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We have just moved my mother-in-law into our home. My husband works and I will be her primary caregiver. I will be working with a team of doctors and would like to use home health care. She is 87 and has congestive heart failure, stage 4 renal disease, and type 2 diabetes. The past several years she has stayed up until 2-3 am reading and sleeping in her chair. Then she goes to bed and sleeps until noon. The doctor has stressed to her that a schedule is imperative because of taking her medicines on a regular time frame to avoid dialysis. How should we change her schedule and how much should she be sleeping? She wants to sleep all the time. I am having to constantly wake her up to give her medicines to her. I know that she is 87 years old but I am trying to give her the proper care. She was living by herself in an assisted living facility that prepared her meals and home health was coming on a weekly basis to fill her medicine box. I am now preparing her meals and dispensing her medicines. Any help would be appreciated. This has been a real challenge!!

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How is her diabetes being managed?
How's her appetite?
Otherwise I agree with everyone, especially about the happy sleeping compromises.
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About trying to get her to change her schedule: The goal should be to stick to a fairly consistent schedule that makes it convenient for you to give her her medications as directed. If she needs a pill twice a day, 12 hours apart, that could be noon and midnight -- but would that be convenient for you? How about 10 and 10, even if you have to wake her at 10 for the pill and then let her go back to sleep. If she is a night owl, try to accommodate her as much as you reasonably can, but don't ruin your own sleep schedule. She is depending on you and you have to maintain your own health.

I have a sleep disorder and so I have done a fair amount of reading and regularly see specialists. As far as I can tell, there is nothing inherently healthier about going to bed at 9 pm compared to going to bed at 2 am. We all need a certain amount of uninterrupted sleep per 24 hour period. But there is no "magic" period when that has to occur.

I don't think you have to change her schedule for her health, but it is perfectly OK to change it to suit your needs.
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I say let her eat and sleep whenever she wants. My mother takes her morning meds at 11 AM, her lunch meds at 3 PM and dinner meds at 10 PM. We are a household of late sleepers. So long as she gets them with the proper frequency, it shouldn't matter.
As for urine output, it's much easier to weigh her every AM & PM. A gain of more than 2 pounds should be treated as needing a diuretic. Ankles sometimes swell, sometimes not. The weight is the key. Make sure she drinks PLENTY of water - at least 8 glasses per day. That's water, not cola, not tea, not juice, not coffee.
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If you can, collect her urine in a commode, and get an idea of how much she puts out, the color and odor. You monitor changes. With CHF you don't want a fluid build up, and you check her legs daily. If the urine output decreases and the legs swell up, call the MD. Keep the salt shaker away from her, avoid salty treats or salty condiments. Hide the sugar bowl too. Meds that are taken twice a day should be 12 hours apart, such as 8am and 8pm. Ask the MD what order the pills should go in, and if any should be given separately.
Bear in mind that diuretics like Lasix can make her GFR results look abnormal. Buy a stethoscope and listen to her lungs. On a good day you just hear air whooshing in and out. If fluids build up the lungs will be muffled or crackly and she may cough a lot. Summer heat and humidity are tough on CHF patients.
Listen to her heart, get to know the normal sound so you can tell if it is too slow or too fast or if it is faint. Watch, listen, learn.
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