Sundowning Sid — Alzheimer's Disease: Sundowning, Safety and Calm Redirection
Every evening the sun goes down and Sid goes looking for a job he retired from twenty years ago
Sid was pleasant all morning. At 6 p.m. he is at the nurses' station demanding his car keys, and his daughter is crying in the hallway.
Sid has Alzheimer's disease — a progressive, irreversible dementia with memory loss that begins with recent events, then steals judgment, language and recognition. His hardest hours are late afternoon and evening: sundowning brings agitation, pacing and exit-seeking as light fades and fatigue builds. Nursing care is environmental and calm: consistent routine, good lighting before dusk, limited caffeine and naps, uncluttered paths, door alarms, and redirection instead of arguing. You do not reorient a deeply confused client by force — you validate the feeling and guide to safety. Cholinesterase inhibitors like donepezil slow decline but do not cure.
Read Sundowning Sid's full story →The story arc
The setup
Sid misplaces his keys, repeats questions and forgets what he ate — but covers it well in conversation.
The turn
Every evening Sid becomes restless and suspicious, pacing the hallway and insisting he must get to work.
The crisis
Sid is found pushing the stairwell door. A nurse argues with him about the date and he becomes more agitated.
The save
The team keeps his routine identical, brightens the room before dusk, offers a snack and a familiar task, and walks with him until the urge passes.
NCLEX study section — Alzheimer's Disease: Sundowning, Safety and Calm Redirection
What this chapter is testing: the recognition cues, the numbers and the priority action.
Study section: Mental Health
Take this chapter into practice questions on the same topic.