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Mother is in last stages of Alzheimer's. She also suffers from Sundowner's. September 24, 2011 she broke her hip, which accelerated the Alzheimer's.

My grandmother died 21 years ago, and my grandfather died 51 years ago. She knew about both events, but her mind is no longer able to grasp this fact.

Daily, sometimes for hours on end, she will try to go home to her family. When she is unable to go, she becomes quite agitated and then decides the reason she cannot go is because her family doesn't want her. I've tried telling her they are gone, I've tried telling her they'll be right back (her case manager's suggestion). I've tried distracting her. I've tried telling her they died. I've tried going along with her. I've also tried just letting her ramble on and on. I really have tried almost EVERY approach under the sun!

NOTHING works. This is her usual segue into wandering. Unfortunately, she doesn't want to use her walker when she's wandering (because she doesn't remember she needs the walker), and she is at great risk for falling. She gets VERY violent when you try to convince her to use the walker, but if I don't, then she will fall and I can get in trouble for denial of critical care if she falls and breaks her other hip!

I really need to know some new methods to address this, to help prevent her falling and injuring herself.

So... is it kinder to just let her believe whatever she wants? Or is it kinder to gently tell her they are dead?

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Hi Laura:
I'm certainly no expert on this subject. My Mom has just started to lose some of her memory and is misunderstanding some circumstances, but I have a Son who has delusions at times because of mental illness. I found it impossible to convince him of anything other than what he believed within his imaginings (hours and hours trying to sell reality, to no avail.). I had a wonderful GP at the time, who was forceed to retire for health reasons, and she helped me immensely when my Son was refusing to go to hospital at one of the times he seriously needed professional care. Over the past few years, whenever my Son has been in crisis I have found her advice invaluable. I have to admit that I felt a little dishonest putting it into practice, but the results were very positive . You might want to try this:- simply get into the illusion with your Mom and find reasons within her illusion why she (and you) should do something for whatever benefit you feel that she would relate to in her present state. All the arguing in the world didn't help with my Son, because he didn't need adversity - he needed to be believed - that in his world things were happening that no one else knew about and that dangers lurked everywhere. I simply told him that Dr. so&so (at the hospital) told me he had all the answers he needed and had instructed me to bring my Son to him and he would share the secret. I felt horrible, lying to him like that - but he thought for a moment and suddenly said, "well then, let's go!" Maybe it won't hurt to reserect Mom's parents and Grandparents who now live to far away for her to visit, but send all their love, but that they said to tell her that they hope she will use her walker so that she doesn't have any set-backs and will get stronger and well enough to visit them some day. Let Mom know constantly that you're "on her side" and "in it with her" and dispite some "untruths" that may tug a little on your sense of integrity, you might find some positive results(?) In any case, won't hurt to try (that is If you haven't tried this already). Love to hear from you if it worked. Good luck - I know it's a "tough go", and you deserve kudos for your efforts, (but I heard somewhere that we're never sent more than what we can handle:) Surely there's a special place in heaven for caregivers.
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Thank you sibling. I will try this to see if it helps to distract her.
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Sibling speaks from experience and it sounds like she discovered an approach that really works with her son. I suspect it will be useful for you, too.

You really cannot argue, reason, or explain away the irrational beliefs of someone with dementia or certain other mental illnesses. As Sibling says, getting into their world with them is more effective. This is where the suggestion to tell her they'll be right back comes from. Good approach ... but maybe that particular answer wasn't effective with your mother.

So what is her world right now? Her birth certificate might say she is 77, but in her world it sounds like she is maybe 12. Of course she wants her parents. She is in a strange place and she hasn't seen them in a long time. Why can't she go to them? And walkers are for old people. Adolescents don't use them for goodness sakes!

Other behaviors and comments should help you pinpoint how old she is in her world, and then you can talk to her on that level, and say things that will make sense to her. "Your Mom and Dad went on a trip for Dad's business. They know you are being taken care of here. Your mom called last night but you were in the dining room. I told her how well you are doing and she is looking forward to coming back and seeing you." If her dad never traveled on business, make up something that would fit her family. Church retreat. Fishing trip. Sick relative in another state. Whatever it takes to sound feasible. And then use that to change the subject. "Do you ever go fishing with your Dad?" "Do you enjoy the activities at your church?" etc.

