How to stop nocturnal wandering?

Sounds like memory care is the next step.

Meds can maybe help with the anxiety that keeps her up, but there’s no way to truly stop it or talk her into staying in her room.

Evaluate her evening behavior, including what she eats and when.   While it may not be the cause of her nocturnal activity, it could be keeping her awake, especially if she's consuming sugary foods or coffee.  

Turkey contains tryptophan which can contribute to sleepiness (think of all the people who nap after a Thanksgiving dinner!).   A bit of turkey at night might help allay the overnight activity.

This is dangerous for her. My aunt, having wandering issues due to her Alzheimer’s, left her completely secured home during the night, wandered throughout her neighborhood with her jewelry box, and distributed the contents in many places, one of which was a ditch. This was after the family had secure locks put on every door and window, my aunt couldn’t tell your name but managed this escape. Don’t think you wouldn’t sleep through such an episode. No one especially wants memory care for their loved one, but a safe environment with eyes on a person around the clock is invaluable. Not to mention your own health and rest

Wandering is a serious safety concern and one of the major reasons a caregiver will place their LO in care facility. Daughterof1930's story of her aunt's wandering is a familiar one. My wife's first experience was leaving the house at 2 AM on a cold, snowy winter morning. I found her by following her footprints. After that I secured the doors, but that didn't deter her, the next time she went out the window. Even after securing the windows also, I still “slept” with one eye open. Reason number two for placement; caregiver is exhausted and sleep deprived.

So I, too, was not only frightened by my wife's wandering episodes, I finally decided that I couldn't safely care for her anymore and started looking for an MC facility.

Your MIL's wandering throughout the house is, in itself, a safety issue, especially when the family is asleep. Her next step could be leaving the house during the late hours. As Daughterof1930 has mentioned, and to which I can attest, those with dementia can be very resourceful, and securing both the doors and the windows can present a significant fire hazard. If needed, this should only be a temporary solution while you look for a care facility.

Wandering can occur for many reasons including just wanting to get out, or being confused where they are. It may occur as the result of a delusion that the person is experiencing. On one occasion, I found my wife a few blocks from home with a pad of paper and pencil. She was making sure all the kids were safely on the bus (she was a teacher).

So your MIL's change in behavior is significant and dangerous. Time to consider an MC facility.

I know there are alarms you can put on her door (check Amazon) that will alert you when she’s up and about. Maybe you can put her back to bed in time?

The other thing is that it doesn’t seem she’s going into a deep REM sleep. Like her internal clock is messed up. Perhaps speaking to her doctor about her taking a GRAVOL before bedtime. They’re very safe, as even pregnant women can take them. She more than likely just needs a bit of help going into a deep sleep.

Unfortunately giving your MIL information such as we have an alarm clock doesn't help her; her brain just can't process the information. While the doors are alarmed you should be concerned about wandering into the kitchen and turning on the stove top starting a fire.

AD disease may be messing with her internal clock - especially since she dresses for the day. It will be like having an infant in the home. You should consider having an in-home aide during the night or look into MC for your mother. While it something you and hubby may not want to consider - MC is staffed 24/7/365 and are trained to handle nocturnal wanderings.

Good luck to all of you and be safe.

There are 2 options and only 1 is fool-proof.
1 - Talk to her doctor about a sleep medication since has problems staying asleep at night. Make sure she doesn't get more than 30 minute naps during the day. This one might work.

2 - Professional help. Hire a sitter to stay in your mother's room with her throughout the "sleep hours" and to redirect her to bed as often as needed. The only fool-proof version of "professional help" is admit that your MIL has reached the point where she needs 24/7 care in a memory care unit. Find her placement so the rest of the family can get a good night's sleep.

Sadly, time for placement.

There's really not a lot you can do.

Lock her bedroom door at night and ignore her pounding on it and hope she quiets down.

Give her sleeping medication at night that will keep her from getting up.

Placement in an AL, memory care, or nursing home.

Have you tried a black mat? Some people say that it works for their loved ones as they think the black mat is a hole in the floor.
I’m sorry you are having this problem,

You say “when I get up to get my day started, I have to be as quiet as a mouse”, because she’s finally going to sleep. Instead, make enough noise to keep her awake. She won’t sleep at night if she’s getting enough sleep in the day. Earplugs for you will help cope with the grunting. Don’t provide much liquid in the evening, so that she isn’t waking to go to the toilet.

