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My husband’s AD is definitely progressing but we are dealing with most of the changes quite well . He loves his recliner and has learned, with prompting, to push himself up from it with his hands to his walker . He does this from other chairs as well . We got a hospital bed as his Dr and PT feel he should not sleep in a recliner at night as a small pressure sore , which thank God with much work and attention is healing between his buttocks. (never thought at this stage in life I’d become so much more intimate with my husband’s behind )


The problem is that no matter how often he is shown how to get up from the bed he can not do it . They prefer him to sleep on one side then switch to another to get even distribution and not favor one area . He suffers from knee pain , back pain and neck pain and even though he can get off the bed when the PT is here during the day, at night , trying to coach him just as she does , he just cannot comprehend what I am telling him and it’s a nightmare for both of us . My heart breaks for him as he is doing his best and trying , as I am. When I finally get him up, after going to the bathroom we head back to the recliner where he gets a good nights sleep. We have purchased a roho cushion which he sits on and also place a pillow under one buttock then switch to another so pressure is not in any one area which has really worked quite well . I get him up and moving every hour or so during the day as instructed and that too has helped.


I admit to being horrified when I saw the mild pressure sore as I was convinced, until being reassured by home healthcare, that somehow I really messed up but now I’m wondering what I’m doing wrong that I just can’t get him to push up from the bed late at night. Was the hospital bed a mistake? I remember my mother as she aged couldn’t sleep in a bed at all and slept in a chair which I never thought twice about. As you can tell from my rambling I’m quite frustrated as all I want is his comfort and well being . Has anyone else had this problem. Any (kind) advice would be appreciated.

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Just a small idea. If your phone allows, video the therapist getting him up.
Is she taller than you? Speak faster or slower or louder or lower than you do?
Where does she stand? At the head of the bed, near the foot? By his side? Close to the bed or across the room?
What are the words used that your DH responds to?
So, just think about it very methodically. Watch the video for the smallest detail. Perhaps notice how long it takes for him to complete each movement. Maybe the PT can video you and then allow you to see yourself interacting with DH. She may be able to give you pointers that make sense to you after seeing yourself. Videoing is a great learning tool.
It is puzzling as to why he is able to get up with the PT but not with you. I’ve actually experienced this with my DH aunt, 94 and with dementia.

Once when her therapist asked her to walk to a chair across the room, she could not do it. I knew she walked past that chair every morning and night when she turned her Christmas tree lights off and on. But when he asked her if she could walk to that chair, something stopped her. She really struggled to take the tiniest steps. They had just walked together all over the house so it was really odd.
So notice the therapist words vs your words to see if you can find a key. The tangles in his brain may not allow him to follow one direction when he can another.
One last little thought. Perhaps write down the words the pt uses verbatim. Then you read each step to DH and dont say anything else until he’s completed that step and then read the next step.
Sorry if none of this is helpful.
You are obviously taking very good care of him.
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Somethingelsa Jan 2021
What a great idea ! I will video next visit . Thanks !!
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This is very frustrating! - and it is not your fault and not his fault, for the following reasons:

Late at night he is less alert.
He is not already focused on his PT session.
You are not wearing uniform.
You are probably not using the same vocabulary.
I doubt if the light is as bright.
I think it's very unlikely that your body language, pattern of speech and spoken directions are exactly the same as the PTs.

All of which would contribute to DH's being less able to follow directions at two in the morning.

To be fair, I'm not sure I'd be able to follow directions at two in the morning...

However. Why not ask the PT to watch you prompting your husband to get up and off the bed? - then if there are any glitches or key differences, she can correct you.
For this to work, though, you will have to be patient with yourself and thick-skinned about criticism - invite it, don't hurry past it!

What I usually see with spouses and children engaged in "moving and handling" routines is that: they rapid-fire and repeat instructions if the person doesn't immediately get it right; they are too quick to intervene physically; they talk too loudly and their voices rise in tone; they give commands which seem clear until you act them out but are actually ambiguous.

Where is the routine going wrong? Is he unable to:
sit up
bring his legs over the edge of the bed
sit up on the edge of the bed
place his feet
place his hands
push up to stand

Does he have any kind of equipment for mobilising, like a bed stick or a grab bar?

I've had some success with asking the person to copy me, then literally doing what I want him to do.

I also had to give up with one client after I'd tried every approach I could possibly think of. I sighed deeply and sat down slumped next to him. At which point with no prompting at all he simply stood up and took hold of his walking frame.

The hospital bed was not a mistake. You are not making any mistakes. You and he will find the way that suits you :)
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The problem is not bed versus recliner but lack of movement that causes a pressure sore. If he moves in his recliner at night, it won't be a problem. Does his bed have an overhead rail to help him lift and move? If not maybe rent one for a month, get PT to teach you/him how to use it, and give it a trial use. The goal is for him to move more and stay off the fragile area on his back. Also talk with his doctor about managing his knee, neck and back pain better. Pain can make it harder to move and concentrate, especially at night when one is tired.
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“NobodyGetsIt”.........That’s the best name I’ve seen !!!
The healthcare nurse today was very encouraged by how well his sore is healing and explained again how common they are when you don’t move around enough so I’m realizing the hospital bed is no guarantee. Your reply and all the others helped me to see that I need to do what works for our particular situation and unless you’re us
“ nobody gets it “
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NobodyGetsIt Jan 2021
"Somethingelsa,"

I'm glad your nurse was encouraged to see how well your husband's bedsore is healing. Even though we don't want them to get sores at all, there's a little relief knowing how common they really are. In all actuality, there's no guarantees about "anything" in life period. When my mom lived in her previous ALF she had her own queen bed from her house. When I noticed she was staying in bed longer, I bought a gel pressure topper at least 3-4" thick to put on her bed. I think it can go up to 5" but, I wasn't sure if her bedding would fit over it at that point. She really liked it.

