My 89 year old mother with Alzheimer's has a hard time settling down some nights.

Hi Karen

There are a number of issues. I will try to address some of them for you.

Although she forgets the answers I do think it is important that your answers are consistent. It helps if there are a number of different people caregiving.

I think it is important to tell the truth but always be sensitive about its delivery, especially about people she has forgotten are dead etc.

Give short simple answers, complicated pieces of information will only increase her anxiety and confusion.

Remember that the brain damage that occurs with Alzheimer's is profound. Think of her communications with you as her brain is trying to compensate for the huge holes in her memory. Because of the brain damage it is unable to do so. That gives you a good idea of why she keeps repeating questions and concerns. It can be very frustrating for caregivers to deal with the resulting obsessional, repetitive interactions.

Anxiety is a very common for people with this terrible disease. It may be best to see a specialist gerontologist who can advise you and may suggest prescribing a mild tranquillizer which may help.

Reassure your mother, try to distract her, talk to her softly.

Try changing her evening routine. 

Provide activities in the day so that she is tired before bedtime

Avoid assisting them to bed too early

Do not have stimulating activities before bedtime

A warm bath, soft music, may help relax them-so might a warm milky drink

Hope this helps

Christine

I'm assuming your mother is under medical care because of her issues, but perhaps the doctor doesn't understand how bad her anxiety is. Not being able to remember what is going on (and not understanding what is happening)  is very, very frustrating and produces anxiety and fear.

The continual questions are sometimes because she forgets she asked, but also they can come because she needs more reassurance. I wouldn't argue too much if she thinks she's in a hotel. A lot depends on her stage. There is a time when just validating feelings can help a person relax. Perhaps you could try saying that you'll check about breakfast and you'll make sure she doesn't miss it. If she doesn't feel she is always "wrong" in her assumptions, she may relax more. Obviously , reassurance is vital. Also, perhaps Ativan or something for anxiety may be in order, if her other medications don't rule that out.

Carol

It is not always easy to curb obsessive thoughts and behavior patterns but it is commendable that your brother is making efforts towards reassuring her. Frequent reassurance and redirection are invaluable tactics in behavioral management. Although it is not clear what your brother's current method is, a good approach to take is to start where your mother is. If she thinks that she is in a hotel and is awaiting breakfast, it can be helpful to reassure her by placing a large folded index card or note by her bedside saying "Breakfast is at 8:00 am" and then quickly redirecting her by discussing what she would like for breakfast the next morning. Once she has taken a few moments to discuss breakfast, encourage her to get to bed and shut off the lights. Let her know that in order for her daughter to visit in the morning, it is important that she get enough rest to spend the day with her.

Although your mother may not remember exactly what has been said to her, it is believed that she can still hold onto the underlying emotions that derive from the content. This may explain why she experiences outbursts of anger. In other words, if she is not pleased with a response, she may become upset over it, and although she might not remember mere moments later what was said, it's possible that she is still carrying the negative feeling. For this reason, it is always important to be as positive as possible when addressing individuals with Alzheimer's disease.

If your mother is experiencing Sundowner's Syndrome, a dementia-related symptom that refers to increased agitation, confusion and hyperactivity that begins in the late afternoon and builds throughout the evening, there are a few tactics that you can utilize to help ease her symptoms. Try to put your mother to bed as late as possible, and keep all stimulating activities reserved for the earlier part of the following day. Make sure that your mother doesn't take any naps throughout the day, as this may be fulfilling her need to rest and can inhibit her desire to sleep at night. Also, avoid giving your mother any caffeine such as coffee, tea, or soda. In the later part of the evening, when the sun begins to set, turn on all the lights around the house and keep noise and other forms of stimulation to a minimum. It is a good idea to create a relaxing environment that will prepare her for bed.

You might also want to discuss this matter with your mother's physician. The physician might be able to review her current medications and alter or prescribe an appropriate treatment if she is not receiving one already.