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

She might benefit from a brief stay in an inpatient psychiatric unit to get her evaluated and treated for her severe behavioral problems. Look for ones that specifically treat geriatric behavior problems related to dementia.

They can’t just open the door and release her.
Call Social Services and make them aware of the circumstances.
Tell then about the notice and lack of places with beds.
I have to say, getting an attorney “pro Bono,” isn’t as easy as it sounds.
What a dilemma.
My heart goes out to you.

If she is in Assisted Living, and NOT a "Nursing Home" - yes, they can boot her out when the level of care becomes greater than what the staff is able to provide. Assisted Living means that the person still is fairly independent. It sounds like she is beyond that point now. Her evening behavior is unfair to the other residents.

Most Assisted Living places do not accept Medicaid as payment; the ones that do are the exception.

But this should be your FIRST priority - getting her qualified for Medicaid - so that when a Nursing Home bed becomes available, she is ready for it.

I'd talk this over with a social worker or a health care provider who takes Medicaid. It sounds like the dark very much confuses her. So I would get her a special lamp that imitates sunlight and put on some soothing music and get her coloring books to calm her down.

This happened to my mom but I had my mom enrolled in hospice at the time.She was in a memory care assisted living in the memory card section.She had no money only As and eventually Medicaid but that only paid the facility.I do not know if you have any family members who can help but my brother and sister and I pitched in and paid a couple of the CNAs to help in the hours we could not due to work.The facility let her stay and whatever hours I couldn't provide we paid the CNAs.

Sorry about the spelling before I meant she had AS and medicaid.My mom was sent to the hospital for a one week evaluation and it was a total waste for her.Scary actually they tried different drugs on her and the sundowning continued.She went into patients rooms and caused trouble and did not want to leave.Did not work for us but I was reaching out for any help not knowing what to do.Please try to work with the facility she's at.... more moves will cause more confusion in her.My mom is no longer here but I cherish the time I had to spend walking the floors with her keeping her safe. At the time I did not know what to do. I hope you can work it out for a good result for both of you🌻🌻

Doesn't the facility that she's in now have a Care Manager to assist you in the steps needed to transfer your mom? I would contact the Director there & see if someone help. If you refuse to take your mom after the 30 days, what would happen? Find out. If you need legal aid at that point please call on behalf of your mom as she is responsible for her upkeep. If you are financially & physically able to care for your mom at your house then take her home until placement is available, however do not take this step if your are not able or willing for this responsibility. She will need 24hr. monitoring & care. She may present with agitation, aggression, etc. that you haven't seen unless you've observed this behavior while visiting her at night. You would need to be prepared with respite time for you even if it's just an hour or two. It is not easy to care for LO at home. Just get informed about options, get advice from legal if needed, & be an advocate for your mom especially if you are not able to take her home until placement is available. Good luck in whatever happens.

For years, I'd give Mom 5mg. of Melatonin just before she started to sun down(nip it in the bud) and then another 5 just before I put her to bed. Worked perfect for us.

Tokamame: Imho, as your profile states that your mother is in an AL, perhaps she HAS needed an MC.

I helped my mom through something like this. She was fine at home with 24 hour care but could not sleep at night and got up every hour and was distressed.
She had to move and something that really helped her was the MD who prescribed remeron. After that she was a good sleeper and less anxious. Caution that the dose needed to be reduced several times over several years because it was too strong as she got older.
Best of luck

Get her off Gluten and sugar. It might help some. Fresh or frozen fruit is ok. No refined sugar at all. Gluten spikes blood sugar and creates inflammation in the brain. If you can ease inflammation she should calm down somewhat. Good luck.

Sorry about your mom. My mom had sundowning issues in the past but was due to a severe UTI that required IV antibiotics. After the IV'S she had no further episodes until the next infection which is less frequent now.. I gave her a small dose of Ativan and it worked well per neuro. I also tried Melatonin 5mg which worked well most nights but made her agitated and sleepy during the day. I know it works for some people. Good luck.