As Taarna and Liz have said, ask the doctor about sleeping tablets. They are usually addictive, but many nursing homes (and hospitals) dole them out as standard. Addiction for the elderly is not going to lead them into an abuse culture, it's not the worst thing in the world. For me, Garden Artist’s turkey would keep me awake with indigestion! The black mat might be worth a try, perhaps just outside her door. If the kitchen is dangerous, get a lock. A bolt or hook-and-eye catch at the top of the door out of sight might work, and would be easier to fit than a lock. Don’t let her watch it being fitted, keep it a secret.

Sympathy, and good luck..

We have used melatonin with some success. It doesn't keep MIL asleep all night, but she is sleeping longer than the two-hours she used to. It also keeps her from wandering the house as much. She sticks closer to her bedroom, now.

When people are placed in memory care or nursing home, one medication that is often started is Trazadone, a prescription anti-depressant that is quite sedating and helps with sleeping through the night, but it doesn't work or suit everyone. Melatonin is an over-the-counter, safe option. However, nighttime wandering is very common with dementia. As others have said, this potentially dangerous behavior sounds like your MIL is ready for a night caregiver or placement, but talk with her physician, especially a geriatrician or neurologist who deals with Alzheimer's.

They had my mom on trazodone but that only seems to make her drowsy, not keep her asleep all night. They have to be careful how heavy a sedative is for fear of elderly people falling so I doubt you can get/give her something that will keep her asleep thru the night...just my experience. My mom took it nightly at 8 and still got up unaware of the time all night.

I am dealing with the same thing with my 90 year old mom. She also would pound loudly if I lock our bedroom door.This form of dementia is called Sundowners. If my mom isn’t wandering around, she will yell in her bedroom or mess around with her TV. Turn on & off, raise the volume up & down.(@ night I remove the remote control) For peace of mind I have tied bells on every door. My hubby installed extra locks ( up higher) on the doors that lead to outside. We had to block off the kitchen area as my mom would open all drawers, cupboards,raid the fridge & the pantry. It’s very overwhelming. My sleep pattern is a mess.I have anxiety 😥 *my nerves are shot*. My poor husband, for his job he wakes up @ 3:30 am, works from 5 am to 5 pm. I try to be the one that is on alert-so he can get some sleep. With her age & dementia; her primary doctor will not prescribe any sleep aide medication. Melatonin is all he recommended. He approved that she can take up to 50 mg a night. To my mom melatonin is like skittles or candy -it does not make her drowsy or fall asleep. Her social worker has suggested to keep her awake & give her actives during the day. So hopefully she will be exhausted by bedtime. I’m grateful for 1 out of 7 nights that she does not wander around & does sleep. I suggest talk with her doctor, maybe can get a sleep aide medication prescribed . Or at least try giving melatonin. I buy Nature’s Bounty- the 3 in one kind. It’s alittle more expensive but it has additional supplements in one pill. Wish peace and happiness for us caregivers. Stay safe 🤗🐞

Some information & suggestions( to help with) on Sundowners::::

Keep them active
Many people who experience sundowning syndrome have trouble sleeping at night. In turn, fatigue is a common trigger of sundowning. This can create a vicious cycle.
Too much daytime dozing and inactivity can make it harder for your loved one to fall asleep at bedtime. To promote a good night’s sleep, help them stay active during the day. For example, go for a walk together or clear some space to dance. This might help improve their sleep quality and reduce their sundowning symptoms. It can also help them enjoy better physical health.

Late afternoon and early evening can be difficult for some people with Alzheimer’s disease. They may experience sundowning—restlessness, agitation, irritability, or confusion that can begin or worsen as daylight begins to fade—often just when tired caregivers need a break.
Sundowning can continue into the late night, making it hard for people with Alzheimer’s to fall asleep and stay in bed. As a result, they and their caregivers may have trouble getting enough sleep and functioning well during the day.

My mom's sundowning was totally controlled by exercising her every day--I walked her every day in the park for five years, and keeping her up all day. She ended up having to get a specialized upright walker but it kept her going. She slept all night. I only had rare occasions she would get up but it generally was to go to the bathroom. Oh and be sure to toilet her before bedtime. I had a floor mat alarm it would go off if she got up and put her feet on it.

IF she sleeps during the day she WILL wander at night. Short naps during the day are okay but don't let her sleep for any length of time. Keep her going! I also took her out during the daytime whether in the mall or just another stroll outside.

