Friday, May 29, 2020


Q: "Sundowning" can be related to nurses'  shift changes in ICU? (select one)

A) True 
B) False

Answer: A

Sundowning was first described almost 80 years ago as nocturnal dementia. It still remains one of the least understood phenomena. There have been multiple definitions described but there is no general consensus. Many factors have been identified besides patients' frail and diseased state including unfamiliar environment, noise, unstructured nurses' shift changes, and reduced staffing. It would be a misnomer to name it purely as a disease of evening time. Sundowning has been reported with shift changes at 3 PM also.



1.  Cameron DE. Studies in senile nocturnal delirium. Psychiatr Q. 1941;15:47–53

2.  Jacobson S, Pies R, Katz I. Clinical Manual of Geriatric Psychopharmacology. Washington, DC: American Psychiatric Publishing, Inc.; 2007. pp. 580–586. 

3. Mace N, Rabins P. The 36 Hour Day. New York: Grand Central Publishing; 2006. pp. 234–235.

4.. Khachiyants N, Trinkle D, Son SJ, Kim KY. Sundown syndrome in persons with dementia: an update. Psychiatry Investig. 2011;8(4):275‐287. doi:10.4306/pi.2011.8.4.275

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