"I know you don't want to been seen by your friends with this darn walker and I don't blame you! So let's make sure you use it all the time you are here, to get stronger for when you are with your friends."

Whew! This is not easy, is it?

My mom (92, mild to moderate dementia) moved into my sister's home (an hour away from me) a few weeks ago. She is going to spend one weekend a month with me and the first was this past weekend. The change in environments so soon after her move was extremely confusing for her and she had an especially bad day on Friday. She apparently thought that my dad had been with them in the car and she wanted to know why he didn't stay. Oh-oh. He died 15 years ago. But I'm not new to dementia and I didn't panic. I explained that this was just a girls' weekend and he was going to do things with his friends. She kept coming up with questions and I just answered them calmly. It wasn't his car that they came in. How is he going to get around? They'll drop him off at his car. Can we call him and make sure he is OK? I think he was going to be playing poker with friends tonight, but I don't know which friend or the phone number. You know his poker games and I'll bet he won't be home until late. Let's wait until tomorrow.

Oh my! My sister hadn't mentioned anything like this! But Mother was especially confused and anxious and I suppose it was natural she wanted the comfort of her husband's presence. The next day there was no mention of Dad. She was still anxious enough that she didn't want me out of her sight, but she was no longer delusional.

With all dementia, and probably all caregiving situations, we just have to take it one day at a time, one incident at a time, and do the best we can in love.

Do let us know, laurabmundy, what you try and how it works out for you. We learn from each other!
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I have tried doing this with her. Unfortunately, she escalates pretty quickly. And she gets pretty nasty when we don't say what she wants to hear. It's like she has a recording in her mind, and she keeps replaying the tape. I've been dealing with this for many years, but it is getting worse.

As for her "age"... it changes A LOT! :) One minute she thinks she's a kid, the next she thinks she's a young mom, and then she's something else the next. She will change her story to try to get what she wants (to "go home")... first she'll tell you her folks are waiting for her, then she'll say that her kids are looking for her, then she wants to go visit her daughter (me), then she'll say that her daughter called and told her to come home... it is just a never ending battle. I cannot really go along with her, because she will get up and go out the door! If I can get her to use her walker, then I lock the deadbolt and just let her wander about. She gets angry about the door being locked, but at least I get a break from her asking about her parents and trying to leave the house. If it was nice out, I'd let her go outside and walk a bit, but with a foot of snow on the ground, that would be a recipe for disaster. Thanks for your help!
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When mom starts talking about going back home to see parents and friends I tell her that after she got married and moved away everybody in her home town moved away too and that she wouldn't know anybody who lived there now. If she insists I tell her she can go but first she needs to take her pills and eat dinner and then she can go. 5 minutes later she has no clue about the conversation.
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All of these things are great answers... I've tried every one of them... nothing seems to work. I'll just have to continue doing what I'm doing and just let her continue to be the way she is. I think it's probably stressing me much more than it does her.

Thanks for all of the help!
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Hi laurabmundy, I really like the suggestions you got- (@sbling-my heart goes out to you and your son!)It is too bad they won't work for you. Could her anxiety be so high that that is why the suggestions won't work? And can you get an anti-anxiety medication for her? When any behavior modification will not work I tend to think the next step is medicine. Good luck and God bless.
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MishkaM... the anti-anxiety meds make her even more psychotic than she already is... it's all part and parcel of the Alzheimer's/Sundowner's... I was just looking for the kindest way to deal with this. Thanks!
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Hi again, sheesh. That is too bad. Even meds like klonapan? We are on a trial run of Zoloft for my daughter's anxiety and it has made her way more stressed- her psychiatrist said that can happen with people with genetic syndromes-so I feel your pain. We are so sad that the Zoloft isn't helping as my daughter is so very anxious and so many others with her syndrome have found relief . -* sigh.
Good luck!!! I will keep you and your Mom in my thoughts and prayers!
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Good luck with your daughter as well.
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