As I've often said, there's no caregiver's "step-by-step handbook" and there's no "one-size fits all" solutions. People come to the forum and ask for help/advice/suggestions (in your case you asked for "kind" ones at that) and it's up to them to read through each answer taking what they like or feel is at least worth a try and discard the rest. No two situations are alike even if there are some similarities because no two people are alike.

This is the first forum/social media platform I've ever been on and I'm glad you like my screenname. I'm an only child (58) to depression era parents with my mom's remaining siblings ranging in ages from 75-90 who all live in other states. They took care of spouses in their homes and one cousin brought my aunt and uncle into hers for several years. Whenever we had a crisis with no support, my husband and I would always be upset and say (rather loudly I might add) "NOBODY GETS IT!" and that's what I went with.

Blessings to you as you forge ahead in this journey!
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My 96 yr old Dad loves his new recliner and has chosen to sleep on it instead of his bed.

It has been one year now and he's never had a bed sore.

He keeps in the lying position with his feet up so to keep less pressure on his butt then if sitting.

It also keeps his feet from swelling keeping them elevated.

The recliner chair purchased was tge one with the hand held remote that makes the chair sit and lay back. This particular chair bottom goes down at a slant that help make it easier for him getting in and out of the recliner chair to a standing position to his walker.

Hospital beds are awful.

They are very uncomfortable even when you have a thick gel pad on it.

Just try it yourself like l did and you'll understand.

The Hispital bed I purchased was a waste of money.

Let him sleep in his Recliner and besides the pillow for his butt, also use a nice comfy fitting single bed topper. A Size Twin fits My Dad's Recliner perfectly.

Prayers
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Somethingelsa Feb 2021
Great suggestions ! Thanks
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Mom last 6 months of life pulled muscle in back, breathing issues, etc. I have recliner that lays full flat and comes all the way forward to assist in standing. (Motorized - heat settings and massage seatings, too)She preferred to sleep in chair (She was very small and chair is very large) With pillows positioned to alleviate pressure - this worked well for her. Hospital bed was a joke. Recliner saved my back from having to assist her up and down. (She lived to 1 month short of 104).
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Somethingelsa Feb 2021
At this point I’m almost at the point of totally agreeing with you about the hospital bed . I did order him a lift chair so we’ll see how that works out .
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You say you have a hospital bed, so I don't understand why you can't just raise the head of the bed until he is upright and then pivot his legs to the floor? A bed cane or similar product

https://www.agingcare.com/products/bedcane-136322.htm

would give him something to grab.
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Yes that seems so simple and I truly wish it was as easy as that . I thought a hospital bed would make my problem like grouting up from bed easier and that was the first thing I attempted after the PT’s way did not work . However he is propped on his side and does not understand that he has to roll onto his back for me to raise the bed . He also cannot move his legs himself at that hour and protests when I try to do it . If it was just a physical issue we could deal with that one problem but it is an Alzheimer’s brain issue that has terrible sundowning issues all night and any direction I give is not understood . Thank you tho for your suggestion. I appreciate it .
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My father had same problem, he kept falling getting out of his regular bed and when mom & dad moved from Independent to AL because of his constantly falling (I'm sure his bones were made of rubber from the number of times he fell), they had a hospital bed brought in for him. They would adjust it to his liking, then he'd fiddle with it and be uncomfortable.

He too slept in his recliner starting while in Independent and traded out his manual recliner with a used chair lift. The doctors and nurses also didn't want him sleeping in the chair. He also got a pressure sore. It was suggested we get a chair pad for him to relieve it. While at VA for his hearing aids, I asked about chair pads. Bless them for they just gave him one - It was plastic, filled with air and had sealed holes throughout which worked. I don't know what the cushion was called.

He continued to sleep in his chair until he went to the SNF. He was on hospice by then and they provided a bed with the appropriate mattress.

Long story short the hospice nurse (while in AL) said his sleeping in the chair was fine. Just find a cushion that will keep him from getting pressure sores.
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Somethingelsa Feb 2021
Yes thank you . We ordered a roho cushion from Amazon which sounds like what you just described . Nurse just left and said pressure sore is healing well . PT is on her way and I will show her exactly what is going on again and video her getting him up .
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If you have a hospital bed, will the back go up high enough to get him into a sitting position? (I'm sure you've tried that, but had to ask). Then all he'd have to do is put legs/feet on the floor. If the bed did not come with a rail, get one. Once you have him in sitting position he would have something to hang on to in order to get to the right position to prepare to stand.

I know a lot of people who sleep in recliner. I did it for a very long time because laying flat in a bed was not comfortable. They also have recliners that go all the way to a laying down position that would help relieve pressure. Chairs have 2 arms to push against when standing, so I can understand why it might be more difficult to rise from a bed. I've also seen a bed on the internet that goes up to sitting position and turns to exit - just like a chair. Search for: ActiveCare™ Standard Rotating Pivot Hospital Bed. More than likely, pricey, but may be a huge help now and in the future.
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