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I woke up at 4:30 am to the lights all on in my condo and my 94 yr old mother sitting in the living room fully dressed. I asked what was wrong. She said " I don't know". She said she had a dream, but wouldn't tell me what it was about. I went to her room and her bed was made and her nightgown and robe were rolled up and stuffed in her depends bag. Almost like she was leaving on a trip to somewhere. She uses a walker so she can't get anywhere very fast. She sat in her chair for a few minutes and said she was going back to bed. Asked me not to tell anyone about this. Yah Right! This is the 3rd time in a couple weeks this has happened. Different dreams, but are real enough to make her to act on. Had her talk to her primary doctor last week and had them give her a cognitive test. All checked out fine. My sister is POA over healthcare and not very involved. Comes over for an hour or so every couple of weeks and thinks she is helping. I know mom is declining, but not quite sure where to turn next.

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This can be typical with dementia.
You say in your profile mom had Alzheimer's/dementia. Not sure what the doctor was saying when he told you "all checked out fine" unless the doctor was saying that there had not been much of a decline since the last test done.
You need to take precautions that she can not leave the house without you being aware.
There are alarms you can put on doors that will sound if/when the door is opened. If precautions can not be taken to ensure she can not leave for her own safety you might have to consider placing her in a Memory Care or due to her medical conditions a Skilled Nursing facility might be appropriate.
Discuss this with the doctor. There are medications that can help with anxiety and or agitation.
If I were you my next step would be to contact Hospice.
due to the fact that mom has cancer and she is refusing further treatment she would most likely qualify.
With Hospice you would get a Nurse that would come in each week, more often if necessary. A CNA would come in at least 2 times a week to give her a bath or shower and order supplies.
All the supplies and equipment that you need would be provided.
And you can request a Volunteer that could come in 1 time a week to sit with her while you get out.
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You say in your profile that mom suffers from dementia/Alzheimer's yet her doctor gave her a cognitive test and all checked out fine. So....? If she scored in the no dementia zone, then she's not suffering from dementia. Vivid dreams do not equate to dementia. I myself used to wake up at 1 am and get fully dressed and ready for the day before realizing my mistake. My daughter did the same thing. That's a sleep disorder, not dementia.

You mention mom was on Paxlovid meaning she had Covid, I take it? If so, she could be suffering the long term effects of IT rather than anything else. Neurological issues and brain fog are side effects of long covid. At least 40% of people with long covid suffer from moderate to severe sleep disturbances!! See this link:

https://consultqd.clevelandclinic.org/sleep-disturbances-are-highly-prevalent-among-people-with-long-covid/

What help would you like from your sister, mom's POA? Ask for it, that's my advice.

Perhaps your next step should be getting mom a sleep study to see if she's having a sleep disorder going on, or sleep apnea, etc. Quite often, when an elder isn't sleeping properly, they can have all sorts of issues that appear to be cognitive in nature.

Best of luck.
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Is she on any new medications? Checked for a UTI? PCP could refer mom to a neurologist if she doesn't have one already. Your sister is a lot like mine. She visits for a few hours on Sat or Sun, but plays on her phone or outside having a smoke.
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If it's not a cognitive issue it could be a physical or an emotional issue (the dreams) that is frightening enough that she is getting up and dressed in preparation for the worst case scenario. Your mom is at an age when thoughts of mortality are not so easily pushed aside, I think all you can do is reassure her that there is a plan in place for her care and that you will always advocate for her. A baby monitor and a door alarm to ensure she can't leave without you being aware might be reassuring for you.... the baby monitor might be reassuring for her as well.
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Get her checked for a UTI.

Now is the time for mom to make any changes to her documents, a visit to her attorney would be a good idea.
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Is she on any new medications that can cause "confusion" "disorientation" (the two tiny words that are an encyclopedia worth of behaviors)? Is she having any silent symptoms of UTI (cloudy urine, going more often than normal -- reporting of pain stops, and I can empathize, they stopped bothering me too already and I's still clinging to my 40s)

My mom's dreams since 2020 had gotten more and more vivid. When she went onto hospice, the morphine that she was finally allowed to have for air hunger gave the added effect of delirium and her dreams popped out into reality. With the morphine dosing much lower (i mean they were tiny doses to begin with) she is back to her "okay", but mom had a few warning signs of mild dementia for a bit now.

I would consider this thing a warning sign of the beginnings of an issue.

Your mom's Dr saying "She's okay" or "She's fine" is with the known qualifier that she's with you, versus piloting a space-shuttle or something of the sort that requires endless orientation.

Just more often than you feel might be necessary point out that your mom is so so very welcomed into your house. Remove "my condo" replace with "our condo". That sort of thing. She is probably subconsciously feeling homeless.

(this was the hardest with me because I am in love with te word my, that should be obvious to most :D. Hubby and I now live with my mom in HER apartment. *shifty eyes* it keeps her subconscious calmer to refer to things that way, otherwise she feels homeless. When she was able to come up from the howling of "i want to go home" she explained that, that was exactly it. She wasn't home. She was in her daughter's apt. She wanted her own home. in several episodes she had dreampt that he bought a house or already rented an apt somewhere etc)
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jefdalt07 Jan 2023
No new meds. Did have a UTI and covid in Nov. Was on antibiotics and Paxlovid then. Would think any new infections should have shown up last week at PCP with having blood tests and a full exam. Maybe not. Will also start using our instead of my. Thanks for all responses. Gives me more answers than I had.
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It may not be "dreams" but just her dementia brain. Dementia can screw up sleep patterns. It may be time to have a discussion with her primary doctor about sleep aids or other medication to maybe regulate her days and nights... this will impact your sleep as well. And, there may be a time when she actually decides to walk out the door in the wee hours.
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What medications is Mom currently taking. Some sleeping meds can cause hallucinatory dreams that are very real. Are they certain Mom has Alzheimer's and not "Lewy's" which can give amazingly real, AMAZINGLY real hallucinations, especially at night. My brothers descriptions of them were amazing, and they were to him so "real life" at the time, though later he would recognize they were not.
Wish I had a clue, but this is worthy I think, of discussing with her doc and going over her medications.
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If these dreams are so disturbing then there is medication for that. Who diagnosed her as having a Dementia? I hope a neurologist. If she does not have a neurologist then get one. In my experience a PCP/GP knows a little about everything and alot about nothing.
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