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He just sits in a chair. Is this common in later stages? Will this deteriorate his heart issues more? He has three partially blocked arteries and one totally blocked. Any suggestions?

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I believe that there is a time for every purpose under heaven. There is a time to focus on consistent routines for those with dementia. The final stage may not be it.
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You mention late stage Alzheimer's. You realize that ALZ is a terminal condition, right, and it will progress at its own pace?

If his doctor is satisfied with his care, I think you best just relax about it. I'm not sure what "other vitals" you think may be harmed, but since he is in the late phase of a terminal condition, does that really matter? I don't see what harm will come from sleeping when he is tired and eating when he is hungry.

Enjoy the time you have left with him. Try not to antagonize his wife, who is under a great deal of strain. Accept what you can't change.
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If he doctor says to let him sleep as he wants, I'm not sure how you can argue with that. I have heard that blocked arteries does cause extreme exhaustion. It's my understanding that your body does suffer decline as the dementia progresses, even if you do get sleep.

Apparently, he's receiving Palliative Care is that right? I would think that getting a good night's sleep would make him feel better overall. Plus, if he's resting and getting good rest, so can his caretaker. I'm not sure if your step mom has really thought about that. If she's resistant, I might inquire if she needs some outside help with his care. Perhaps, she's too exhausted to get things back on track and manage his care.
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I'm sure the answer to that would be..."he would only get angry and get back out of bed." I agree that being on a consistent schedule would most likely help my dad. Even his eating schedule is not awful. If he is hungry at 3:30 pm he is given his dinner and that becomes his evening meal. if he is hungry later, she has him snack on cereal. Other days his evening meal is at 5:00. My efforts fall on deaf ears. My main concern is what it may be doing to his other vitals aside from the Alzheimer's health issue.
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Is there any reason that he can't be led to his bed at night, then awakened in the a.m. and then put to sit in his chair? Plus, sometimes a sleep aid at bedtime might help him get a good night's rest. It might make him feel better during the day and allow his caretaker to get more rest if he was on a schedule.
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Thank you all. My stepmother complains about him sleeping during the afternoon but doesn't do much to keep him awake because his PCP said "if he is tired,let him sleep". He is not on a prescription for anxiety or depression. When he wakes in the afternoon he is confused and asks repeated questions that my stepmother finds annoying and often his mood has changed for the worse.
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Sleep issues are extremely common in dementia.

How do you know that he doesn't doze off in his chair at night?

Does he sleep during the day?

Getting enough sleep is important, but it doesn't have to be at conventional times or in a bed.
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Sometimes medicine can keep you awake at night. I had that issues with a prescription meds for anxiety.... it worked for the jitters but it kept me wide-eyed the whole night... not good. Had to get off of it. So check and see what type of meds your Dad is taking.
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Sounds like he is dozing off during the day. Can you keep him awake until bedtime?
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