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My mother has been doing a rhythmic moaning usually in the evening but occasionally during the day as well. Is she in pain? Or is this a form of 'sundowning'? Also I've been told that caffeine could make it worse is that true? She also recently starting babbling a little at night and moving her hands around almost like she is conducting an orchestra, occasionally holding one hand out to someone/something she sees? Any recommendations? We ask her if she is in pain and she always says no but I wonder if she even knows herself? Thanks

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Your mother is in the last stages of Alzheimer's. She lives in a world of fantasy of her own that you will never understand.
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This is a guess, but it could be self-soothing behavior, much like rocking back and forth. Did she do a lot with her hands when she was well, or did she enjoy dancing? Those hand movements could feel pleasant to her, like she's dancing around the room or performing a job. In fact, I was watching a video of the choir concert at my mother's current AL, and there was a lady in a wheelchair who was moving a hand back and forth in a graceful way while she (sort of) sang. I'm sure it was unconscious on her part. Using ones vocal cords can also be comforting. Think about when you sigh heavily and vocalize a sound with it. It helps alleviate stress (at least, it does for me).


I suspect it's not something to worry about and just part of your mom's journey, but ... what do I know. Just a thought.
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My mom would always say no if anyone asked if she had any pain, but if I went down a list - do your knees hurt? headache? backache? etc - she often answered yes.
That said the "moaning" could be just random vocalization about nothing at all,; the lady across the hall from my mom made rhythmic sounds all day long (I called it singing although there was no melody), my mom would repeat a phrase when she was agitated, and anyone who has ever visited a nursing home has probably heard the constant plea for "nurse! nurse!" "help! help" or "I need to go to the washroom" from some people.
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