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I sent this message a few days ago, and was surprised to hear no response from this very responsive group. Maybe it didn't actually make it to the server? My mother is 84. Recently her PD has advance rapidly, probably complicated by one or more small strokes. At this point she cannot walk without great danger of falling. Unfortunately, her short term memory and her cognition as a whole have greatly diminished, and therefore she keeps attempting to get up from her wheelchair and/or her bed despite being reminded repeatedly that she needs assistance. She also has a great deal of difficulty sleeping at night, and has recently been prescribed Ambien 5mg, which she appears to tolerate well. It ensures at least 3-4 hours sleep, but this still leaves up to 20 hours of wakefulness when she is in danger of falling. We have moved her to a skilled nursing facility and even there we are being asked to provide private duty caregivers from 3PM (when most of the activities end) until 7AM to see that she does not get up and fall. This solves her safety problem but will be very expensive to maintain for any length of time. Does anyone have experience with easing PWP's through this transition? Has anyone had any success with any kind of counseling or behavior modification approach when there is significant cognitive impairment? Any other ideas? Carol Lemlein caregiver to Marie 84/79/