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I would start by having him checked for a UTI, which can cause serious symptoms in elders.

Has a doctor listened to his chest? Might he have developed pneumonia?  

Can you get hold of his doctor by phone thus evening and ask how you should proceed?  Or does your insurance company have a 24 hour nurse line for questions?

Please let us know what you find out from the doctor/nurse.
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According to the VA website, there is a 24 hour nurse line. I would call them with your concerns.

Yes, at 91, the body takes longer to heal because the immune system is not as strong as it once was. But I know that the several bouts of pneumonia that my mom had in her NH all started with increased fatigue as the only symptom. I would get professional advice on the phone.

Has anyone ever taught you how to listen to your grandfather's chest by putting your ear to it?

The next time he's at the doctor, ask the doctor to let you listen so you can identify what a clear chest sounds like. It makes it easier to identify the sounds that accompany bronchitis and pneumonia.
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Welcome, Morgan! Grandpa is lucky to have someone as skilled as you looking after him!
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He does have sundowners. And I'm a CNA II just left the hospital were I worked before. I left to take care of him. All of his vitals are great for his age and with having CHF. No wheezing at all, when I treated his sypmtoms a lot of mucus came up, but now is clear. So I'm watching him close and plan to take him first thing tomorrow. If anything gets worse tonight I'm taking him right away.
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I also found link below on PubMed.gov...discusses Parasomnia. But one needs to be VERY careful with things read on the web:
https://www.ncbi.nlm.nih.gov/pubmed/20525541
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By no means am I a doctor and have no medical background! However, there’s a possibility that he has developed Sundowning, or Sundowners Syndrome, also known as “Sleepless Nights.” Some are said to sleep fit-fully, some cry or moan, some wander or roam their house while others have horrible night terrors like your grandpa is experiencing and keep them awake for hours. I’ve read that experts have little information about Sundowning (Sundowners) or its cause. I also read that wearing head-phones tuned to favorite music can lull a person to peaceful sleep and has proved that they awake in the morning feeling rested and without memory of any night terrors. Just an idea. Seems harmless and worth a shot.
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And right now he is acting completely normal, just ate a bowl of fruit and is watching a western with me and my husband. Thank you all!! I have so much to learn and a lot more questions about different things. So I'm SO grateful, I found this group!
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Update-Had a rough night. So I took Grandpa to Urgent Care first thing this morning. Vitals were great, no fever when they checked. But, he has a mild/moderate case of Pneumonia.. Its crazy though since we left the doc this morning he has been completely alert, no sleeping. The only thing I notice is he gets winded when I take him to the bathroom. So he is on a antibiotic and a pump. They sent him home with me bc of his of his mental state. I'm taking him back tomorrow for a O2 stat, which today it was 93 before the treatment. That is good considering CHF. And he has super thick fingernails so it's hard to get period. As long as he does not get any worse we will hopefully beat this. If not, we will have to go to the ER.
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Thank you all again for your help!!! This group is Amazing!!
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Morgan, I'm so glad you went to Urgent Care!
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