My older brother is in an ALF because of dementia. He gets up during the night and acts disruptively. Any advice?

There may be some meds that would calm him down. Talk to the doc. As Maggie suggested, he may be a candidate for a higher level of memory care if he's endangering himself and others.

Talk to his doctor. There's somewhat of a reluctance to prescribe sleeping pills because one can end up STILL getting out of bed . . . Unsteady on one's feet . . . Falling and making a bad situation much worse. But perhaps his doctor can help.

It sounds as if assisted living may not be appropriate for your brother any longer.

Dementia is a terrible reward for living too long. Terrible.