I gave mum coffee in the morning which helped get her going for her morning exercises and moved her bowels! In the afternoon she loved Mountain Dew sugar free (she was insulin dependent diabetic). That kept her up during the afternoon. Ironically it was caffeine that prevented sundowning. And exercise. My mom never had a single narcotic or psychotropic, and she lived to be 90 years even with insulin-dependent diabetes and had end-stage Alzheimer's. She was bedridden for 2-1/2 months. only because she could no longer focus how to stand or walk. Her daily walks improved the quality and quantity of her life. She loved her routines. And yes mom was on hospice for 2 years.

NO caffeine after 3 pm!

Gosh I went through this and it made me feel like a zombie. My mother would walk around the house starting at midnight up to the early morning hours. Yes, we locked some cabinets too, but that doesn’t stop her from rummaging or rearranging through everything. When she was still strong enough to walk around, we stopped her when we were able to catch her and were extra vigilant with the doors and crucial stuff like the stove or faucets. But when she started falling, that was when things became more hairy. She would still try to hobble along to the bathroom and there would be mornings when I would find her on her bedroom floor. I was running ragged and going insane trying to watch over her 24/7, so I had to take her to a nursing home.

Tiring her during the day while she's still strong enough to do activities might help, as posters here have suggested. I'm not sure about the medications, you will have to discuss that with her doctor.

If you can have aides watch her at night so that you can get some rest, that would be a great help. Take any measures you can to get sleep and rest, or you will not be much help to her, and that doesn’t help the situation any. Dealing with sundowning is very hard for caregivers. Loving and healing energies to you.

NO, you face the facts. Check with doctors about sleeping pills or something to make her sleep. Second, consider a caretaker for the night time. Or, with dementia, and the negative impacts on YOUR life, you must consider placing her. This would be intolerable to me and you won't be able to stop her.

SeaMar: Imho, perhaps it's time to relocate your MIL to facility living, as her Alzheimer's disease may now be beyond your scope of abilities. Do not wait until her disease progresses even further, e.g. think falls, et al.

Unfortunately there is nothing that can be done. No drug will keep her asleep overnight, that is the reality of Alzheimer’s. My dad is at an assisted living and 4:30am you will see him getting up, getting dressed and goes walking the hallways, or to the facility’s restaurant, or the fitness center. The CNA’s often finds him asleep in chairs, couches around the facility, they actually found him asleep in the fitness center on the exercise bike. 😅

There is no reasoning with him, you take him back to his apartment, he either throws a fit or comes right back out.

Giving her sleeping pills will only increase the potential for her to fall. Many here suggested either a night caregiver of a facility which is better equipped to handle what comes next.

Best wishes

Can you baby gate off your area or her area? I use high-backed bar stools to provide a visual barrier into the living room/kitchen area. She has her "wing" - her bedroom, bathroom and the guest bedroom. She clearly mucks about during the night (has shoes, jewelry on in bed in the morning and goes to the toilet) but doesn't try to get past that barrier and it's easy to move in case of emergency.

The doc has us give my mom melatonin, and anxiety ( low dose ) at dinner time in her meal as she has a hard time swallowing pills. This will work most of the time. We have a door alarm that when open it alerts my cell phone if she gets up. We also have a baby monitor that I look at throughout the night for at time she will get up n walk around the bed, making it up n rearranging her pictures n clothes. I go in after a while n put her in bed. Sometimes I think she forgets how to get back in bed. Then she sleeps longer in the morning.

For sundowning, I tried to make sure that I took my mom out for a walk every evening. I tried to keep her awake during the daytime.

It worked for awhile . . .

My Mom is 102 and is still at home, is very frail but still ambulatory with a walker. The four siblings (all in our 60's and 70's) in our family have been staying with her, rotating weekly, for the past several years with her since we are relatively close. She has moderate cognitive decline but tends to get up at night, in particular to go to the bathroom, but we have found her showered, dressed and sitting in a dark living room at 2am, or wandering the hall. We started a schedule of setting our alarm for every 3 hours getting her up to go to the bathroom, but we'd miss some times when she had already "gone", and other times she was in such a deep sleep we couldn't wake her. The best solution we found was to get a motion detection sensor alarm. $25 on Amazon. Works like a charm. Had to figure out the best place to put it, so put it under the bed (so her turning over in bed didn't set it off) and as soon as her feet hit the floor the alarm goes off. The sensor uses 110 power but the alarm is battery powered and can be moved from room to room, depending on where you are. The alarm has a gazilllion choices for ring tones. We can move it to the bedroom we are staying in or the living room, for example. We are all getting better sleep and we know exactly when Mom is up and can head her off or help her with toiletting.