2008

Hadelol trazidone or any of those drugs are in the same family. Some people have the reverse reaction to those. I sit with a 98 year old lady who they have tried different drugs in this branch and all seem to have the same effect. That is when you just have to have patience and let go until they are so tired they finally want to sleep. As they get closer to death they will need less, which is very hard if you are a caregiver or family taking care of the person.

By GloriaS — On Mar 14, 2008

I would like to ask if someone knows what the most positive residence is for someone with Sundowners/Alzheimer's. I have an 83 year old female presently living with my Husband and I. She has a caregiver from 8 - 4:30P but some days are extremely difficult since I work from home.

Thanks for any suggestions.


By anon9731 — On Mar 12, 2008

Before considering meds, make sure you know the metabolic reaction of the patient. My dad was somewhat combative and was given a small dose of Ativan, because his body was slow to react, a large dose of Haldol was administered. Consequently, forty eight hours later, my dad finally woke from his sedation and has more issues.... His swallow reflex is gone, he is more confused and now permanent extended care is our only option. Haldol is a drug given to inmates when they are rubber room material.... It is a terribly old -fashioned remedy, used in today's society only as a last alternative. There are other precautions and therapies that should be considered before using. Be warned! Haldol is a psychotic narcotic and should only be used in last result scenarios!

By Ggg — On Feb 27, 2008

Years ago my wife was a private duty nurse for a young boy 10-12 years old, Stuart. He had to be kept in a cage and tied around the times of the discussion sometimes all night long. During the day he was a genius. None of the doctors could beat this kid at chess. What a mind. Eventually Stuart was killed by a nurse who gave him the wrong medication.

Today I was told by a friend that sundowners is common after by-pass surgery. Does anyone know if this might coincide with stopping the heart during the procedure?


By einnob — On Feb 09, 2008

My mother was getting addled, with all the signs and symptoms mentioned. Nursing home staff said it was commonly called 'sundowners syndrome'. They said it could also be related to the fact that she had a urinary tract infection (UTI) because they frequently see that with UTIs. When I said it seemed like she might be having mini strokes, they did an MRI and found old blood on her brain from a fall, she had surgery to remove the blood and she is fine now, back to her 'old' self.

By anon7928 — On Feb 05, 2008

My Grandmother has Sundowner's and the secret is light. Even a small light at night is helpful. If it is sunny out and you have great natural light, open the blinds and let it in, also supplement that with artificial light. This helps keep her upbeat and more like herself. She still repeats stories a lot, but I act like it's the first time I've heard the story. Don't argue with them, this is just discouraging and can make symptoms worse. be patient! When we are getting ready to go somewhere and she begins fixating on when we are leaving, I give her a count down each time she asks the EDT. I am a teacher, so I do the same thing with my 1st graders when they begin asking about recess and lunch. I just say "1 hour before we go....45 minutes before we go...15 minutes before we go." This seems to be quite calming and reassuring without being disrespectful. I know it's frustrating, but like I said above, don't argue. When they tell you the same thing for the 1500th time, don't say..."You already told me that 1499 times!" This can be frightening for them. Just stay calm, be patient, and remain a loving caregiver.

By worried — On Jan 31, 2008

My husband was just diagnosed with anaplasty large cell lymphoma stage 2 on top of several other major illnesses. Now he is exhibiting signs of sundowner's late afternoon into the evening. It is frustrating and scary and I am not sure what to do. He had is first chemo treatment about 9 days ago. Does anyone have any suggestions?

By mdmurray — On Jan 28, 2008

My mother-in-law was diagnosed with mild Alzheimer's as a year or so ago. Recently, the condition has worsened, to include Sundowner's Syndrome and put on a psych med, which I believe is Aricept. She has also recently gone downhill physically in that her pacemaker is not functioning well and needs replacement, although she is not well enough to survive the surgery. She had a heart attack a few days before Christmas, and the first few days home from that she fell and hurt her hip and sprained her ankle, and now has difficulty walking even with a rolling walker.

I traveled to her home for a family meeting to decide for her terminal care in her home, and witnessed night-time behaviors that match what the home health care service says happens during the dying days. Is it possible that the psych drugs could cause hallucinations of her dead friends and family that she is talking to and it not really be "her time" to go?

By anon6840 — On Jan 10, 2008

I work in a nursing home and we frequently see sundowners....usually right around the 4pm hour and lasting just through dinner. Yes, medications like Aricept, Exelon, Haldol and Ativan help to reduce some of the stress, it's also important to try non-medicinal resources first: redirection by intellectual stimulation, soothing music, massage, snacks, visiting, providing a task for the person, etc. Also, be willing to try anything and everything and be creative with interventions. Take turns in caring for someone as that will eliminate feelings of helplessness and impatience.

