Sundowning actually is common in the elderly resident patients, in many cases you will hear staff joke about it being a full moon and the sundowners will be active tonight. This is no joke, they actually do sundown during that period of the month for some reason. Sundowning can occur in any illness not just dementia. When I was a ICU supervisor I found that buy putting the overhead lights on bright it seems to deter this activity. With my own mother I always left her bedroom ceiling light on and we did not have a problem with sundowning. Once she fell asleep I would go in and turn it off. The light does not seem to bother them or interfere with their sleeping. And Dotsie, it is extremely common for a terminal patient or a patient who is near the end of life to converse with expired relatives and too see them. I have seen that many, many times as a nurse.