It began as a new sundowning episode about a week ago. But now it has carried over into the daytime. I have always managed to adapt to her changing needs and behaviors, but this one is throwing me for a loop. I have been her live-in caregiver for three years. I can handle it in the daytime. I’m considering going for a ride every night and coming ‘home’, but her sleep patterns have changed and she is up all night pacing. I’m afraid she will try to leave and I won’t hear her or she will fall because she is sleep-deprived.

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I never thought I'd be the person to suggest this! - but do also try to catch a urine sample to rule out a u.t.i.

People always told me that, and I always did check, and it NEVER was a uti! - but it's still true that they're very common and do terrible things to demented older people's perceptions and thought processes. It can't hurt to check, especially as this change in her has been quite abrupt; and you can get dipstick sets at any pharmacy.
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Yogamermaid Sep 2019
Thanks! She is actually on antibiotics for this at the moment. It is the first thing we checked! 😊
Please consider asking her doctor for a calming meds for night. My FIL was keeping my MIL up at night with his worrying and anxiety. His doctor prescribed a very low dose of Seroquel, An day now he sleeps great all night! No more agitated nightmare waking.
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Tell her that Daddy said he would pick her up here first thing in the morning, that he has a flat tire and can't get there tonight. It's like giving her a sugar pill - it helps her believe something to get her through the tough times. Please call her doc and get her a prescription for anxiety at night.

This is very common in dementia. My mthr was in a memory care, on anti anxiety meds, and paced all night. At least she was not trying to get out anymore. It's probably time to move your mom to memory care so that she is safe while you sleep. We can't do this alone.
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Another example is saying “Ok, let’s get your sweater so you won’t be cold when we go outside.” Then, while you’re both walking to get the sweater and chatting about something pleasant, stop for a cup of tea or get involved in an activity they enjoy.
Or, ask them to tell you about their home. After a while, guide the conversation to a neutral topic.
Asking about their home validates their feelings, encourages them to share positive memories, and distracts them from their original goal of going home. Open questions that encourage them to share their thoughts work well.
For example:
Your home sounds lovely, tell me more about it.
What’s the first thing you’re going to do when you get home?
What is your favorite room of the house?

What to do if they refuse to let go of the idea
Sometimes, your older adult will refuse to let go of the idea of going home, no matter how much you try to soothe or redirect.
If that happens, you might need to agree to take them home and then go for a brief car ride.
Experiment with how long it takes before you can take them home without protest. Or, suggest a stop at the ice cream shop, drugstore, or grocery store to distract and redirect.
If it’s not possible to actually take them out or get into the car, even going through the actions of getting ready to leave can still be soothing. This will shows that you agree with them and are helping to achieve their goal.
Meanwhile, the activities of getting ready give you more chances to distract and redirect to something else.
Keep in mind that not everything you try will work the first time. And even if something works once, it might not work the next time. Do your best to stay calm, flexible, and creative – this technique gets easier with practice.
The other thing that can work wonders is to give her a baby doll to hold and rock. In many instances, women with dementia/Alzheimer's find a HUGE level of relief & comfort with a doll.

Since this is happening at night, during sleep time, you may have to call her physician for medication to help her sleep.

Best of luck!!
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Yogamermaid Sep 2019
Thank you SO MUCH! These are fantastic suggestions and great ideas! I have always been able to redirect and calm her down, but this has been new territory that I wasn’t quite sure how to respond to avoid more agitation or appearing that I wasn’t listening or didn’t care. Hugs are working! We have a therapy pet that I am introducing slowly. I have an activity blanket that I am working on, but I will definitely be trying the doll. She absolutely loves children. Her doc has prescribed a new medication for the evening. I hope that helps for the nighttime restlessness. Thank you, thank you, thank you!
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3 tips for when someone with Alzheimer’s says “I want to go home”
Hearing someone say “I want to go home” over and over again is something Alzheimer’s and dementia caregivers often deal with.
It’s especially frustrating to hear when they’re already home.
But when someone has dementia, it simply doesn’t work to use logic to explain that they’re already home or that they can’t go back to a previous home.
Instead, it’s necessary to respond in a way that comforts and calms your older adult.
We explain why someone would keep asking to go home and share 3 kind, soothing ways to respond that help them let go of the idea.
Why someone with dementia asks to go home
Alzheimer’s and dementia damage the brain and cause a person to experience the world in different ways. 
So, what we hear as “I want to go home” is often a request for comfort rather than literally asking to go somewhere.
The kindest thing to do is to meet them where they are, focus on comfort and reassurance, and respond to the emotions behind their request. The goal is to reduce your older adult’s anxiety or fear so they can let go of the idea.
Helping them to calm down also gives you a chance to check if discomfort, pain, or a physical need is causing this behavior.
3 kind, calming ways to respond to “I want to go home”
These suggestions will put you on the right track, but it’s a good idea to get creative and come up with responses that are tailored for your older adult’s history, personality, and preferences.
1. Reassure and comfort​ to validate their needs
Sometimes saying “I want to go home” is how your older adult tells you they’re tense, anxious, scared, or in need of extra comfort. 
By responding in a calm and positive manner, you’ll validate their needs and feelings. This helps them feel understood and supported.
Approach your older adult with a calm, soothing, and relaxed manner. If you remain calm, it often helps them calm down too.
If they like hugs, this is a good time for one. Others may prefer gentle touching or stroking on their arm or shoulder or simply having you sit with them.
Another way of giving extra comfort and reassurance is to give them a soothing blanket, therapy doll, or stuffed animal.
2. Avoid reasoning and explanations
Trying to use reason and logic isn’t recommended when someone has a brain disease. It will only make them more insistent, agitated, and upset.
Don’t try to explain that they’re in their own home, assisted living is now their home, or they moved in with you 3 years ago.
They won’t be able to process that information and will feel like you’re not listening, you don’t care, or that you’re stopping them from doing something that’s important to them.
3. Validate, redirect, and distract
Being able to redirect and distract is an effective dementia care technique. It’s a skill that improves with practice, so don’t feel discouraged if the first few attempts don’t work perfectly.
First, agree and validate
Agree by saying something like “Ok, we’ll go soon.” or “That’s a good idea. We’ll go as soon as I clean up these dishes.” This calms the situation because you’re not telling them they’re wrong.
Next, redirect and distract
After agreeing, subtly redirect their attention. This redirection should lead into pleasant and distracting activities that take their minds away from wanting to go home.
For example, you could gently take their elbow while saying “Ok, we’ll go soon” and walk down the hall together to a big window or to the kitchen. Point out some of the beautiful birds and flowers outside or offer a snack or drink they like. Later, casually shift to another activity that’s part of their daily routine.
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My father was waking up through the night and pacing around agitated. I spoke to our local pharmacist and learned about cbd oil. I started him on cbd gummies (325mg), one per day and the difference has been remarkable.
He will still occasionally wake in the night, but is no longer agitated. And he sometimes sleeps through the night -what a relief!
It might be worth a try.
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Yogamermaid Sep 2019
Thank you! She is on CBD but not that dose. I will talk to her pharmacist. 😊
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