By anon6250 — On Dec 21, 2007

Another drug that is helpful with sundowners is Haldol. The dose varies a lot depending on the person, but what seems to make it most effective is to take a regular dose on a scheduled basis to maintain a steady blood level. I am a nurse and have seen this drug work successfully for this problem in numerous cases. Hope this helps.

By anon5386 — On Nov 23, 2007

First of all, I want to say that I am so sorry that you all are going through this with either yourself or your loved ones! I went through it with my Dad, and I can relate.Right now a dear friend has been diagnosed, and he is 80, and alone in the world except for his companion who is trying to help him, and she is 75, and it is taking a toll.If possible, avoid TV news or shows that my be confusing or scary, especially in the late afternoons. Things that may help are very peaceful music played quietly- more of a background noise, Sleepy Time or Sweet Dreams herbal tea helps as a calmative. Scented lavender candles are good too, but MUST be watched, and sometimes the fear of fire makes this not a good thing depending on lucidity. Abdominal breathing /in through the nose to expand belly, and then slowly out through the nose or mouth on a slow count gives back control. Reading a favorite holiday story or carols is good. I work in a Behavior Intervention Class, so the key is to redirect, and distract the person.Lastly, there are meds that help, ask you MD for Ativan, or Lorazepam, these are addictive, but I feel at this point the quality of life takes precedence. Start with a very low dose, ie 0.5 mgs, and see what if any help this offers. Be strong, and be patient, my prayers are with you.Aloha

By halselll — On Nov 11, 2007

Thank you for this information. I am shocked that my mother has something diagnosable. I really thought she was putting on. Thank you so much. She lives with me so it is important that I am informed because I can get pretty fed up.

By anon4509 — On Oct 21, 2007

I am 20 years old, and I have the same symptoms as Sundowners. I believe that anyone of any age can suffer from it for the same reasons it states above. As the day goes on, we get more stressed...leaving the nights to be kind of crazy on us. But after some sleep and rest, I wake up feeling new again.

By anon3379 — On Aug 26, 2007

Can someone as young as 38 suffer from Sundowner's? I get an overwhelming since of sadness about 8:00 or 8:30 pm every night that lasts until I go to sleep. It is over the next morning, and starts again at night. Cindy

By anon2468 — On Jul 12, 2007

my dad is 71 years old and everyday he asks me where he lives and this is so hard because it came on so sudden it seems like in one day but he is on ariceft, but it doesn't seem like it's helping him. is there anyone that can tell me how to handle this its breaking my heart this is my daddy.

By anon2073 — On Jun 27, 2007

My father-in-law, who has a host of medical problems, exhibits classical "sundowner" behavior -- which is, of course, terribly hard on mom-in-law.

We have noticed that, contrary to the suggestions made above on dealing with a sundowning patient, with him it is a help to have some kind of mental stimulus in the late afternoon or evening. This stimulus (as simple as having someone other than his wife show up for a short visit) is enough to "wake up" his brain, as it were, and keep him rooted in present reality. Otherwise, he becomes agitated and disoriented, frequently wanting to know "Why am I here?" and "Why can't I go home?", even though he's in the same house he's lived in for the past fifty years. Without the stimulus, he is confused and frequently verbally abusive; if someone drops by for a visit, especially if they make him sit up and take part, he is coherent, reasonable, and otherwise himself. The suggestions above of "privacy" and "quiet" would, at least in my father-in-law's case, only make the situation worse.

By anon1995 — On Jun 23, 2007

My dad is in the hospital awaiting carotid angioplasty. He has been roaming the halls at night without any clothes on, and when we greet him in the morning, he is disoriented and convinced that the events of the early morning are always someone else's fault. This is so disheartening. My childhood memories of my father are slowly being nullified because of these behaviors. I feel like he has become another person whom I don't know. Can anyone tell me how to cope with this in a positive manner? Any help would be appreciated.

By anon259 — On Apr 19, 2007

My father has been on various heart medications over the past 12 years. He just recently exhibited signs of dementia, Sundowners, or possibly Alzeimers. He does get agitated at night and frequently wakes my mother at 1:00 or 2:00 am thinking it's time to go or go home. We're wondering if these meds should be stopped now and see if he has positive results. He's almost 77 years old and this condition seems to have worsened in the past three months. Are there any recommendations you may have? It is terribly frustrating and draining on my mother.

Thank you.


Michael Pollick

Michael Pollick


As a frequent contributor to The Health Board, Michael Pollick uses his passion for research and writing to cover a wide...
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