How do you handle an 81 year old that roams at night?

"Holding on to the wall" is a recipe for disaster. Hire a night nurse or amend this situation.

Now that she is wandering at night, she shouldn't be alone. Like the other suggestions below, get her help at night to watch her, get her sleep aids to help her stay asleep. My mom is a wanderer at night and sometimes during the day. I have motion detectors in the hallway, that rings in our bedroom so I know if she is going somewhere she shouldn't. I also have locks on the doors that she cannot open to get out. I have bells on her walker so I know she is up walking about. If she walks without her walker maybe putting a ring of bells around her ankle that she cannot take off at night so you are alerted when she is on the move. I usually am a light sleeper so any kind of noise I usually get up. A bed alert that lets you know when she gets off the bed. Mom doesn't wander every night, just maybe once or twice a month. Depends what is going on in her mind at the time. She always says she has to catch the boat, bus, or go home. She has also accused me of kidnapping her and keeping her prisoner when she gets angry because she cannot get out. During the day, I lock the gate so she cannot get out. She can be outside, but she cannot go anywhere. I was losing a lot of sleep in the beginning of her wanderings, but now it is ok. Take care of yourself, get enough rest. Hugs and prayers to you.

So, it sounds like at this point wandering OUTside the house isn't an issue, but needs to be contemplated maybe just in case?  And the primary issues seem to be your fear of her falling (assuming when she walks using the walker she is safe and can manage).  I'd wonder how long she's up for and when she goes back to sleep. 

So for safety, maybe the installation of some handrails in the hallways (holes can always be filled in later).  Making sure you have the door locked as best you can, even if you use a hook/eye type closure higher up that won't require a key to be found in an emergency.  Also check with your local fire dept about installing a lock/knox box outside so they can gain access quickly.  There are some posters out there that cover doors and look like a filled bookcase so it masks the exit...

Alleviate any fire/heat sources like pulling knobs, covering outlets with childproof covers.  We just had an electrician out this AM who suggested an idea for our toaster oven, the only appliance without a child safe mode...he's going to run a heavy duty surge protector cord from an outlet that is childproof into a cupboard where the surge protector will reside, and then we will most likely get a lock for the cupboard...and I will have to remember to turn it off before I leave for work (Dad is home with her most of the time). 

But it sounds like a big issue...and it is...because so many demands are made of us and we can't function without sleep...is your disrupted sleep.  Worrying that you might not hear her, there may be a fall.  Falls happen even in assisted living and nursing homes.  Sometimes a bone breaks first...and THAT causes a fall.  So don't feel guilty if it does happen.  But I agree with the others, if you can afford it, to get someone who spends the night and stands guard...at least a couple times a week. 

In our case my mom has not wandered prior, she just wanders in the house and makes her rounds on the lower level, eventually sitting  down to read.  I suspect it's related to sundowning or boredom though we can't get her easily to cooperate for going out to any programs unless SHE wants.  The good thing, though not in the moment, is that my pup is very protective/guarding, so in order for mom to go down, she has to pass our door, and nobody can go past in either direction without my pup knowing and woofing.  Sometimes it seems the only way for me to get adequate sleep is to doze when mom does...

Sundowners is correct & characteristic to her condition.
Same situation for my mother. Up at night, etc. Mother was with us for three weeks until this same situation developed, but along with other out of normal behaviors.
For you at this juncture... It's all ok considering, but her safety, physically & medically is of utmost priority.
It's time for a good thorough medical eval with a good geriatric doctor to see exactly what stage she is, meds adjustments if needed, etc. Also, as hard as it may be, look into an assisted living with memory care arrangement. My mother has been in AL for almost four years doing well even though her condition has significantly progressed.
I'm sure you would desire the best quality of life for her. It's hard on us because we love them, but we need to be at best for them when we are with them. Caregiving 24/7
will take a great toll on you.
Blessings

My mum too. How about buying a guard rail for the bed? I just checked and they cost about $30.
We also use LifeLine which is a medic alert system. It involves having a "box" (smaller than a shoebox) and a pendant. She needs to wear the pendant constantly though, so it might not be suitable for you. If she's wearing it, her position can be found.

