My mom has been in an alzheimer assisted living facitlity for about 5 months. At first we took her out for car rides or eating out but she would get very confused and anxious when we returned to the facility. She has been asking to go for a car ride (which she used to love to do) but we are concerned that returning her to the facility afterwards causes her too much fear and anxiety. What should I do?

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One additional thought -- does your Mom have a time of day that is better for her? My Mom is fine during the day but starts to get anxious later in the afternoon and evening. We have no problem taking her out in the morning or early afternoon but I wouldn't even try to take her out of the AL in the latter part of the day.
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It is very common for people with dementias or AD to become more confused with anything that resembles a change of scenery, or with any events that are stressful.
No matter how much she used to love going out for a drive,
at some point, it is sensible to stop that,
using how upset, & when/where she gets upset, during or after the trip, & how long that stress lasts, as a guide.

Linderlou has it right.
If any part of a trip causes distress, it is time to stop those trips, and bring entertainment to her where she is--pictures from outside, music she liked, etc.
[one family we know, took Thanksgiving dinner to the AD home where Dad was living, instead of bringing him home--too much stress...visits went great as long as they stayed where he was familiar]

You could test how stressed moving around has gotten, by taking her for a walk just through the rest of the facility, or into the garden nearby, for instance...if that causes distress too, then roaming farther than the familiar hallway or whatever, near her room, is her limit.
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How much pleasure does she get from the outings? Does it give her a bright spot in her day? Does it help her feel loved that you are willing to do this for her? Does she get excited like a little kid promised a pony ride?

How is she while she is on the outing? Does she continue to enjoy the experience? Does she get anxious, nervous, or fretful? Does she start saying "I want to go home immediately?

When you return, how severe is her anxiety? Is her level of confusion a little worse than usual or extremely worse? How long does this last?

Dementia behaviors vary considerably from one person to the next, and also change over time. I think you need to consider the answers to all the questions above and then decide whether the benefits of the outing are stronger than the costs in confusion and anxiety. And re-evaluate the questions before each outing, as things might change.

There are benefits to a fixed routine. There are benefits to some stimulation. Which benefits are stronger depend on the individual, the stage of the dementia, and even the kind of dementia. I know that saying "it depends" is not much help, but in this as in many aspects of your relationship with Mom, you need to observe closely and then trust your own judgment.

Good luck!
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I have my 89 year old mother and 93 year old mother-in-law in an assisted living facility. They have lived there for going on 4 years now. For the past year, we have quit taking them out because upon returning them, they woud both exhibit signs of stress....confusion and difficult behavior. My mother would refuse to get out of the car and would insist she didn't live there. We would have to go in and get an aide to help us remove her from the car using distraction. My mother-in-law would get out of the car, but be confused and then anxious as to whether or not this was her home once in her room. It would take about a half hour to bring her around. I feel bad that we can never take them out, but feel it is in their best interest not to stress them. At this point they require the comfort of a daily routine. I have even switched their physicians to a practice that makes house calls, thereby alleviating that same problem when taking then for required doctor appointments. This has worked out well. They both seem happy in their surroundings. The assisted living does plan for outside cookouts from time to time, as well as other simple activities suited to their coping abilities. Hope this helps.
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