How to keep mom from trying to elope care home during sundowner episodes?

My mother doesn't sundown per se, but she gets bent that her imaginary husband isn't home yet. I tell her he's working late, or he's on his way home and will be back by 5 p.m.

Arguing with her is pointless. Just answer her questions with a plausible answer, and move on to a different topic. Her caregiver should know that.

Sundowners is awful. My MIL has it. We had to remove her from memory care because of her falls and she broke her hip. They just did not watch her enough for us. She is 99 and now with us. The sundowners is terrible. We got hospice involved and after 10 days have it mostly under control. Melatonin did not work. We have to give her Seroquil 75 mg. for sleeping. We start her off with it right after dinner. She gets her meds and just before bed we give her .05 ml of Morphine. This settles her and keeps pain away and keeps her diaper on till she falls asleep. She would be up all night Try to undress and try to walk even with a broken hip. I slept in the room for 10 days and neither of us got any sleep. Being an advocate at home with her has been the best bet for us and her.
nothing is easy now especially with Covid and trying to help figure things out. Try hospice (Trustbridge) in Florida to see if she will qualify for their services. They have been a godsend for us.

Don't argue or try to convince her of anything - it won't hit home. If she is in a place, let them deal with her and you just ignore her during these episodes - get up and leave or distract her, etc. But temporarily don't visit her too often - until the staff gets a handle on it. Stay int he background.

Naia,
I'm just curious if the staff has tried gently reminding her that her husband has passed away all those years ago?
I know it's extremely hard, however, it may stop her behavior for the evening. She will of course do the same thing the next night, because she won't recall the conversation from the night before.
My Aunt packs up her belongings almost every day to go home.
On the days that I call her, when she tells me that she's going home tomorrow, I gently remind her that she is in her new home.
I am told by the staff of her memory care that it seems to help for that particular evening.
In the beginning I tried the "therapeutic fibbing " and distraction. And I still believe they are valuable tools, but in my Aunts case nothing except the truth made her waiver from wanting to go home.
((((Hugs)))) and prayers to you!

Naia, this sounds just like my dad except he was looking for his car. Sadly this went on with dad from day one of assisted living And lasted for about 2 years.

He was spry too like you’re mom. He’d just pop up and head out quick as a bunny.

There is no easy answer. Dad has just recently calmed down due to his dementia increasing and his mobility decreasing. He’s been in two facilities and they were both very good at redirecting but he was a tough case.

You mom may be ready for memory care that is locked down. Sounds horrible but she’s gotta be safe.

My dad was fine in memory care. He wander to one door, take about an hour to meander to the other end, chat with other residents and aides then go try again.

He had no short term memory at this point but driving, well that’s long term, something he did for 70 years.

The day care is doing a great job. The "fanticy" is part of what the caregiver hears. All that "good stuff" never leaves her mind. Her care has been working for 3 years. Her fantisy world is "posative."

Thank you all for your input & kind thoughts. Many great suggestions. My mom's intense urges to literally leave the private Care Home (not ALF) causes her to get physically violent with them. CG has bruises. Nothing seems to work to change her train of thought, she's able to somehow figure out they're trying to keep her from "going home".
Alarms don't work & she breaks the indoor locks cause she's so strong.
The outside gate to the street is locked at nite, so she can't open it but it doesn't stop her from trying.
The evening car rides are to help possibly calm her before returning, hoping she'll forget about leaving. The CG & husband are extremely wonderful & patient. Mom used to help around the care home, but not interested now. CG recently gave a doll which mom sleeps with, but still not enough to distract her from leaving..yet. Her sundowner's goes from early afternoon and can last till midnight even after all meds given. Not sure if her high anxiety prevents meds from metabolizing? My main concern is safety both for mom and caregivers, as I believe she's a danger to herself & others. We did discuss moving mom, but b/c behaviors not under control Dr.s nurse feels it would be harder on mom, and finding a place to accept her would be difficult. All mom's income goes to CG, which thankfully, is way below the starting rate here in Hawaii of $4500. Mom doesn't qualify for Medicaid yet.

Have you ever watched the movie Rain man?
I think it is you that needs the adjustment.

In your mother's mind she is doing what she has Faithfully done for year's for her husband.

