Mom has severe sundowning and is being removed from facility. Any words of wisdom?

Thats sounds very tough im very sorry. Im in MA and you need to be hcp to do anythi.g here. So if you are can you work with her dr to get her on some tranquilizers or nightly meds?

Contact the primary physician for the facility. Ask to have orders written for labs drawn (a morning when she is lucid), for blood sugar, magnesium and potassium level. Repeat blood sugar check when the problem behaviors begin. My brother began similar behavior and they found his blood sugar crashed after dinner. If all normal, have they tried Melatonin or a mild anti-anxiety an hour prior? Sleep aid will not only stop interruption of facility but protect her from injury. God Bless

bad memory is.Caused by a lack of nutrients The b vitamins Is she eating too many sweets or not eating at all? I’m 95 and my appetite is dwindling because I don’t move around well. I have lost my sense of balance and must use a walker. If.
If she can walk well she should have a daily course of walking. Eat no sweets and a B supplement. I recommend Puritan Pride They make their own and are pure. Let everyone know so others can benefit
big pharma wouldn’t want this known since they love MONEY!!
Cancer also can be. cured by an alkaline diet. Acid feeds cancer
Diet is important

Let the facility know that she is on a waiting list and check with mom's Dr to see if she can take an over the counter Melatonin every evening and if that and music therapy doesn't work then ask Dr if she can be prescribed a mild sleeping pill.

Would they be able to lock her door in the evenings to keep her from going on other rooms?

My wife has had Alzheimers for over 10 years and for the last 2 years her sundowning was making my life and hers very difficult. Our doctor prescribed Seroquel (Quetiapine) for her and it helped for awhile. The doctor then prescribed Depakote (Divalproex Sod) and I consider it a game changer. Her sundowning is very mild now and as a mood stabilization drug it has made the whole day more comfortable for her and for me. I don't know if it will work for your loved one but I am happier with these drugs now than I was before. If I am happier my wife is also.

I’m so sorry you’re having to deal with this. One idea is that, as someone mentioned, you contact a psychiatrist and ask if she can be hospitalized to evaluate her psychiatric needs, as it sounds like an adjustment might need to be made.
This might take a week, not sure. You can ask if she can be evaluated in a hospital setting for 2 weeks?
Back when my mom was alive, she was on a 4 year waiting list to get into a Medicare bed at a long term care facility.

The only way to bypass that long wait was to have just been released from a hospital to do 30 days at a nursing home, and then they’d downgrade her to an assisted living. She didn’t have this happen, but I know it was/possibly is still a thing. I don’t know if it still works that way (she passed in 2013)...

...but if it does still work that way, it might buy you another month? I think her program was called the StarPlus program that paid for her long term care? Call to find out if they offer this and if the Hospital Stay/30 day Nursing Home/Downgraded to an assisted living with a Memory Care Wing is an option.

God bless you and your mother, xo

Greetings Tokamame, As I read through the many letters, my heart went out to you after reading yours. My mother recently went through the "Sundowning Syndrome." Like many illnesses that hit our Senior's, this was different. I pray for you and send many prayers to your mother. Soothing her as best you can helps, allowing her to carry something meaningful to her helps and yes gentle music for the mind. God Bless You...

How does your mother spend her days? My mother’s MC has a policy of not allowing residents to sit in their rooms during the day And no TVs are allowed in rooms so they don't sit and sleep. There is a large TV in the common room so staff can watch the residents and rouse them if they nod off. There are 7 planned activities everyday to keep residents awake and engaged. The goal is to keep everyone awake during the day and tire them out so they will sleep at night.

Mom is currently in Assisted Living according to your profile.
Mom probably should have been in Memory Care since the first or second time you moved her.
I know many people do not want to move a loved one into MC "sooner than they need to be" BUT the sooner a transition is made to MC the easier it is for someone with dementia to adjust to a new routine, new surroundings.
Medication can help with the anxiety, sleeping.
Not to rush or push anything but if mom has any condition that might make her eligible for Hospice a Hospice placement would also "fast track" her into a facility. Not to push it but typically with a hospice recommendation a facility would accept a person with an anticipated shorter residential expectancy. (did that make sense?)

You can outgrow a MC. They are not equipped to care for problem patients. Does Mom have a Neurologist. If so, he should be made aware of her behaviours so she can get medication to help her. I think your next step is Longterm care since you are thinking about Medicaid.

Just so you know, 25mg of seroquel is a starting dose and almost always needs to be adjusted upwards.

Have you talked to the doctor who manages her medications about her behavioral challenges and the fact that she's may need to move? I think a change or adustments in meds is in order.

By all means ask for a behavioral evaluation, based on the fact that her current medication isn’t working.

Our AL has a geriatric behaviorist on staff. What a Godsend! If yours does, use that person. If not ask them whom they recommend.

What meds are being prescribed for her sundowning? A consult with a geriatric psychiatrist is certainly in order.

My mom was kicked out of MC as well. Yup her behaviors caused problems. She was hitting, biting, head banging, you name it. She was a danger to herself and others.

She was on hospice at the time. Hospice recommended a much smaller care home that take those that have been kicked out. That care home worked better for mom and would have been better for her from the beginning. And it was cheaper than the large corporation memory care.

Best wishes to you, this is hard.

What is your relationship with this - her 5th - facility….. They like her and share concerns? OR they are over her? I ask cause what might be a way to deal with finding a new facility is for mom to get hospitalized and neither you nor the current place (that sent her to ER/ED) will take her back from the hospital. So the discharge planner at the hospital then has to find placement for her. The scenario would be…. the NH thinks that mom is exhibiting something that requires an Emergency Room / Department evaluation. A TIA aka transient ischemic attack could be this as it’s somewhat subjective as to what seems to be happening visually but needs an EMS to the ER run for the elder to get hospitalized or under observation. Then when she gets the all clear, the NH refuses to take her back as they cannot meet the level of care needed. Now you as POA / family will get the call also to come & take her but you too refuse to go & get her as you cannot provide a safe environment for her and the care & oversight needed. Discharge planner has to find her a facility. Would this place maybe do this?

On the 30 day notice, there should be a CC at the bottom of the letter. Usually it gets CC to a probono legal aid, you might want to contact them as to any suggestions for placement.

If realistically you cannot find a new place and mom has worn out her welcome in any other facilities, AND if you do NOT come to get her, the MC will likely contact APS… then APS will seek an emergency ward of the state action for mom. So mom becomes under the purview of the guardian (judge usually assigns an atty or other professional guardian vetted by the state). Sometimes this can be best as they can find a spot for her and take care of filing Medicaid. If this happens, it does not have to be contentious between you and the court appointed guardian. Perhaps view APS and the guardian as being able to do what you cannot as they have all the resources of the State to use. If there has been no financial misappropriation that would be an issue for mom’s Medicaid eligibility, having her become a ward of the state may be something for you to think about.

Her going naked probably is the tipping point for the MC. Has there been any discussion on changing her wardrobe? There are clothing lines that are “adaptive clothing”, basically clothing they can’t get out of them…. They get called “anti-strip” or “stay dressed”. Silverts Clothing & Buck & Buck carry them.

This sounds very difficult. 5 moves in 4 years? Wow. I guess that this move to memory care could be her last move so at least that will be a good thing.

Be prepared for the 1st Sun in Nov; daylight savings ends the first Sun in Nov for those states that participates.

That can do a number, no pun, on people who don't have mental issues, it can be worse for those that do.