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DaizyMae Asked January 2022

Does anyone have advice on regulating Mom's sleep-wake cycle?

Mom is 86 years old with dementia. I have been trying to keep her awake more during the day so we can all (hopefully) sleep at night. Hospice has recommended her to have a minimal dose of Morphine in the evening, which scares me. I have tried other medications and natural supplements, but we just can't get her regulated. Sometimes she talks all night and sleeps all day. Other times she hallucinates both visually and verbally for about 48 hours. Needless to say, my husband and I are both frequently exhausted and often a bit testy.


Does anyone have experience with the Morphine?

lealonnie1 Jan 2022
I will tell you this; when I was pregnant with my son back in 1985 and having very early labor contractions associated with pre-eclampsia, I was given MORPHINE to stop the contractions and put into a light twilight sleep for about 8 hours. The contractions stopped, I had a healthy baby boy who I carried to term, no further complications, and all was well.

Don't attach an unnecessary stigma to a drug that has many, many uses. Don't question hospice too closely because they're not trying to kill your mother; they're trying to help your mother sleep through the night and thereby, help YOU sleep through the night.

Both of my experiences with hospice have been nothing but positive and excellent. If you have any further doubts about the 'danger' of low dose morphine, run it by the doctor who oversees and is associated with hospice. That should ease any further anxiety you may have.

Wishing you the best of luck.
MargaretMcKen Jan 2022
I’d totally support this, but would perhaps double check what IS a low dose, and what dose your mother will get (for your own future peace of mind in case you question it). I’m fairly sure that a high dose from the doctor hastened my mother’s death, which was probably appropriate and a blessing. However Hospice has nothing to gain by hastening your mother's death, a very different situation from my mother's terminal cancer pain.

My own extensive experience with codeine (which is the bottom of the range opioid) is that it does help with sleep as well as pain. More sleep will help you all.
Lee10075 Jan 2022
Background:
My 99 yo mom has late onset dementia and issues ranging from torn rotator cuff, arthritis, crohn’s etc. She lives at home with live-in caregivers. She is followed by a top notch neurologist, palliative doctor and primary.
Her days and nights were upside down and she was in constant pain and was having psychotic episodes and was very depressed…until we got the specialists on board.
our new normal over a 2 year period is as follows:
zoloft( anti depressant
remeron (sleep medication)
melatonin
risperadone (for psychosis)

methadone (pain)
a small dose 2x a day
Doctor explained that they found that
a low consistent dose is much better than trying to address intermittent pain that can take 1 to 2 hour to respond to medication.
our days and nights are normalized.

our goal: Mom’s life should be as joyous and as pain free as possible for as long as she is here.

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HisBestFriend Jan 2022
DaizyMae! What a lovely name! You are doing well and I know you are exhausted. Give yourself a little breathing time, stand outside in the daylight and take a deep breath.

THEN........ Listen to hospice, they have done this many times and know a lot more about it than any of us ever will! A minimal dose of Morphine before bed might just do the trick and you all can rest. Your momma is 86 years old, a good night's sleep might make the days easier,too.

Be brave, you can do this!
God bless. ((((Hugs))))
DaizyMae Jan 2022
Thank you for your kind words and encouragement! I appreciate you for that! I do take mini-breaks for myself. A trip to the mailbox even seems to center me now! Our Hospice team is wonderful. They are a tremendous help. I am working through my feelings about Morphine, but have decided it might be best after speaking in depth with her nurse yesterday. Thank you for your response!
gladimhere Jan 2022
Don't you think mom might do better during the day if she gets a good night sleep? Listen to and trust hospice. Give her the morphine dose as suggested.
DaizyMae Jan 2022
Mom's situation waxes and wanes. One night she sleeps well, then you have a 48-hour wake cycle. We are going to try the Morphine. Thank you for your response.
TChamp Jan 2022
The benefit of using drugs for making a demented person sleep normal hours, is only for the caregivers. A reverse sleep pattern, is not going to add more damage to an already impaired brain. The use of psychotropic medications in old persons with dementia makes them worse. They are also prone to falls because of prolonged over-sedation. In hospices where the worsening of the patients is not a concern, they use medications to make the patients and staff comfortable.

TakeFoxAway Jan 2022
Yes. I have experience with morphine. For the last month that my dad was dying, we had hospice come in 1ce or 2ce a day. They gave me the morphine to give to him. It kept him calm and peaceful and sleeping. Otherwise he'd wake up and be in a panic and try to get out bed and he was too heavy for my mother and I to hold. Morphine is what they give. Don't be afraid of it. Give as instructed, but especially at night. Sometimes I had to get up at night and give it to him. It was oral. Good luck.

southiebella Jan 2022
I've tried so many things to keep my mother in the bed at night. She's at the mid-to-late-stage of dementia. She has lost her ability to reason and understand. Even if she could, she doesn't remember anything in the short term.

RIght now I'd be thrilled to get 4 hours of continual sleep, but we're up every 1.5 to 2 hours to go to the "peepot" as she calls it. Her doctor prescribed trazodone which has the opposite effect on her.

I've been using melatonin, a chamomile/Ltryptophan/melatonin combo and magnesium which haven't been as effective lately. So she wakes me up all night long and then she sleeps like a baby all morning. It's currently 10 am and she's been sleeping soundly since 5:30 ish. She doesn't have enough brain function to realize what's going on so I can't be mad at her. I've tried so many days to keep her up and it accomplishes nothing but making both of us miserable. It was like I had an over-tired baby on my hands.

I'm going to start using some Dandelion tea to see if it will settle her bladder down.

Like someone has said here, there is no fixing or reversing the dementia, which is at the root of the problem.

I'm currently waiting on an assessment for palliative care - waiting on her doc to send the orders - maybe when I get her on board with them, they can offer some help.
Drivesmemad3 Jan 2022
Hi my dad was given some tablets for an overactive bladder. They seemed to work ask the GP
dollycarlton1 Jan 2022
My 83 year old mother used to take a child's dose, 25 mg Benadryl at night to help her sleep. I would rather try that first than morphine. If that doesn't help, give her 2 pills. There are many other medications for sleep than morphine.

Avalenz Jan 2022
The first time I gave mom morphine she turned red and hot. She needed the blankets off of her and she is always freezing. She also experienced awful stomach pain. She held my hand and squeezed through the pain. She kept looking at me like please help me! After two hours w with hospice on the phone I finally gave her the nausea medication that was in her "Emergency! Kit". She is on Norco 10-325 and doing better.

Taarna Jan 2022
Morphine can be sedating but won't last the night unless it is a sustained or extended release formulation. It is better to talk to her doctor about her sleep issues - difficulty getting to sleep? difficulty staying asleep? difficulty getting up at same time every morning? - since there are prescription sleep medications to help with each of these types of problems. As an RN, I have had success using Benadryl (25 mg over the counter medication) and Restoril (prescription medication) to help seniors in the hospital to get to sleep and stay asleep at night.

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