By REGINA D. Posvar LPN,RNA
Q: Dear Regina, Do you have any suggestions to help with my mom’s sleeping pattern? The caregiver during the day says she sleeps most of the day and when I come home from work she is awake and I will have a hard time getting her to bed or she will wake up at midnight and for the rest of the night. I can’t take this anymore. I was told to get a sleeping pill for her. Is this the best answer?
A: Certainly taking her to the doctor to get a check up to make sure nothing is causing the changes before just ruling it as dementia is worth the visit.
Before trying medication for sleep you can have your caregiver keep her busy most of the day. Engage with something your mom likes to do. If she is in the middle stages of dementia allow a nap but no longer than an hour. She may be tired more than a person not living with dementia. Have the caregiver make sure she is exposed to sunlight during the day and take her on walks. If she is in wheel chair then wheel her on a walk outside. Exercise that is appropriate for her will help her to sleep better at night. Have her heavy meal for lunch and her dinner before dusk. Turn on lights before dusk to keep everything bright and day-like. Before bedtime set the mood and theme, tell her “let’s have some warm milk or (sleepy-time) tea.” Any natural remedy that will enhance sleepiness and this is the time to turn down the lights. Make this a routine. If these do not work, try the medication the first 3 nights with the same routine. If the medication seems to work better after not giving for 3 days, go back to the medication for 2 weeks then start decreasing it. Most sleeping medication was only designed to be used temporarily. Each person is different so be sure her doctor is involved. There are rare cases where medication is needed continuous.
The other option you have is to have someone relieve you during the night so you can get some rest. This person can be a family member, friend or you can hire someone to temporarily help out until the pattern changes.
In the event that your mom is not responding to anything you have tried, even with medication, having someone at night would be the safest alternative so that she is supervised and cared for at night and you get your needed rest to stay healthy yourself. The night person will need healthy rest time as well so it is not recommended to have the same person doing the night time care for an active person with dementia also working the day. That person will experience the same fatigue as you are so be careful when hiring persons for the night.
Q: Dear Regina, My family and I received doctors diagnosis of Alzheimer’s for my mom who is 66 years. We are all taking responsibility to care for her. What is your recommendation for us to get things in order?
A: Receiving the news that your mom has Alzheimer’s can be devastating, overwhelming and a relief of knowing what is causing the changes has a name. I am first going to recommend that you learn as much as you can about the disease. For you and your family including your mom, you should have a family meeting and talk about who is going to be the pack leader of the family. One or two at most should step up to this role. I recommend a dementia coach to help you get started to organize your team. Some of the discussions will be:
• Identifying where each of you have strengths?
• Who can mange medical and financial affairs
• What kind of finances are needed?
• What kind of supervision/care is needed now and the future?
• Safety of your mom’s environment
• Emergency plan of action in place
This is just a few things to consider but always involve your mom as she will always be your best teacher.
This is also a time to get things in order legally regarding banks and assets and even her funeral and “Will” wishes. Do it now while she can make those decisions and all of family around. This will save heart-ache in the future. It is hard to talk about these things while she is living but it is actually the best time. It can be done in love and dignity. Let me remind you that a person can live well with dementia. It is not easy but there are things to help make this journey more pleasant. Continue to seek support for your mom and all of you as family.
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