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Confusion expertly managed

BMJ 2003; 326 doi: (Published 15 March 2003) Cite this as: BMJ 2003;326:590
  1. Paul Finucane,
  2. Philip Henschke, physicians in geriatric medicine
  1. Adelaide, South Australia.

    In people with dementia, an exacerbation of confusion at day's end is often referred to as “sundowning.” We encountered this phenomenon on a recent flight between Croatia and London, when a dramatic Alpine sunset was overshadowed by an even greater drama on board. An elderly passenger became increasingly agitated, and neither his wife nor other passengers and cabin crew could appease him. His interest in the nearby emergency exit and a metal object protruding from his clenched fist worried us all.

    Happily, disaster was averted. The …

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