Are these to be expected from mom with Alzheimer's?

Sounds like she might have Sundowners Syndrome which affects many elderly people who suffer from Alzheimer's disease or other forms of dementia.

My dad has it... It normally affects him in the after noon after he's woken from a nap.

Here is one of many articles on the subject:
www.aplaceformom.com/senior-care-resources/articles/sundowners-syndrome

My Father who has Alzheimers has issues with sundowners syndrome very badly, especially when he is away from home.

He was in the hospital in March and I stayed with him a couple of days because of how bad he would get, and he thought he was back in the army, he kept asking how could he get out of this, that he didn't remember signing up for this, and he hopes they don't keep his check(when he got paid in the army he would send his money to his parents, and when he got out they spent it all due to alcoholism). He would cock a gun, and it was traumatic for him. They gave him some ativan which only made him worse to where they had to restrain him in the bed.

He does much better at home, he does get up during the night always looking for his check book, and frequently forgets the day and year, just a very sad illness.

Hello Alice! Thank you for sharing what might work with my mother. All along I thought that telling her that what she saw were not true could make her realize that she's just hallucinating but it turns out that it is not what she needs. Thank you for clearly explaining what validation therapy is as now I know how to deal with her without aggregating her condition. Do all nursing homes practice validation therapy when reality orientation does not work? If not, can I request it from the director or the one managing the nursing homes?

Sundowner's Syndrome affects people with their symptoms when the sun sets. If this happens all day, I would think it's just dimentia. The Hep C wouldn't affect the Alzheimer's at all. Have you mother exercise and get out of the nursing home a few times. Maybe a change of atmosphere would help her out. Good luck!

Some further info on Lewy Body dementia and the drug issue, from UCSF (my boldface):

"ndividuals diagnosed with Lewy body dementias often have adverse reactions including confusion when taking medications that affect the brain, such as anti-anxiety drugs (examples: Valium®, Ativan®), anticholinergic drugs (examples: Benadryl®, Detrol®), and antiparkinson’s drugs (examples: Sinemet®, Mirapex®). To avoid adverse reactions to medications, physicians should carefully monitor medications, introduce medications one at a time and prescribe minimal doses when possible.
Diagnosis

An extensive neurological and neuropsychological evaluation is essential for Lewy body dementia diagnosis. Structural brain imaging (e.g., MRI or CT) and laboratory tests are used to rule out other diagnoses. Lewy body dementias can be difficult to diagnose because they can resemble and overlap with other causes of dementia like Alzheimer’s disease, other parkinsonian syndromes (examples: progressive supranuclear palsy, multiple system atrophy, corticobasal syndrome), and vascular dementia. As in many neurodegenerative diseases, a definitive diagnosis in only available after an autopsy. However, clinical diagnosis by experienced providers can be quite accurate and reliable.
Disease progression

Onset of the disorder usually occurs in older adults, and disease risk increases with age. There is substantial variability in the course of the illness. In general, symptoms progress over several years as cognitive decline becomes more prominent and psychiatric symptoms emerge or worsen. The progression of symptoms represents increasing pathology in the brain including more widespread Lewy bodies, loss of neurotransmitters (examples: dopamine and acetylcholine) and nerve cell death.
Management and treatment of Lewy body dementias

Lewy body dementia patients are often frail, and their symptoms can worsen quickly when faced with infection, medication reactions or changes in the environment; these risks should be closely monitored.

Nonpharmacologic interventions, including physical, occupational and speech therapy, community resources and assistance with home care should always be considered. The motor symptoms of Lewy body dementias are generally treated with dopaminergic therapies. These medications are usually helpful in decreasing the severity of motor symptoms. However, it is advisable for these medications to be initially prescribed at a low dosage and gradually titrated upwards as necessary given the possibility of potential side effects such as worsening confusion and hallucinations. Cognitive symptoms of Lewy body dementias are often treated with cholinesterase inhibitors (e.g., Rivastigmine®, Aricept®). These medications can improve the attention deficits, cognitive fluctuations, neuropsychiatric symptoms (e.g., hallucinations, apathy, anxiety), and sleep disturbances by boosting acetylcholine in the brain, a neurotransmitter that is severely reduced by these diseases. Memantine has also been tried for treatment of cognitive impairment in Lewy body dementias. In general, the results have suggested that this drug is well-tolerated but not reliably effective. Depression is very common in Lewy body dementias and can be treated with antidepressant medications.

For psychotic symptoms (e.g., hallucinations or delusions) that are troublesome to the patient and/or family and that are non-responsive to psychosocial interventions (e.g., making changes in the patient’s environment) or cholinesterase inhibitor treatment, atypical second generation antipsychotic medications such as risperidone (Risperdol®) and quetiapine (Seroquel®) can be tried but must be used cautiously due to the risk of motor and cognitive side effects. Older, first generation antipsychotic drugs such as haloperidol (Haldol®) or chlorpromazine (Thorazine®) should be avoided because they can cause extreme adverse reactions in many Lewy body dementia patients. A patient treated with these drugs could become catatonic, lose cognitive function and/or develop more muscle rigidity.

The symptomatic treatments available and described above do not slow down the disease course. The current search for disease-modifying drugs is focused primarily on preventing the misfolding and buildup of alpha-synuclein pathology in the brain."
source: http://memory.ucsf.edu/education/diseases/dlb

There is actually some exciting news due out soon re progress in understanding Dementia with Lewy Bodies - I'll post it here soon.

Elena