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Mom walked off the property, insisting that someone in an empty building lived there needing help. She didn't want to believe me that there wasn't anyone there. She threatened to hit me. What do I do if she actually does hit me?

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Nancy, You've hit a hard spot. Keep reminding yourself it's the disease and not your mom acting. It sounds like you need a residential memory care facility for both mom's and your safety. Then you can enjoy your time with her and not be the bad guy responsible for keeping her safe when she has a delusion.

My mthr's been in a memory home for 2 years and she loves it - in the morning! By the time her sundowner's has started, about 1PM, she is convinced her white car is right there in the parking lot, and she has to go to a meeting at the school after lunch. The staff do an excellent job redirecting her, and I can visit with her and her friends and just ooze love and enjoy their company. I don't have to be the one explaining that the meeting has been cancelled, her car's in the shop, and that is a rental car she sees that someone's brother hired when he flew in last night. Mind you, there is no car, but it exists in her mind. The staff knows how to deal with this, and I am learning from them.
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Early in his dementia my husband Coy was mad and said he was leaving. He packed a little yellow gym bag and headed for the door. I tried to talk him out of it, of course, but back then I was still trying to reason with him. When he got to the door I told him that if he opened it without keying in the code an alarm would sound and the police would come. He said, "You deal with the police, then. Leaving isn't against the law and I'm outta here!"

Oh dear! I wasn't prepared for that. He did open the door and left. Now what? Do I let the alarm go? In hindsight I probably should have left it on, but I turned it off and followed Coy. I caught up with him and again tried to reason with him. That had no effect, of course. He took a threatening stance and I believe he would have hit me if I'd try to restrain him. Why didn't I grab my cellphone on the way out the door?

Finally I said, "Coy, look at us. I'm standing here in broad daylight in my nightgown in the middle of the street. I am cold, I am embarrassed, and I'm frightened. I am going home. I hope you will come with me." And he did! Perhaps enough time had passed that he was over the strong spell of his delusion.

My point, Nancy, is that that was the only time he ever left the property to "escape." And it was the only time I thought he really might hit me. Some people with dementia leave frequently, and some do become violent. But one instance isn't enough to base major decisions. Take steps to prevent Mom from leaving the property.

Also, as others have said, learn all you can about dementia and how to deal with it. Reasoning doesn't help. Join a caregivers support group. Read. Watch online videos. Keep coming here. Life is so much better once you get into the groove of dealing with the dementia effectively.
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Nancy, you need to learn more about sundowning in order to understand and anticipate your mother's increasing violence. My mom had it really bad. She definitely became very angry and attacked us kids. Dad had to put several locks on each of the doors because mom had this habit of leaving the house after dark, and we spent hours on the road looking for her. The doctor did prescribe meds for this but dad refused to give it to her.

If you click on this link, it will take you to Sundowning here on AC. The other link is another info on it. You can also do your own research here on this site by typing 'Sundowning' on the top right page of your screen.

You can also go to YouTube and see examples of the different people sundowning. And even tips on how to handle it.

https://www.agingcare.com/articles/sundowners-syndrome-133187.htm

https://www.agingcare.com/questions/dads-sundowners-under-control-168107.htm
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my Dementia Dad wanders a lot, escaping fires or monsters or trying to take his "girlfriend" home. He socked me in the jaw the other day and that was it. I was done. Called my brother said Dad's outside I'm not there, come help him. The CRAZY thing was... my brother CAME!!! actually came over and helped dad in the house. of course Dad was all sweet and wonderful to him and saying how I was sneaking around the house smoking and lit the bathroom on fire. I've never smoked a day in my life, my brother found that hilarious but he said he does believe me now about the violence, my jaw was red and swollen so maybe that gave it away? anyway.... locking deadbolts and keeping the key around your neck is awesome! Good luck to you!
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You say, "Ow!"

Sounds like you're not accustomed to your mom's dementia. If your mom IS a violent type person, that's a whole new dimension added to your caregiving. You'll have to decide if you want to continue caring for her if that's the case.

I think the "issue" probably started with her actually leaving though. Perhaps you can make your home more elopement-proof so she can't get out the door. Double-bolt locks with you holding the key will go a long way.

Seriously, though, we can't be expected to care for someone who may act out violently. You may have to make other arrangements.
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It's her first time walking off. We are in the habit of leaving doors open for the cool air and sunshine. I will need to discuss the locks with family. Having that kind of lock would help & also allow us to sleep peacefully. She wouldn't be able to leave in the middle of the night.
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What is sundowners?
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Nancy, I would be more concerned about you walking off than her becoming violent. Perhaps alarms on the doors if they are opened.
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