How can I get my nan to sleep in her bed instead of a very unsuitable chair?

My mother slept in a chair for seven months in her first nursing home. She absolutely refused to sleep in the bed because after 66 years of sleeping in a king-sized bed with my dad, she was afraid she'd fall out of a twin bed (or so she said).

She developed terrible edema in her legs from sleeping in a regular non-reclining chair and her legs were literally dripping water out of them. She refused to put her legs up, and she couldn't operate a manual or a motorized recliner. (Dementia plus bad vision.)

We ended up moving her to a new nursing home closer to me, and we just didn't bring the chair with us. She's slept in her bed ever since with no complaints.

Sometimes it's just as simple -- remove the chair.

Maybe she is sleeping in the chair because an upright position is more comfortable. My mother has slept in a chair for years - it helps her breathe better and her back does not hurt as much.

Maybe you can change the daily routine and find one that works now. Unfortunately, you didn't give us much information to answer beyond that.

My Mother wanted to be where the "action" was,in the den and where her lift chair was and she sat all the time.
She was comfortable there,so I didn't fight it when she wanted to sleep there too.
I hope your Mother finds her right spot soon Emm,Take care~

My mom does this too. For my mom it is a mobility issue. It is easier for her to get up from a chair than a bed.

Other issues are that she has to use the bathroom so frequently so getting up often is necessary. She also says that the covers are too heavy and she gets tangled up in them. She doesn’t ever get a full night’s rest so she would fall asleep in the chair due to exhaustion.

Like you, it used to bother me to see her sleeping in a chair but I realized that often she slept better in her chair. There may be legitimate reasons why your mom prefers the chair to a bed.

I never woke her to get in bed because she was finally getting much needed rest. It’s hard being old when things start to go so far down hill.

She’s no longer living with me and my sibling allows her to remain in her chair as well. She is well into her nineties and barely has any energy left. One of her common expressions is, “It’s hell to get old!” Indeed it is when there are serious health issues.

You have good intentions. I just don’t feel like we have control over some situations and I suppose if you have tried endlessly to change her habit of sleeping in a chair then you may need to let it go.

Caregiving is an endless job. It sounds as if you are doing your very best to make her as comfortable as she can be. That’s all that you can do. All the best to you and your mom. Take care.

Sounds more like a urinary tract infection.
Deb RN

Dear "Emm1981,"

My 95 year old mom with Alzheimer's has been the exact opposite. The LTCF gave her a brand new recliner because she was developing bedsores and every time they put her in it, she wanted to get up (to the point she fell) and crawl back in bed.

If your nan doesn't like to lie flat on her back, they make those wedges that elevate the upper body with the most height for the head. They also make cooling ones. They can be good especially for those of us who have GERD/acid reflux.

Put a chair in her room.

