hardsundowningdementiaAlzheimer-diseasedeliriumgeriatric-assessmentbehavioral-disturbancecircadian-rhythm
An 81-year-old woman with mild Alzheimer's disease is brought to the PMHNP by her daughter, who reports that for the past three weeks, her mother becomes increasingly agitated, confused, and suspicious every evening beginning around 4:30 PM. During these episodes, she accuses family members of stealing her belongings, attempts to leave the house insisting she needs to 'go home,' and becomes verbally aggressive when redirected. By 9:00 PM she is usually calmer, and her mornings are relatively lucid. Her medications include donepezil 10 mg daily and a multivitamin. She had a urinary tract infection treated six weeks ago. Her vital signs are stable and she is afebrile. The PMHNP is conducting a comprehensive assessment. Which of the following assessment approaches most accurately reflects evidence-based evaluation of sundowning in elderly patients with dementia?