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Edahmen Asked December 2015

My husband (75) has vascular dementia. A couple of weeks ago he had a major TIA and was hospitalized overnight. Need help with recovery?

When he gets up at 4 or so, he is completely befuddled. He can barely make it into the bathroom. I put him back to bed and he gets up every 10 minutes or so - obviously making my life difficult. Sometimes after an hour I get him up and by then he is nearly "normal " and goes into the living room without his cane or rollator and goes to get coffee, walking unaided with a full cup.
Then later in the day he turns into a zombie and is befuddled again, especially after a nap. Has anyone ever experienced such Dr. Jeckle and Mr. Hyde behavior?

Edahmen Jan 2016
Thank you very much! Very helpful! I did a lot of online research.
First of all no med changes - he has been on them for years.
I always take a nap when he goes down and I do have home care coming in. I am increasing the number of days.
Thanks again!

jeannegibbs Dec 2015
That is not unusual behavior in some kinds of dementia. There is a lot of research going on regarding the impact/relationship of dementia and the sleep cycle. Transitions between sleep and wakefulness become blurred and difficult in many cases.

What drugs is he on? When does he take them? The "zombie" syndrome may be related to medications.

I know from experience that the sleep disruption is extremely hard on the caregiver and that you cannot go on indefinitely in a sleep deprived state, or you become the zombie. And that is dangerous for both of you.

Do you have any help coming in? Perhaps you can grab a nap while help is with him.

Being befuddled for an hour or so in the morning is really not so horrible except for the timing! I wonder if you could gradually try to shift that. Would moving his bedtime later help him sleep longer in the morning? I'm not sure if that would help since it is his bladder that is awakening him, and also part of his sleep mechanisms are probably "broken." But if he didn't wake up until 5:30 and then stayed up it would be easier to deal with wouldn't it? So it might be worth a try. Is the every-10-minutes issue because he thinks he has to pee again? For my husband that was a prostate problem and we solved it with saw palmetto (took several weeks). Or is he getting up for some other reason? For my mother I got a clock that projected the time on the ceiling. After the first time she got up, I'd point out the time and say, "You can stay in bed two more hours. Don't get up before it says 8:00, and I'll have a nice breakfast ready for us."

My husband had LBD (which includes strong sleep issues and highly vairable cognitive skills) and I have no experience with vascular dementia. But based on my experience here are my suggestions:

1) Discuss the sleep issue with his doctor. There may not be anything that can be done medically, but I'd start there.

2) Figure out ways to avoid severe sleep deprivation for yourself. Zombies caring for zombies is a pretty scary picture. This may mean having an aide come in from 4 am to 8 am, or you napping while a volunteer is there. Do whatever it takes. Get your sleep.

3) Cherish every "good" moment you have with your dear husband. If he is usually at his best after fully waking up in the morning, plan your activities with him for that period. Go for walks. Read the paper together. Look at scrapbooks. Play cards or board games. Visit the hardware store. Don't try these things mid-afternoon if he is likely to be befuddled then.

4) Accept each "new normal" and adjust to it. Dementia is progressive. The good periods may get shorter or less frequent. He may display new odd behavior. At each change, discuss it with his doctor and also with experienced caregivers (like us). Belonging to a local caregiver support group can be extremely helpful.

Hugs to you, Edahmen. This is a very hard journey that you are on. I wish you both well.

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