Sundowning

This is a common call overnight. The patient can present with confusion, disorientation, or combativeness in the evening hours. Things to consider:

• • Identifying and treat any underlying conditions that could be contributing.

  • Minimize sedation. If absolutely necessary, haloperidol (Haldol), 0.25 mg PO/IM qd; increase to 1 - 5 mg as needed.

  • Provide frequent reorientation; family members can be helpful.

  • Increased lighting.

  • Maintain a quiet structured environment to help calm down the patient.