Oh, no, that's hard on her and on you. I'm afraid it's time to move on it, and do hope your doors are locked for her benefit.

My Gramps in 1978 left the house at 3 a.m. on several occasions in the small town he and Gran lived in. The police knew him well because he'd lived there since 1936 and they brought him back each time from downtown to the great distress of everybody but him. The sitch never progressed to an AL decision because he developed pneumonia and died in hospital a few months later. His wandering could have been terrible for him and anyone who struck him with their car, etc. Best of luck to you in this trying time.

This is a sign that your mom needs 24/7 care. I didn't realize how bad my mom's dementia was until I had a State Trooper knocking at my door at 7AM on an October Sunday morning canvassing the neighborhood to find out where she lived. When I thought she was tucked into bed, she had snuck out a couple of hours earlier, carrying a bucket with 3 pairs of reading glasses, a box of crackers, her scandal magazines, and her pajama top. She did not, however, take any ID nor her cane. She fell on the side of the road in front of a neighbor's barn and lay rolling in the wet grass trying to get up until a nurse coming home from a night shift found her and called 911.

Ironically the lawn on which she was lying was that of an elderly woman whose husband had also had dementia. A couple of years before, he had slipped out overnight while she was sleeping. The State Police, the fire department and the neighbors looked for him all over the area that day and into the next. They finally found him in a nearby creek clutching his bed pillow. He had died from hypothermia. He had never before showed signs of exit seeking or wandering.

Your mom might start wandering outside and be lost or hurt. Please get her into a facility or hire an overnight caretaker. You'd feel awful if something happened to her.

My dad also has dementia and Sundowners and was doing the same thing.

I have been in Healthcare for a long time...Time to Get Mom a Caregiver or Put her in a Safer Environment...Bottom Line.

Please do not give your mom sleeping pills - they will aggravate her dementia and could lead to psychosis. Ask her neurologist for advice.

To prevent her from leaving the house, install a lock on all doors that requires a key to lock and open. You can remove the key each time you lock the door. A warning though: this is a safety violation because if there is a fire and you cannot find the key ... uh oh! So, keep several copies around the house where she cannot find them.

Lastly, if you have the money, hire a night caregiver to keep an eye on your mother while you sleep. Caregivers usually work a min of 4 hrs, so that works well because you need 8 of hrs of sleep.

Good luck!

This is a crisis waiting to happen. She is displaying a behavior known as "sundowning". It is a common behavior with people diagnosed with Alzheimer's disease and can be dangerous bc they can potentially wander outside or even trip and fall within the home. There are two types of sundowners...those who wander with purpose "I have to go to work..." and those who wander without purpose "shuffle around with loss of facial affect, garbled sounds".
Any wandering is dangerous and should be addressed immediately before something bad happens.
I am a dementia educator and I see this so often. The sad reality is that families feel so much guilt even thinking of placing their loved one that ultimately they wait too long and the inevitable happens.
I hope you find strength and do what is safe for mom. You know the answer...its just saying it aloud and not thinking you are a bad person. Good luck.

I think this is pretty common. When pops wanders at night one of us just follows to make sure he's safe. I sleep on a cot or couch just outside his room so I will wake when he opens his door. He wanders less now that he is taking Melatonin Ultra before bed.

Do you live with her? She is in definite danger from the roaming w/o the walker. She could go outside and roam 'away'.

I think we need a little more information. She may need a mild sleep aid to help her stay asleep. Try keeping her awake more of the day so she is tired at night. Probably a good time for a checkup with her PCP to see what can be done.

Dementia is a whole other animal--she isn't aware what's she's doing and so there's no point in reminding or scolding--they simply don't remember.

My granddad was a daytime roamer--and the street they lived on --all the houses were the same. He'd wander away and some neighbor would walk him back home. Poor grandma. She was always chasing him down. He, however, did not need a walker or cane. He walked MILES during the day.

Sorry I'm not much help--other than thinking something for sleep may help. Melatonin works for a lot of elderly people--but do talk to the dr.

You're right--she cannot stay by herself!