She is your Mother, NO Doubt! But since she has fallen ill. She hasn't been like Mom.
I think that you need to seek help and educating yourself on this matter.
Maybe one day soon you will learn how to connect to the person standing in front of you.

God bless and Best Wishes
Life is not fair.

Elope?

Melatonin not for sleep!!!! It will calm down sundowners when I give it to my husband

MELATONIN

Imho, there is no reasoning with someone with a broken brain. Prayers sent.

Your mother's words & behaviors are very common with dementia/ALZ. What's not so common is for a care giver in a care home to take a resident out for a ride in the car...........? I've never heard of such a thing and I've been involved with quite a few ALFs over the years.

If your mother is not in a locked down Memory Care facility and has access to getting out of there, that's a problem that needs to be fixed immediately. If she's already in a locked down facility, then she cannot get out and 'go home', so you have nothing to worry about. If you feel that her anxiety is too high at this point, her doctor may be able to prescribe a stronger sedative to keep her calmer. But even so, the 'wanting to go home' scenario is very common with dementia. You may try getting her a baby doll with a blanket to swaddle it in; many, many times, caring for a baby gives the resident something useful to focus on and takes away the anxiety of wanting to go home to fix her husband dinner. She'll have another important duty to be involved with instead, you know?

Best of luck!

Does Mom actually have access to leave? If not, this is just a rut her mind got stuck in due to combo old routines in her mind and her current dementia. Just let her say it, as long as there is no danger of her actually leaving. I doubt you will change the habit if distractions and such haven't changed it yet.

If she was living in a locked memory care home you would not need to worry. If not she could sneak out at anytime and it would be a terrible danger. She will continue to try and leave. This is the world she lives in now.

My Dad was in a home before he passed, and he liked to roam the streets. (He was born with a roaming gene! LOL) The nurses took his shoes away and he'd wander around the facility looking for them. They fortunately "found them" when he was due to go out for some reason. It did stop him from wandering around dark, rainy streets. They also allowed him to push a dust mop around and be helpful.

My mom had this and I found some technology equipment that helped me with her. I had an alarm for her bed or wherever she sat. I also had an alarm that attached to her clothes to her walk or seat. She was prone to falls and this is the only way I could keep up with her without being with her continually. We had to put a bell (for business doors) on the door so we knew when she was coming out of her room. Check out Assistive Technology Services https://www.assistivetechnologyservices.com/
this is where I bought most of my equipment.

There is a big difference in talking about leaving and actually leaving. If she needs to go through the discussion about leaving, ok let her talk.
But if she is actually working hard to sneak out, that's another problem involving her safety. Make sure the facility is secure and she can't leave it.

Sundowners is the worst. What I found was that when it starts (or even before hand) turn on bright or brighter lights in her room. Ask the ALF caregivers if when they do their check on her they make sure the lights are on. They don't have to discuss this with her just do it. Mom would be at her worst on cloudy, darker days, or at Sun Down. The lights helped, but mostly just talking with her letting her express herself and when possible just sitting with her a while helped too.

Good luck, this is something that will not really just "go away" and adjusting or different meds did not actually change the events.

Is there anywhere your father would have eaten without your mom? Would he go out with the guys or have work dinners? At this point, it seems that calming her is more important than reorienting her so I would find a plausible scenario of why he’s not eating at home tonight (every night).

Maybe let her help with meal prep or setting table for other residents. Have them explain that there is a big dinner that they need her help for and that she must have forgotten that she was invited and responded "yes" to invitation. It's a little bit of a fib but every dinner is a "big dinner" when it's more than 2 people. She has been invited to have dinner every night since she is a resident. If she is involved in the preparation, it might get her through this confusing time of day.

I echo what Isthisrealyreal has said. Have them give her a task to do.
While she may not be allowed in the kitchen (depending on health department regulations) they could have her set the table, do some early prepping like scrubbing potatoes, peeling potatoes, measuring some ingredients.

Have they tried letting her help prepare dinner at the care home? Perhaps she could help do prep work or make salads and be told that she is eating here tonight and her husband has a dinner meeting and won't be eating at home tonight.

I think that having a "job" is so helpful when they are compulsively focused on doing something, give them something to do.

Sounds like the care home is doing the right things. What your poor mom is going through is reality in her mind. You can’t change it. You just have to keep her safe and do it again the next day. One day she will decline and stop doing this behavior and then you will miss it.