Dementia doesn't develop overnight, in a week, or even in a month. The 2 conditions often confused with dementia that DO develop fairly quickly are Depression and Delirium. The 2 most frequent causes of delirium (a sudden change in mental status/capacity) are: a urinary tract infection or pneumonia, though ANY type of infection can cause delirium. If her primary care physician cannot see her within a day or two after hearing about this fairly sudden onset of a change in her mental status and functional capacity, then she needs to be taken to an emergency room where she will receive a complete workup for the underlying cause of these sudden changes. There's no reason that at this point there isn't a definitive answer as to whether or not she has a urinary tract infection (UTI). If she can answer questions accurately, please ask her if she has seen any blood or pus in her urine, if she has any burning when she urinates, if she feels like she has to urinate more than normal, does she feel like when she gets the urge to urinate that she has to hurry up to get to the bathroom to avoid having an "accident." Does she feel like she can never completely empty her bladder when she urinates? Whomever does her laundry should be checking to see if it appears as though she has been incontinent. Even a walk-in center can get back urine test results in a day or two AND, more importantly, they can do what's called a Urine Dip Stick (they obtain a urine sample and pour it into a cylindrical test tube and then insert about a 4 or 5 inch test strip with multiple tests indicators on it and wait the specified number of SECONDS or minutes for the results of each test). They should have a good idea by the end of the visit if a urinary tract infection is present. The benefit of having this test done in the hospital is that they will (likely) obtain the specimen with a small urinary catheter and the sample will be sterile (no contaminants from her not wiping well). Then not only will they be able to test to determine if a UTI is present, but the remainder of the specimen can have tests done in the lab to determine which antibiotics the bacteria causing the infection is most susceptible to. The walk-in can do lab work and a chest x-ray as well. In most cases the results should be available the same or at least by the next day. In the hospital however, the ER will have the results in a matter of hours. In addition to doing a chest x-ray to rule out pneumonia, they can do a CT scan. This test will allow them to check for bleeding in the brain, a clot in the brain, or even the presence of a small tumor in the brain. In view of how long this has been going on and the (seeming) lack of aggressiveness on the part of her doctor, I'd suggest taking her to the hospital. She doesn't have a fever by any chance, does she? If a thermometer isn't available, place the back of your hand on her forehead then compare it to the temperature of your own skin (assumes you are not ill and don't have a fever yourself). I worked in nursing homes for nearly 10 years. A sudden change in mental status is an urgent situation. She should not be allowed to stay alone until the underlying issue has been determined and a treatment plan implemented. This is a B-I-G potential problem waiting to happen and if she's left alone, she may wander, she may fall on the floor and not be able to get up, she may try to call for help but forget the 9-1-1 emergency response number. Who knows how long she might be left on the floor. Could she be dehydrated? Most of us, not just the elderly, are not good at staying hydrated during the warmer weather. This whole issue could be as simple as she might just need some IV fluid to correct dehydration & she could spring back to her old self. She needs to go to an ER or have her PCP admit her to the hospital to determine the underlying etiology of this new problem. Congratulations on recognizing the potential seriousness. Best wishes to you!

Imho, perhaps she needs a new mattress. In addition, make the bedding irresistible with new bed linens including comforter and blankets, if needed. Add in white noise machine/soothing sounds. Of course, she should be checked for any medical conditions. Always keep a cool bedroom.

Check side effects of medications and mattress. Make bedroom cozy maybe sound machine, soft blanket and pillow etc.

Exploring possible medical reasons for the changes is always a good idea. In the meantime, there are chairs that are safe and comfortable and allow reclining with legs elevated. Could your mother handle that kind of chair on her own? Look for a chair with arms (to help keep her safe) and not low, so that it's easy to get in and out of. The suggestion of an overstuffed armchair might work if you don't want to get a reclining chair. My aunt used to sleep on her living room couch. There's nothing wrong with it, as long as she's comfortable and can sleep, unless it bothers other people in the house.

There could be several reasons.  First I would have a full blood panel done by the doctor, she might be deficient in one of the minerals/vitamins which could be causing the memory issues.  My Mother in law had the same problem until the doctor discovered she was deficient in a mineral (once he had her on supplements for that, she seemed to not have the memory problems.   

The reason she is getting up could be because there are other people in the house or she is not comfortable lying in the bed, or habit.  There are several things you can try.  1. a TV in her bedroom? 2. a comfortable recliner that she could possibly sleep in 3. No napping during the day.  We had the same problems with my MIL, and it seemed to help her sleep to have the TV on in her room but she still got up at 3AM, so we found it helped to buy her a power recliner for the living room that she could get a fairly decent sleep in it. (not ideal, but better than fighting her about staying in bed.)

Actually, it could be that the chair is a little more comfortable versus laying flat in a bed.

When you put her to bed, maybe she's laying there wide awake and can't nod off. Would a TV help? Does she know others are still up in the room where chair is? If she is sleeping/napping during the day (in the chair) you might need to start keeping her awake so she sleeps at night. It takes a little time to redo the sleeping times, but can be done.

It seems that she sleeps in the chair because there are people in the house. She certainly can’t go to bed while they are there! She probably sits and watches them, worried & anxious, until she can’t stay awake any longer - that’s why she falls asleep sitting up.

Once she is on some anti-anxiety medicine, this behavior may subside or at least be lessened. Her doctor may have to work different dosages to fine tune it, but hopefully something will help soon.

Push her doctor for an appointment sooner, rather than later. I know how upsetting this can be. Thank you for watching over her.

During most of the last couple years of my father's life (while he was still ambulatory), he slept in an overstuffed chair in the family room. He seemed comfortable there, and I believe it made it easier for him to get up to use the bathroom, etc. than it would from a bed, and the fact that the bedrooms were upstairs probably added to this.

In any case, the best choice is probably the one that works the best, even if it isn't "conventional" or the usual choice.

