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She tries to get out of the outside doors when she can barely walk with a walker. I have to lock all doors to prevent her from leaving. She says she has to go she has things she has got to do even if she has to walk two hours to get there. She gets verbally abusive when I prevent her from leaving.For three to four hours she goes from one door to the next trying to get out of the house or begging me or my husband to take her to get somewhere. She can't tell us where she wants to go or how to get there but she just has to go like now. She has dementia. She walks constantly during this time and I have to stay close for fear of her falling. There is a step down to the back door where she has fallen going up and down. When she gets to these steps I have to be there to help her up or down. This starts around three pm every day and goes on until she is so tired she can't walk anymore. Is this sun downers? She will continue to beg me to let her go or take her where she has to be. She tells me she has to pick the kids up at school although her youngest child is fifty years old. She will say her mother is expecting her when her mother has been dead for thirty years. My dear mother is ninety-two years old and so confused she will not believe me when I tell her she has adult children or that her mother has been deceased thirty years. Every day for hours it is a battle to prevent her from wandering off no matter what I tell her. I can't take my eyes off of her for one minute. Her doctor will not medicate her. I refuse to put her in a nursing home. I want to be her caregiver. I want her final years to be peaceful for her. I take her to visit her other children although it is difficult to get her in and out of a vehicle. What can I do to get her through these few hours of horror every day?

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Oh katstyls, this is so hard! Dementia is such a cruel disease!

It sounds like in her mind your mom is a young mother. Of course she doesn't have adult children -- she is much too young for that! But she does have kids she has to care for, and late afternoon is a busy time. They are coming home from school, she has to start dinner, supervise homework. These memories are all jumbled in her head and it feels very real to her. She is frantic to get going and do her duty.

Many caregivers find that it is most peaceful and most respectful to get into their loved one's reality. Reassure and sooth your mother. Don't try to convince her of your reality (you can see that doesn't work). "It's OK. The kids went to Aunt Doris's this afternoon, so you can have a little break. Next week all the kids will come to your house and give Aunt Doris a break. You get to just relax this afternoon. Let's sit down and have a Coke and look at some magazines." Make up a little story to fit the time when she was a young mother. Where might her children be that they are safe and don't need her right this minute? The goal is to reassure her and relieve her of feeling anxious.

One of Agingcare's experts has just written a short, helpful article about this topic. https://www.agingcare.com/articles/validation-therapy-for-dementia-166707.htm

Has Mother's doctor explained why he or she does not want to try medication? Is Mom seeing a dementia specialist?

Perhaps it would help if you had some in-home help during the late afternoon.
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I would take her to a different doctor. This behavior is stressful to her and to you and is making your life even harder than it is already. Like Jeanne said, tell her whatever you can come up with to reassure her.
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I strongly agree with the above comments. Trying to convince her that her mom has been gone for 30 years and that her kids are all grown up does no good and may agitate her even more. Think about it. If you knew your husband was coming home from work and you had to get dinner on but someone was telling you that your husband's been dead for years that would upset and confuse you. Your mom has her own reality now and to her it's real. Like Jeanne said, it's best to go along with what your mom believes. Be there with her in her reality and then try to problem solve from her vantage point.

Have you tried to redirect your mom before she goes into this state? Anticipating her becoming upset, how about bringing out some photo albums or finding something on tv she may find interesting. If this agitation has become the norm try to break the habit. Is there something she can do to help prepare dinner like set the table? Sometimes redirecting works and sometimes it doesn't.

Bless your mom's heart. In her mind she still has a full day ahead of her. Dinner to prepare, kids to care for, she has to return her mom's call.....If she believes these things that's fine just do what you can to alleviate her agitation.
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As another person said, get advice from a doctor. My grandma with Alzheimer's used to act like this. It's traumatic for everyone, but there's really no way to just convince her that she doesn't need to do this. You can't reason with a person who has lost or is losing their sense of reason.

My mom used to use the posey on my grandmother to keep her from wandering off. It was the only way my mom could go to the bathroom or fix a meal without grandma wandering off, possibly getting lost and/or hurt. It's for her own protection, but she sometimes got quite angry about it. The main thing to do is to find a way to keep her from getting through the area where she could fall and get hurt. A child gate isn't sufficient, because she'll possibly try to step over it and/or pull it out. If she tries to step over it, you can imagine she'll probably trip and get hurt, that way.

I don't know if there's a way you can just take her around the house -- if there's one exit that's safe for her to use, but where you take her for a walk and if that would satisfy it. Or, possibly a quick car ride. In some people, they'll forget why they're going around the house or in the car, so it might be worth trying.
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Mom does this and several remedies were applied to make the behavior manageable.

(1) -- Key-only locks were installed on the outside doors and since then I've worn the key around my neck.

(2) -- The doctor prescribed medication to help with the agitation and anxiety.

(3) -- The local Sheriff's Office loaned us a tracking device which attaches around Mom's ankle. If she gets out, they have equipment to locate her within a range of a mile and a half.

Mom still talks about leaving and going home to her mother's house. Sometimes it works just to change the subject. Otherwise I assure her that she's already home and I want her to stay right here with me. Adding hugs usually helps too.

