She thinks they are in school. She gets very anxious when they don’t come home. We explain they are older and have their own kids and she couldn’t possibly have kids that are 7 yrs. old. She then wants us to report them missing or else she wants us to go out looking for them. We would lie and say they are staying by someone’s house and then she wants to know who and when they’ll be home. When she leaves the house we have to get home because the kids will be getting home from school and no one is there. This goes on most days in afternoon and evenings.

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That is kind of sweet in a way, isn't it? She still wants to protect and nurture her children. You can see what has been important in her life. But I don't suppose it sounds so sweet the sixth time you have to address it in an hour.

Go with the flow. "The twins are at sleep-over camp with their school class." If you can remember something they did at that age that kept them away overnight, use that. "While you were in the bathroom Mrs. Smith called. The twins and the youngest Jones girl are there and they are going out for pizza." Then offer a treat or ask her help with something or otherwise distract her from that topic.

Don't try t convince her her kids are adults now. That does match her reality and will only frustrate both of you.

While she is such a nurturing frame of mind, I wonder if she would enjoy a realistic baby doll. They make them about the weight and size of an infant. My mother wasn't much into cuddling hers, but she did enjoy seeing it dressed in various costumes. (A doll intended to fit into the arms of 7-year-old isn't the same. You may not be able to readily find one locally, but you can find them online, for about $100.) I'm not suggesting that you tell her this is one of her babies. Just that this is a cute doll you thought she might enjoy. Let her take it from there.
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Lindalou22, most days my 96-year-old dad thinks I'm either his dad or one of his brothers and I just play along. Usually the CNAs also play along, but once one told him, no, that's your son and he told her, no, he doesn't have any sons that big. Most evenings he wants to go home (to his childhood home because he doesn't remember any other home) and I tell him, okay, get a good nights sleep and we'll leave right after breakfast and he says, okay, that's a good plan. It took me a while to learn that to minimize his anxiousness it's best to agree with whatever he thinks is real, and, as BarbBrooklyn suggested, use a distraction or a white lie. I now use those same techniques with my many new friends in my dad's memory care facility -- it works almost flawlessly and has never caused any harm. Late stage dementia creates its own reality and there's nothing to be gained by trying to correct it.

My dad doesn't need to take any medication for his false reality and maybe that's because his caregivers usually know how to agree, distract and fib. I'm glad for this because most medications have potential for too many bad side effects.
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Google the term "sundowning" and you'll see that this is not uncommon among dementia patients.

Try adding a distraction to a therapeutic fib, i.e., they'e at Jeanne's for the night, how about some ice cream?

Talk to her doctor about meds for this.
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