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My 94 year old mother is now in assisted living. The doctor says she has mild cognitive impairment. My therapist thinks she has Sundowners. My mother goes to bed at about 6 or 7pm. About midnight she starts calling me on the phone, about 3 or 4 times a night. She is confused, disoriented, doesn't know what time it is and can't tell time. What should I do? How do I handle this? Should she be moved to a nursing home? Should I ignore her nightly phone calls so I can get some sleep? Please let me know, as I have no family to help me. And I am wondering if the assisted living facility can handle dementia, etc. Thanks.

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It sounds like more than MCI to me. I would have her re-evaluated.

As for whether or not she should go to a nursing home, the answer is, "that depends on the nursing home." My mom's nursing home accepts people like your mom to one of their dementia units. Everyone there is very high functioning, they just need more supervision. In our nursing home, for example, she would have a private room, and get more attention, if that's something you feel is necessary.

If your mom is confused at night, is it possible for her to get up and walk out? You need to have a talk with the director of nursing, the social worker, or the administrator at the ALF. Tell them exactly what's going on. Ask them if she "wanders," and ask them to detail what measures and staff they have in place to take care of people with progressing dementia.

ALFs *do expect residents to be more independent, so they might recommend nursing home, or memory unit. They might even be able to tell you which ones are the good ones.

If you don't go that route, unplug your phone at night. You might also consider getting a "trackfone" you put on only at night, and give that number to the facility incase they need to notify you of an emergency in the middle of the night.

good luck
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Could you spend the night with her and see what's going on? You are up anyway right! Or hire a sitter for a few days to help her go to bed later and observe her at night ? Is she up in the mornings? Does she sleep during the day? This may be too simplistic but it sounds like she has her nights and days mixed up.
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Have a friend with this exact same problem recently. She turned off her phone and made sure to get call display and return the call when she had some time.
She also had her father moved to a full care facility when things got out of hand.
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sounds like memory care might be a good place for your mom. My mom started calling me like this from her hospital room following hip surgery at the onset of her dementia. It was very frightening, for me and her and I share your concern. I didn't appreciate the nurse letting her call me at midnight and two in the morning. She like your mom was confused, and scared and I did not want to drive to the hospital where they should have been taken care of her in the first place , in the middle of the night. Memory care centers can better help your mom, whereas assisted living facilities expect them to be more independent. I would talk to the facility to establish times where you can reach your mom and the facility, not your mom calling you personally in the event of an emergency. This might help. It helped me to give the facility my cell number where they could reach me for any medical or concerns for my mom. My mom called the fire department and told them the facility was on fire. We had to move the phone out of her reach, and If I call the nursing station they will personally hand her the phone to talk to me or hear my voice for reassurance. Hope this helps Hugs
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Wow, I know most people don't realize, a big facility is not the place for someone with memory issues. In part because they're feeling their identity slip away. And the large place is the Last place they're treated as an Individual, with their own unique identity. The paradox is that.
Of course families buy into the myth that the big place is better. To them, it looks like it will control the resident more and keep them safer. Nothing could be farther from the truth in reality. The Small Home ALF is more Familiar, and thus less scary. Less anxiety, fewer phone calls. Staff can monitor them more, have a cup of herbal tea with them, tell them the phone is charging and when it's ready they'll come help them call... In a big place, they will just Drug them, or ask that you remove them. Or as someone said dialing 9 disables them getting the comfort and reassurance they so crave and need. No wonder they get anti-psychotic medication. It can drive a person mad to be in that state, unable to feel safe, and feeling more confused. It's not "insanity" but dementia.
Sadly in south FL where we have our Angel House, large places tend to take them, and exhaust savings, getting a big chunk in advance, often up to $10,000 or more equity buy-in or deposits. Then they milk the bulk of the estate, raising rates frequently to provide the extra care they need more rapidly as they decline far faster, detached as they become from their true self, and it's a cycle of despair for the family. Drugs don't help them stay connected. We get them out to walk, giving them vitamin D, connection to life itself, nature, each other as a family. The mob scene is not helpful at the big ALF, with where they are mentally. Our residents generally sleep from 8 pm until 6 or 7 am, and they have a better grasp of what's day and night. Melatonin, Tryptophan, music with Delta frequency to put their brain in a healing, restful mode also helps. We have individual wireless speakers in the rooms, with a transmitter from the tv. Each room's volume is set for the resident's own level of hearing. Hydration is incredibly important, and that it begin at waking. Good nutrition and all sorts of meaningful engagement, with a daily routine. It's not immediate, but within a week or two, things change.
You Can Do This at Home too, those of you still not at the AL stage. You will be amazed and the results. My recommendation is find a good Small place, Before the funds are gone. They will also help you plan for benefits, while large places do that at the end, and send you on your way. The law provides for a LOT of individual care, we must have Hundreds of staff hours per week at the small home. Large places have separate kitchen/cleaning staff, so actual hands on people to Listen to your mom/dad/aunt, are about ONE for every TWENTY Residents. That's a Fact and a sad one.
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My Dad had sundowners but I was lucky as he would call around 8pm.   If he was confused about something, I would try to fix whatever was worrying him in his mind.   Usually I would tell him I have trouble remembering things, too, and that would calm him down.   Once in a great while he would call right back with the same worry.

Eventually Dad was moved into Assisted Living/Memory Care, which was in the same complex.   While there he rarely called me.   Dad had a landline in his room, through the facility in which to call out one would need to dial 9, so not remembering to dial 9 usually stops the calls, unless Dad's mind was in a loop where he was thinking clearer at that moment.

I agree with Sunny and cwillie, above, going to bed at 6 or 7pm is too early.   At midnight that is 5 to 6 hours of sleep.   And elders tend to need less sleep at night because they nap throughout the day.
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From my experience, AL may not be the best place to rely on help for a person with progressing dementia. Apparently, her short term memory is suffering, because likely she keeps calling because she has forgotten about her previous phone calls. And, she is not oriented to time, or she would not call you at that hour. Still, I would meet with the staff and discuss the issue. I'd see about limiting access to her phone after 9:00 pm. and if she has her own cell phone, that she's using, I'd arrange for her to use only the landline.

At the same time, I'd question if she needs to be going to bed so early. Perhaps, a sleep aid from her doctor would help and if she would take it and retire a little later in the evening, she might sleep through the night.

I'd pay close attention to how the facility is able to manage and care for those with pronounced dementia, because, she may eventually need a higher level of care. Maybe, not Nursing home, but, Memory Care.
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It might help her to have one of those clocks that differentiate between night and day. I've been told that when they fall asleep early some AL residents show up at the dining room at 8:00 thinking it is morning and time for breakfast ;)
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No not a nursing home, they would not accept her. Turn off your phone, do not answer it. Tell mom that she needs to get help from facility staff, let them know this is happening.
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