One sign is the person starts pacing, following you around and more agitated or asking more questions late in afternoon. Best if you can keep them active during the day and strict evening routine. Keep lots of lights on in the house and outside. My mom is up all night, fearful, paranoid and constantly checking door locks and out the window. Then she falls asleep at dawn and sleeps late. She lives alone...so not there to keep her active during the day.
Nancy, you said it so well. Many people with Alzheimer's become more agitated at night. They may become nervous and restless. Delusions and perhaps hallucinations become worse, so it can be a frantic time. Some professionals say it can help to close the blinds so the person can't see the shadows of evening or the dark of night outside.
My mother also has sundowner's syndrome. Not unusual for Alzheimer's patient. I asked her doctor for help and she gave Mom prescription for Lorazepam. Mom is happier and I feel better. My mother went around the house crying "Help me! Help Me! Won't someone help me!" So sad! I now give her the medicine, sit down with her and a cup of tea. I try to get her to let me hold her hand. Trick is ... give the medicine around 6 PM and she never gets as upset as she would without it.
I've noticed with my mother-in-law, that her dementia/alz just gets worse in the evening. After dark, or just the evening hours is when she'll be all wigged out about something that happened years before, thinking it was just today that it happened. She'll have a whole scenario about someone calling her and telling her that her husband is dead (yeah 5 years ago true) or she'll call for operator assistance and want to talk to her parents who died 15 years ago. I've had to talk her off the edge so to speak multiple times when she has called me and is agitated and says she doesn't know where she is, or why she's there. Stuff like that.
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