I’m sorry you’re both dealing with this- not good for anyone. Has your nan had any back problems? If so, sometimes sleeping more upright helps, but the issue of edema becomes a very real problem, so changing positions is needed. A recliner might be a good option. Dad has one that lifts him up, too. It’s been a godsend as his internal clock has been off for years and he broke his back 2 years ago. Hope you find a solution.

My mother has lewy body and vascular dementia, years ago she was sleeping in her recliner and we could not get her to sleep in her bed.  Yes it does take a toll on their health, but it is nothing that you can do about it but let her go back in her bed on her on.  With dementia a person sees, thing that we cannot see, it could be that she saw a piece of paper or lint ball on her bed for example, I don't know what's keeping her out of her bed but with my  Mom we had to be very creative to convenience her to get back in her bed.

Maybe for some reason it is more comfortable. Rent a hospital bed so she can sleep with her head elevated and a good proper position for her legs.

Ask her primary care doctor to check her for UTI and maybe add something for anxiety to calm her at bedtime. My mom takes melatonin which is OTC.

If she sleeps with her feet up, it's OK, but if her legs are down like she's sitting she'll end up with edema in her legs.

When my mother was in her first nursing home, she refused to sleep in her bed and only slept in a chair. The staff couldn't force her to use the bed (it's illegal to force them), and eventually her legs were so swollen with excess fluid that her skin started breaking down and they were leaking. I ended up moving her to another facility, and the chair didn't go along. Now she's in a bed every night, and her legs have healed.

It sounds like Nan shouldn't be living alone any longer.

How awful for your poor nan! The poor woman must be quite frightened!

However, sleeping in a recliner seems to be a very common thing that many elderly folks begin doing.

I know my father began doing it after he hurt his ribs. Daddy also suffered from CHF - he said he was more comfortable in the recliner. The problem - for me at least - was that his recliner was in horrible condition and would surely have begun bothering his back.

Since my dad would never spend money on himself and never liked anyone else to do so - I used the next available holiday as an excuse to buy him a new electric lift recliner. They can be expensive but I considered it a bargain if it would help him in any way. He loved it! And, he never had any issues working the remote.

As for the confusion and hallucinations - you’re on the right path looking for a UTI or another physical cause. It’s just off the charts crazy what a basic UTI can do to the mind of an elderly person.

As well - I’d suggest looking into any
medications your nan is taking. Especially, any pain meds. Both my parents went bat poop nutty when taking morphine. It would usually start about day three on that particular pain med. Other pain meds - even opioid based ones such as hydrocodone (Vicodin®) oxycodone (OxyContin®, Percocet®)  did NOT effect them the same way. Just the straight up morphine. It was odd - but then again - so much is when our aged loved ones get to older old age.

Is it possible that getting in and out of the chair is easier?
Is it possible, if this is a recliner, that the foot and head position are more comfortable?
Many people I know either sleep in their recliners or they have loved ones that do.
If she is watching TV can the TV be placed where it would make it more comfortable to watch in bed?
As far as the recent confusion that could be caused by a medical condition, if she is getting up often to use the bathroom it could be a UTI and that can cause confusion. And if she is having an urgent need to urinate it might be just easier for her to sit back in a chair rather than go back to bed.

My mom sleeps on her couch. She is comfortable there. She is in an ALF.

Question is WHY is your Nan doing this? Is the chair by the TV and she wanted to watch and fall asleep watching? Is she more comfortable sitting up because of breathing issues? Could you move a TV and some real big comfy pillows to the bed so Nan could watch, sit up in bed? I would suggest some of those lounger chairs but many are naugahyde and not especially good for skin over time, and some are difficult for an elder to get positioned with feet up; they take a certain amount of strength, unless ordered as electric; and if there is dementia electric becomes a problem.

She should be tested for a UTI. My mother gets confused when she has a UTI, better to get her tested right away. My mom does better when antibiotics are started early for a UTI. Let her sleep in the chair for the time being.

How is the chair unsuitable? If it is a recliner, sometimes it is more comfortable for the elderly person to sleep in a recliner than in a bed for arthritic, gastric and breathing reasons. If she gets more sleep in a chair, or if you could get her a more sleep-friendly chair, let her sleep there. It would be better than being awake most of the night and not getting much sleep at all.