Medical Surgical Alzheimer’s Disease #4


An Alzheimer’s client is experiencing restlessness and agitation in the evening. Which suggestion by the registered nurse can help the client be more calm and satisfied during this time?


  1. A change of routine to help prevent boredom
    • Rationale:

      This answer is not correct because sticking to a routine or schedule is best overall for the client with Alzheimer’s disease, especially when experiencing sundowner’s syndrome. This will help reduce the agitation and restlessness associated with sundowning.

  2. Having increased lighting during the evening time
    • Rationale:

      This answer is correct because some studies suggest increasing the lighting in the client’s environment to help reduce agitation and restlessness. Light therapy, specifically a fluorescent light when the client feels confused or agitated has shown to improve these symptoms.

  3. Encourage daytime naps to help them feel rested
    • Rationale:

      This answer is not correct because daytime naps can make any client have difficulty sleeping, especially the client with sundowning. To promote sleep, the client should remain active throughout the day and avoid daytime napping.

  4. Perform more challenging activities to keep their mind occupied
    • Rationale:

      This answer is not correct because for the Alzheimer’s client, stress should be reduced to help the client remain calm in the evening hours. Simple activities should be all that is performed in the evening hours. Calm music can help relax the client and promote relaxation, rest, and sleep.


Having increased lighting during the evening time can help a client with Alzheimer’s disease be less restless and agitated. Alzheimer’s disease is a form of dementia.


Learning Outcomes

Alzheimer’s disease is a form of dementia. It is a disease that is progressive, where memory issues and other dementia symptoms worsen gradually over several years. Memory symptoms are mild at first, then worsen. In the later stages, the client with Alzheimer’s disease is unable to carry on a conversation. Another common occurrence is sundowner’s syndrome. As the sun goes down, the client begins to have worsened memory problems, with behavioral and emotional changes. They can become restless, agitated, and pace the whole night. According to the Alzheimer’s association, sundowner’s syndrome can be improved by increasing lighting as the sun sets and keeping a consistent routine. Furthermore, keeping the client active during the day and avoiding daytime naps can help the client. Also, decreasing stress during the evening by having them perform easy, non-challenging tasks at the end of the day can help decrease agitation and restlessness.

Test Taking Tip

Sundowner’s syndrome is just like it sounds like, when the sun goes down, the individual comes up and stays up, all night long. They can wander all night long, agitated, anxious, and confused.

Video Rationale