Alzheimer Symptoms in Elderly: Restless at Night

by Sharon

My father has Alzheimer's and lives with us full-time.

We have a paid caregiver during the day while we work but family is home with him at night.

He gets very agitated late in the day. Are these normal Alzheimer symptoms in elderly?

REPLY from
Some people with diseases such as Alzheimers, that affect their memory, can get restless or agitated later in the day. This is often referred to as "sundowning".

Restlessness or agitation may be in the form of mood swings, increased abnormal suspicious or demanding behaviour, becoming upset or disorientated or even seeing or hearing things that are not there.

The cause for sundowning is unknown, though there are a number of theories.

Some suggestions for dealing with the effects of sundowning are:

  • try to keep your loved one busy during the day, a walk outside may help to keep your dad's body attuned to the time of day
  • try to follow a familiar routine that your father was used to prior to having dementia; both daily routine and evening routine, such as helping to prepare dinner
  • you can try a posted daily schedule for him to refer to
  • provide comfort but don't argue or try to reason with him
  • don't take accusations personally
  • distract him with a meaningful activity
  • calm him with music or touch or other sounds he is used to having in the background (ie, TV or fan). You can also try a white noise machine to see if this will help.
  • look for a pattern and attempt to be with your father at the time he becomes restless or have someone else be with him
  • if the behaviour does not bother you, do nothing
  • distract the person with simple activities (ex. folding laundry, polishing the furniture/shoes, knitting, etc.)
  • redirect/change the subject
  • stay calm, be soothing
  • do not judge or scold
  • provide affection
  • look for unrelated needs (Does he need to use the toilet? Is he lonely or bored? Is he too hot or cold?)
  • provide privacy

For more information about spending quality time with loved ones with dementia or how to have better communication with loved ones with dementia:

If anyone else has any suggestions that have been helpful in dealing with their loved ones with sundowning, please share them here.

Thank you for your question,

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I've worked with elderly dementia patience for 20 plus years. The previous suggestions were wonderful however a few more:

1) There's some thought that sundowning may be to over tiredness. A brief nap after lunch might be helpful.

2) Sometimes over stimulation can be a cause or at least aggravate the situation. Providing a quiet environment with little talking, no TV etc might help.

3) Go to their world - If the individual is insisting on "going home" talk to them reassuringly. Ask them about their house, who lives there, what it smells like. If they feel they have to meet or find someone, tell them that individual asked you to take care of them for the time being and that the individual in question is safe but busy. This may seem unethical as it is a story, but the idea is to provide reassurance, safety, calmness, comfort and peace to a person who is worried, afraid, or determined.

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