I need suggestions on how to keep my mom from falling asleep standing up and then falling.

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She is 63 yrs old on oxygen and pretty much self sufficient. She has been doing this for years and so far has not seriously hurt herself. Shes on a fentanyl patch which i think has a lot to do with it. When she first puts the patch on she will be up for the next 24-36 hours minimum, then the 2nd night she starts getting up for water or the bathroom or to eat and between getting out of bed and doing whatever she intended she will fall asleep. If I dont hear her get up usually i hear her hitting the floor and shaking the house. Alarms dont work (the kind you attach to nightgown to bed) because she wakes up to do something so she just unplugs them. I cant stay up 24/7 listening for her and she never sleeps on any schedule, never has. I really dont know what to do short of say a posey vest, and im sure she wont let me anyways, not to mention the fire dangers and such. I was wondering if maybe someone has heard of an alarm that either wears like a watch of she holds in her hand that once she gets up it will go off every 30 seconds or something unless she keeps resetting it. That way if she gets up if she falls asleep standing and doesnt reset it, it will go off and wake her? I used to be a CNA yrs ago as well as an EMT and honestly I dont want to have to use the latter skills on her if possible, so i need to figure out something before she does break something.
Thank You all in advance, and I hope you are all having a blessed day!
Craig

35 Comments

I am menohardys daughter and caregiver. Meno cannot get ordinary rem sleep and it seems humanely impossible but he can remain awake for days or nights on end. I have caught him standing up with his eyes closed many times and he sometimes falls. During the day I can monitor him as I have monitors in every room. At night I use infrared alarms that wake me if he gets up and moves about the house. The beam is invisible. Each alarm is less than 50 dollars and they come in two parts-one part sends the beam to the other part and this beam is powered by a single 9v battery. When Meno breaks the beam the alarm sounds. It wakes him up and me and I put him back in bed or set him in the recliner and set the alarm I have that puts a beam from the living room to kitchen so if he gets up from the recliner he breaks the beam and the alarm goes off. These alarms are good for burglar proofing the home as well. I am not a fan of the patch-Meno seems to absorbt the medicatrion faster and he gets high and doesn't want to sleep. I talked to his pain management and he is on a time released pill that after about a week he does not set stimulation and his pain level has decreased and blood pressure is back to normal. He has stopped asking for pain medication altogether. His doctor stopped the medication for 3 days and he at the 3rd day began crying and asking for medicine. It seems cruel but since Meno doesn't understand how to judge his pain from a 10 to a 1 we had to get his medication lined up by starting low and working up to a therapy level that keeps him calm and I realize that if I medicate him at the same time every day exactly 8 hours apart we have had no issues. It sounds to me that your patient is "nodding" from the high and falls asleep-I would seriously consult the pain management and tell them how she acts especially with a new patch. I have heard alot of over doses have happened with the patch because some people perspire, even body temp. can cause the patient to absorb the medication at a faster than wanted pace. Then if this is the case the patient uses up the medicine faster and suffers the last week or so because the medication has been absorbed.sooner than expected. God luck and bless you.
Hi Ramblingman, I think you are absolutely right about the pain patch. I really sounds like the dosage is too high. My mom has been on fentanyl for 7 yrs. We are thinking of trying something else soon as I think its not really working out for her any longer. I used to could tell on the first day that she felt much better and had more energy, but never did she stay up for 24 hrs. She may have had a night of not being able to sleep well, but everything went back to normal by the second day. It seems now her body is absorbing it too quickly. Does she apply the patches herself? Is she taking the other one off? I guess being that you have been a CNA and an EMT you probably don't need me to ask that. I think Menohardy's daughter had great suggestions about the falling. I don't have any advice on that. I guess I just wanted to add what I knew about fentanyl and if anyone knows what is a good replace I would appreciate advice. Our last Dr's visit she suggested a change. I would like to make an educated decision based on facts from people who know. Blessings to you, Vivian
Set up one of those small portable potties right by the bed at night and put bottled water and some non-perishable snacks on a table by the bed within reach. She could probably use some Ambien to keep her from staying awake for 24-36 hours. This is not healthy at all.