Good luck and God bless.
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Kat, try not to paint yourself into a corner...you are dealing with a sneaky enemy in this disease. Never say never about anything when it comes to dementia. Flexibility is key to surviving our parent's dementia. You need a different, more flexible, more informed doctor. This suspending phase is awful but in my experience, it passes. Don't allow your mother to suffer this painful agitation, get her medication that will lesson the terror. Start with finding a geriatric psychiatrist. I'm so sorry you and your mom are going through this painful time.
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I would first change doctors. Medication is needed for the elderly when they get confused and agitated. A very small dose of an anti-anxiety medication may give you a break and more importantly it would give your Mums a break from that circuler thinking that she gets stuck in. This phase does end but it is very difficult when you are in the center of it.
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Yes it is Sundowners. I did experience it for 4 years until my loved one had a hospital stay in Nov 13. Since then it' sonly been mentioned twice. I usually can not make head nor tail of what my loved one says but at least she is talking more then she was. At times I can understand her. Especially when she has to potty.
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What is a posey?
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My mom has dementia and luckily, I was in the caregiver field 40 years, so I learned plenty of what I know at work. It still didn't prepare me for having to be the main caregiver for my own mom!

When they are having what seems irrational behavior to leave or see someone who is long gone, it is important to acknowledge their thoughts and feelings, even if we do not understand.

Validate their fears, their sadness, their emotions. Talk about whatever it is they want to talk about, even if you've heard it so many times you could tell it yourself. Commiserate with them, let them know you understand and hug them a lot.

Dementia is a rough thing to go through, but if my mom has to go through it, I am glad I am here to go through it with her.
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Is taking her out for a short drive at that time an option? It may settle her down? Just a thought.
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Your mother is a sundowner. It is dangerous for her if she is trying to wonder outside. I took care of my mother for 12 years and lived with her until her death in 2011. I never regret doing it. There are times when they are confused and when your mother talks about her parents. She really believes they are alive. To tell her different is to make her more agitated. My mother use to wake me up at 2am faithfully asking"when are you going to take me home to see my mother and father". I would reply we will leave in the morning but, we have to get a good night sleep. She would go back to sleep and forget it in the morning. You have good wishes. But, the best for your mother is to see a Geritrician. They will clean up her medicine and if need give her medicine for her behavior it will make a big difference. Regular MD without geriatric training can do more harm than good. They don't have the training. I wish you well!
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Thinking that you may need to put her in an Alzheimer's care center. If you object to moving her there permanently there are centers who do "daycare" on a daily basis. They will know how to handle the sundowners. You might also contact the national Alzheimer's association for suggestions and help. Best of luck and hugs to you on this journey!
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A posey is a restraining device that goes around the waist so the patient cannot get up by themselves.
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Lots of good suggestions. I especially like the suggestions that help distract her.
Have you been in touch with the Alzheimer's Association (www.alz.org). They provide consultation and have the wrist tracking device (medicAlert Safe return) available.
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Change the clocks. She will never know the difference. Drawing a clock with the hands on the face is a test for dementia patients. Ask her to do the same thing every time she thinks she has to go somewhere and then ask her where she has to go. This game will probably go on for awhile, give it a try. Make sure your locks are secure...
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The posey concept scares the crap outta me but maybe it's ok if it's only for a few hours a day, on the other hand, how the heck you gonna put that on someone that isn't medicated? Ferris, doesn't sound like she would think she had time for a game of draw the hands on the clock. But I would change the clocks during that time every day, I suspect she'd come up with something else just as unpleasant to need to do immediately. Does she need fresh air? Can you go outdoors for a few hours before the appointed time to make sure she doesn't feel imprisoned? I commend you intentions and hope to hear more from you. Having similar issues with my father. Not nearly as severe, but it is always traumatizing to the be the caregiver to be accused of not wanting to help when you are knocking yourself out for him/her.
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Never never use a posey. The world is moving from physical restraints. This can be dangerous and result in death. There elders who have chocked themselves and died. We are a society of restraint free. We use medication as needed People should not attempt something they have not researched.
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Time is on the side of the caregiver. You must be more patient with those with dementia. If you find yourself losing control because of the 3 p.m. behaviors, go for a walk. In fact, take your mother. Also, NEVER restrain a dementia patient with ANY device. They might suffer a heart attack from the trauma and unless you have a doctor's order because of combative behaviors you can be charged with elder abuse. Keep waiting and those behaviors will stop when she moves into another phase of the disease.
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I have to agree on the posey thing. NO posey's. I didn't even know they were still around.
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When my grandma would fuss about "have the boys bring in the wood for the night". I finally apologized for not telling her before but the boys brought In The wood and stacked it right by the stove. Every thing is done just like you wanted it. My mother never got gram to give up on "going home" . She even drove her all around the county where she had lived. None were the right one. When they got back to moms house gram wouldn't get out of the car. Mom had to think up a story to get her inside. (like I need your help, the kids will be home soon for supper) My mom takes an anti-anxiety pill and gets really frantic and afraid when she misses a couple doses. She hasn't started trying to leave the AL home yet, and I pray she won't but dr says the dementia will turn to Alzheimer's .
Mom used to tell gram that grandpa was in the barn putting the horses away for the night and that would give her peace for a little while. God bless.
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Have you read about Dr. Helen she is a Geriatric Psychiatrist on this website. You mother is in need of her services.
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my mom does the same thing. and i worked in the field of caregiving for 30 years. i knew it was sundowners when i saw it happening. sometimes it helps to keep alot of lights on, sometimes nothing helps. we have to use medication to calm her down. poseys are seriously old school and i agree that they should not be used. i cant believe they even still make them. anyway good luck, i go thru this every night. winter time is worse. i wish i knew it would be true to tell you it gets better but from my experience it doesnt. learning how to cope with it is something im still workin at. my mom just never gives an inch. when she wants to go i see the thoughts just circling round and round and she just gets more and more agitated. i just try and distract her. your not alone. this is so common.
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A posey is a type of restraint. It can be a vest that ties to the bed or other furniture to allow movement but not allow them to get up and leave. My mom has severe dementia and I have started taking her to a local Senior Center where she spends five hours two or three days a week. It gives me some relief, gives her needed stimulation and she can still live at home and i can run errands and know she is safe.
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