My Mom was in Memory Care when I received the 30 day notice that we had to find a Nursing home that could provide better care for her. Best decision ever made! Wish we had done so sooner. Nursing home accepted her even with Medicaid not being approved for another 2 months. (took 3 months to get her qualified for it) Best wishes for you and your loved one.

I would ask the facility to allow you a little more time to resolve issues and find a place for your mom. Perhaps an appeal of the eviction can buy you more time.

First recommendation:

1) GOOD checkup with PCP
   This should include complete bloodwork AND a urine culture (not just the dip stick test.)
2) Consider other medications to manage her behavior.

It is rather disconcerting that a search on Seraquil shows it is often used for dementia, yet WebMD lists it as something that should be avoided if an elderly person has dementia

Source:
https://www.webmd.com/drugs/2/drug-4718/seroquel-oral/details/list-contraindications

I have no experience with it or aricept (couldn't find a whole lot quickly regarding aricept and dementia.) I will say that sure, for some people these meds might help, but for others they don't. If she's having issues every night, then it doesn't sound like these are helping her very much. WE should not be dictating what you should try - that should be the doctor who checks her out. It's fine to say what worked for your LO, but we are NOT doctors and should not be saying DO these things! There are different causes of dementia and not all respond to the same treatments.

The only real sun-downing my mother had was due to a UTI. Others can experience this due to other infections (hence the need for complete bloodwork too.) She would be fine in the morning, like it never happened. She would be fine all during the day, until late afternoon, early evening, then all hell broke loose. She would insist she had guests coming and HAD to get out and go home, she would set off every door alarm trying to get out.

This was a woman who was mild-mannered in MC for 4 years and was well liked by all the staff. Not a problem or trouble maker. She had to take Lorazepam during the UTI treatment, which did NOT dope her up, did NOT cause any falls and kept her calm. Oddly online also shows this as something not to take with dementia, but as noted, it works for some. For her it worked 1st time, every time and didn't need to be weaned off it. I still suggest you take her in for a REALLY good checkup and ask for doctor testing/recommendations.

UTIs and infections can do strange things to elders, esp those with dementia. Mom's second UTI resulted in night time bed wetting, aka soaking everything! This despite toileting, max briefs AND a max pad inserted in the briefs.

If the current medications are not doing the job, they need to be reviewed, removed, adjusted or replaced with something that works. Given that she's had issues for a while, it may have nothing to do with any kind of infection, which is why it is important to get that checkup.

I will agree with others, this sounds like AL, not MC and she likely should have been moved to MC (or care home) before she had to move so many times. Each move will take a toll. While there are *some* MC places that accept Medicaid, they are few and far between. By all means get the Medicaid paperwork going, as that takes time, appeal the eviction to buy more time, get her to the doc for a good checkup and make sure the places you are considering accept Medicaid.

(All too often people suggest NH - in most cases this would require a NEED for NH, which it doesn't sound like is the case here.)

Have them transfer her to a psych hospital if they don’t have psychiatric dr services at the facility. They will find medication or combo of meds that will make her manageable. It is common, for example, for dementia patients to become violent & curse. My mother has ups & downs …her neurologist prescribed Seroquel. However, my mother stopped walking so there’s no wandering problem. When she was in SNF before I took her home 4.5 years ago, there was a woman who constantly walked ..& she wore a bracelet around her ankle. Another resident used to kick & hit CNAs & they sent him to psych hospital for medication adjustment & then came back to facility when he was calmer. So make this suggestion to them & after she’s calmer from his hospital stay, perhaps place her in Skilled Nursing Facility. Go with her when they transfer her to psych hospital. Talk to Nursing Director …Good luck & let us know what happens! Hugs 🤗

The person that mentioned Melatonin for sundowning, is correct. It seemed to helped my Mom with it too.

Sounds like the facility is not doing there job. What kind a place do they recommend for her? I would be asking why and why they don't have the staff to work with someone like her. This would really piss me off. I would work with a Social worker to help you find what you need. Counsel on aging can help also. So sorry to her this. I have my dad is a memory care unit and I understand it's hard and sad all in one but you got this.