Anyone have recommendations for helping Mom sleep at night and nap less during the day?

Dear "daisy10178,"

When my mom lived in an Assisted Living Facility since 2015, her sleep patterns were erratic. She is 95 with Alzheimer's.

After nearly dying of severe dehydration and COVID in April and being in the hospital/rehab facility, we moved her to a new ALF in their memory care wing where she had hospice services come weekly. She was bedridden but kept getting up in the middle of the night and often would fall. She would also be a little agitated during the day. So the facility wanted me to let hospice give her something to help her sleep. I was concerned because I didn't want her to be in la la land. After I talked with hospice, I agreed to let them order the lowest dose of Trazadone. They made the prescription for 1@bedtime and up to 3x during the day as needed. I kept a very close eye on her through window visits and hospice told me they only needed to give her two doses once which I was thankful for. She did so much better with sleeping through the night and then they were able to get her up for breakfast. She was never up for breakfast at her previous facility. I ended up changing hospice companies and they kept the order for Trazadone but they would only have her take it at bedtime - so just 1 a day.

Now, it's not that she doesn't take naps during the day - she does because they take her to some activities and at her age, she gets tired but overall, this is the best schedule she's been on in years.

She may also have some depression going on especially being blind and having been confined for 10 months alone in her room with not much to do or that she can do which makes things very difficult to combat. They ended up giving my mom a low dose of an anti-depressant as well which seems to have helped.

It doesn't sound like your mom is on hospice so I would ask her doctor. There are other medications given for the same issue(s) and it will depend on her health history and other types of medications she may be on.

I hope you will be able to find a solution that will work for your mom.

Best wishes to you both!

Night time wakefulness is very common in older people, my question is in what way is this a problem for you? If she is simply unable to differentiate between day and night get her a talking clock or watch, but if she expects you to be up and at her beck and call perhaps her sleep patterns are not the real issue and she is either self centred, or cognitively unable to give your needs any consideration.
Find ways to keep her active during the day between naps, a little bit of physical therapy will be good for her and give her some chores around the house - folding laundry, setting the table and putting the clean dishes away should be within her ability. To reset her circadian rhythm you might try melatonin, start with a very small dose.

Put her chair in front of a window. If she can see the TV then she can see natural light. Set a schedule for her. Wake up time. Breakfast time. Lunch time. Dinner time. Bed time. And one or two naps. A nap after breakfast (if necessary) and one mid afternoon should work. Keep naps to 30 minutes. If she can get outside for some sunshine and fresh air, that too will help. This of course starts to become more difficult toward the end of life but it sounds like your mother is pretty hale at 95, yes?

There are loads of things available to keep her entertained during the day. YouTube, TuneIn radio, Pandora, etc etc etc have an amazing archive of radio programs, music programs, concerts, etc. Your local library has books on tape and more. There's also exercises she can do called Sit and Be Fit.

My mother sits most of her day in the kitchen which is probably the 'brightest' room in her apartment. She has her routine, which takes forever, but so what? She dresses each day, does her hair, puts on full makeup (at 90, I find this so cute..I don't wear any and I am only 64!) and spends her days in her apartment in brother's home. She goes nowhere and may never see her friends from the Sr Center again, which is very sad. All her friends have passed away.

She does move, after lunch, into the TV room where she works puzzles and reads. Brother repeats that she dozes a LOT during the day. But at bedtime she has her 'cocktail' of sleep aids, one of which is Trazadone and that, plus melatonin and one other drug (can't remember it, sorry) knock her OUT. She sleeps 12 hours straight. (She is catheterized, so no need to get up to go to the bathroom).

She's tired. Her body is worn out. I honestly don't KNOW what keeps her going. We have long since stopped trying to engage her in any kind of outside activities, trips, etc. She won't even go for a car ride and get a burger to eat in the car, she's so terrified of COVID.

I think we worry too much about our elderly LO's and their sleep habits. My MIL states with great fervor that she has not slept a minute since 1975 when I joined the family. Why my existence keeps her awake 46 years later is a real mystery. I mean, she's insistent she NEVER sleeps, but DH has gone into her house dozens of times and found her sound asleep and he takes a pic each time, then shows her, but she thinks he's pulling her leg b/c SHE NEVER SLEEPS. She was robbed once and the thieves cleaned her out before they realized she was even there.