I realy think we need to know why she is staying awake and since it seems to happen around the time of the patch change that would be my guess. I worry about too many side effects from drugs for this and drugs for that.-where does it end? 6 feet under alot of times. Older folks that do not get sunlight stop producing a certainnatural sleep aid our bodies produce-it is made in the liver-I can't think of the name-30 minutes of sunlight is required for us all-it can be indirect-I'll research it and get back-I have it on the tip of my tongue-senior moment-menos daughter
AHa-google it- Sunlight causes our livers to re-set our sleep clock-it makes our liver produce serotonin and melatonin-hormones necessary for sleep and elderly persons do not get enough and that is why they sleep less as they-(we age)- I just googled it-Meno is going for a shuffling little walk with me starting tomorrow-I need it and so does he! Menos-daughter Ruth
You need to call the doctor, thats Not normal, safe, or fair to your mother to go thru that. Are you sure shes not having a seizure either? Please stop that patch as soon as you can. Other than that, I hung bells on strings hanging from the ceiling, moms bed, chair, or where ever I needed to hear her. Good Luck.
Hey thankyou all for taking the time to answer me. Reverseroles, unfortunately this sleep disorder has actually been around for a long time with her, at least 10 years. She has always been on lots of meds because of degenerative disk disorder, shes had cadaver vertebre put in and fused, but it collapsed, now she has a titanium cage supporting her spine and us in pain a lot of the time. I have talked with her doctor and thankfully she has a appt tomorrow with a pain specialist, maybe he will get her meds in order,
Vivian, sounds like you can partially relate to the fentanyl patch, i know she is on the lowest dosage of them now which off hand i believe is either 25 or .25 Id like her to get off them altogether. I sometimes wonder how much of the pain is from the opiates tricking the brain and how much is from her actual problems. I personally have experienced addiction to lortabs, and had a running script for them for a broken neck (not that bad. lol really) i was always in pain, that is until after 18 months on the pills i decided to stop taking them, it took about 2 weeks to get over them and after that, no more pain. sore once in a blue moon now thats it. I just wish Docs would explain in detail to patients how addictive those patches are, basically like heroin, only stronger and every bit addivtive.
Thanks to all of you again, nice to see people are still out there that have time to help even a stranger.
Craig aka ramblingman
I often wonder how much pain will someone subject there loved one (who has no say in the matter )to before they realize that Pain management doctors are being scrutinized in tripliket for over prescribing and giving already depressed patients huge doses of injections of Steiroids and wh knows what else into their spines which work
it's way to their brains , or burn off nerves only to have them grow back and the procedure is repeated? Dad was injured in the service and had part of his spinal cord chipped and then a few years after discharge he had ruptures-then surgery, then more surgery and a rod, then a cage, then 3 years ago the patch which nearly killed him now he is addicted to Morphine via pain pump and he has no pain and out of the clear blue sky his new pain management doctor wants to burn nerves again. I said he is in no pain so when you burn his nerves will you get him off the Morphine I asked? No-he will need that for the rest of his life. Well why burn off nerves that are going to grow back anyway if he isn't in any pain? I said no. The doctor said okay and that was that. His Psychologist and Psychiatrist said this: Never-under any circumstances let your father be subjected to any more injections of any kind. Your father is dying! Let him die painless. Steiroid Injections cause Major Depression in many persons especially the older ones. I thought back to my dad crying for no reason days and weeks after spinal injections. I was balled out by his primary care physician as well. He said he never got a report that you okay'd any procedures on your father! Read this order:. I read it. It was an order for the Pain Doctor to limit all procedures in this 63 year old male to Narcotic' s only
as a remedy to keep this patient as free of pain as possible as he is not expected to recover. Note: Suggest standard dose meter pump. I never read the doctors order I just handed it to the pain management doctor. How stupid of me. I think back to my dads tears and how he screamed while the doctor was inserting large needles in his spine and dad was calling me momma! Help me Momma! Why momma?
