My mom has Alzheimer's and is tired early in the evening. She's started going to bed too early ( sometimes right after dinner ). Her 24 hour care person wakes up to find her up and preparing for the day as early as 2 am. She often is showering which is dangerous as her balance is poor.

Any advice?

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I had a similar problem with my aunt when the time changed. She would get up and start drinking coffee with sweetener very early. When her aide arrived at 8 to give her meds (one of which had to be on an empty stomach) she had been up drinking sweet coffee several hours. ( I knew because of cameras)
So, to solve the problem as it related to the pill, we removed the sweetener. She was already on decaf. She lost interest in 2 am coffee, adjusted to the time and now is back sleeping all night. This was in about a week. So it hadn’t gone on too long.

If I were you, I would turn the water off to the shower if possible. You might have to have a plumber help you figure it out so her caretaker can turn it off and on as needed. I know you want her sleep straight not her shower broken but if a morning shower is her habit, she might find it difficult to go back to sleep afterwards.

Look up Dr Breus “The Sleep Doctor”. He has hints on how to adjust sleep patterns and much more.

If you think caffine is a problem, you can adjust it slowly. My aunt already drank half caffeine. We simply mixed decaf in the same can as the half c. We adjusted it slowly. For awhile now, she is on total decaf.
Coffee is good because of the antioxidants which is in both caffeine and decaf versions.
But caffeine is a diuretic. I can’t get enough water in aunt so we switched to decaf only. She’s probably been drinking coffee for 90 of her 92 years so she’s not going to quit willingly.
There is still some caffeine in decaf but not nearly as much.
Having said all that, I saw a segment on tv about afternoon napping and how an early short nap is refreshing and could help you acheive that later bedtime. The trick is to drink a cup of coffee early afternoon right before the nap. You will still fall asleep but can awaken easily in 15 min or so as the coffee has kicked in. I think this was on Dr Oz if you wanted to check the details.

About the balance, PT helps with that. Ask her doctor for a prescription. They can come to her home depending on her insurance. The exercise is also good to help keep her awake during the day and sleep well at night.
Let us know how you solve the problem.
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Why is her 24-hour caregiver allowing your mom to shower at 2am? Is the caregiver working on getting your mom on a more normal schedule? A shower in the morning might help (as opposed to 2am). Or one at night after dinner.

Trying having dinner a little later. Don't let your mom take a long nap during the day. Cut out all caffeine. Try to keep her stimulated by reading aloud to her or playing a game with her, doing a puzzle with her, any kind of activity that might get in the way of sleeping during the day.

It'll be challenging. Getting days and nights straightened out can be difficult for anyone. It will be a process.
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