The term sundowning refers to people who become increasingly confused at the end of the day and into the night. Sundowning isn't a disease. It's a symptom that usually occurs in people who have dementia such as Alzheimer's disease. The cause isn't known. But factors that may aggravate confusion include:

• Fatigue
• Low lighting
• Increased shadows

To help reduce disorientation in people who have late-day confusion, you may:

• Encourage midafternoon naps or quiet time.
• Keep a nightlight on to reduce agitation that occurs when surroundings are dark or unfamiliar.
• In a strange setting such as a hospital, bring familiar items such as photographs or a radio from home.

When sundowning occurs in a care facility, it may be related to the flurry of activity during staff shift changes. Staff arriving and leaving may cue some people with Alzheimer's to want to go home or to check on their children — or other behaviors that were appropriate in the late afternoon in their past. It may help to occupy their time during that period.