I'd like to stick some of that in that doctors back. People. If your 87 year old loved one is dying or 63 or 23-let them die without pain! Please do not subject them to invasive procedures that cause depression or further stress. These nerve burnings and injections are to get working class people back on their feet but I have read horror stories about things going wrong. Who gives a hoot if your mom or dad is an addict at their age? Sorry about the spelling-I am in a hurry to take Meno for a walk before it gets too hot.
Hey Meno, I understand where you are coming from, and I am sorry that your dad had to go thru all of that. As far as my mother is concerned she is of sound mind, and most likely could take care of herself. I am more here as her errand boy I reckon. Up until recently she was living in Mexico and when she first got there 3 years agp she decided to go off the patch because it was too hard to get in mexico, she was off it for almost 6 months when she decided she was in too much painand decided she would come to the states every 3 months and get the patch, she found a doc willing to write it for 3 months instead of the normal 1 month and went back on it. I think that she could have been more succesful if she had a Doctor that she saw regularly (monthly) and was prescribed something less serious than the fentanyl patch. these patches do not add years to a persons life, they kill people. so its not a matter of her being an addict at her age, its about these patches taking away from a more normal life that she can have not being on something that makes her virtually a zombie nodding off all the time. If it was just about her being an addict as you put it, well if she couldnt have a better life on something else, I could care less if she had to mainline heroin to not hurt. But thats not the case, these are taking away from her enjoyment of life, and no I dont want that to be how the last few years of my moms life was spent, medicated to the gills getting nothing out of what were supposed to be her golden years. Sometimes its not right to have someone restrained by medication, this is one of those times.
ramblingman-I think I have a better understanding now. Meno-my dad- was taking 60mg of Morphine Sulfate twice a day and after about only a week he stopped nodding off and or getting high altogether. He was absolutely pain free and I had to go out of the states so I put him in a Veterans Hospital short term try out in San Antonio because he was an officer in the military. Somehow he slipped in the shower and a man tried pulling him up by his arms and dislocated both of them and even caused damage to his back again. I think something else happened but thats a didfferent subject. So to stop the pain in back and shoulders he is now on a pump because he is end stage and they are not concerned about addiction as am I-I am like you-I wouldn't care if he was given heroin or dilaud, demerol-he is dying anyway I just want him to not suffer. My point is you know the patch is killing your mom. Menos physicians all agree that MS.Contin ER does not hurt the heart or liver-at least that is what I am told and his liver levels are all normal and his heart is strong as a 15 year old but he takes a beta blocker to keep him from going into fibrilation. So maybe ask your moms physician about MS Contin ER. Meno was normal compared to the patch and Oxycontin and other medications . He never asked for more. His pain was completely under control while he was on the MS Contin-he was not a Zombie. For the first week yes-he was "high" but then he adjusted and was fine for a good year until the incident at the VA. I researched MS Contin ER and people who have dangerous jobs can safely do them after there body adjusts. Drug addicts do not like them because the high they seek doesn't happen after a week or so. Only for the short adjustment period. My brother took one to feel the effect and he said wow-how can he take those and not be on cloud 9?! His then pain management doctor says everyone says this for the first few days then they can't tell they are taking anything-but the pain goes away. So maybe this would help your mother. A word of caution. A person cannot stop taking them without going thru withdrawal every bit as bad as heroin. Meno didn't have that problem because he is getting the equivalent in his pump that doses him automatically but he doesn't know the difference. His doctors said the pain patch is dangerous and like you said will eventually destroy her. I hope I am making sense-The MS Contin ER is safer and not as harsh on the body-so they say but I don't know he has lived longer than they said he would anyway. With the Morphine I think it has added more months actually because it is easier on his system as a whole.. When he could swallow pills his PHD Psychologist said get him off the hydrocodein. He is a Palliative care Psychologist and he said in his experience persons taking that drug seem to die sooner

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