My husband is 78 and diagnosed with mild cognitive Impairment/early dementia. Over the last three months he has become extremely lethagic. I try to plan activities but he doesn't have any interest in most. He only gets up to eat. Last night he slept on the couch; it is almost 6 in the afternoon and he has not moved. He has not bathed in 4 days or shaved in 2 weeks. He is on an antidepressant, his second one. I am feeling very frustrated and not know how to handle this.

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Wow, this hit a button!

My mom (93) and my husband (85) sleep all day. Both have dementia and both have well-prescribed meds that have made a big improvement (yes, this is an improvement over depression and nuttiness!).

It has been really hard to watch--especially in the case of my husband. A year ago, he was napping in the morning and afternoon. But over the last six months he has increased the time in bed to about 21 hours a day. He eats breakfast or lunch and goes straight back to bed. After dinner he watches TV for about two hours. That's it. He is just receding away from me. I do insist that he come with me to fitness M-F to ride a simple machine so that he does not lose all muscle tone. He does sometimes refuse--but wants to go and understands how important it is.

Having said this:

Wow, it is a relief to hear from others in this situation. That this happens to others. I am sorry this is happening to your husband so early in life!

And, what can we do? Nothing. Sure, have the meds reviewed but do not expect miracles from that. What we are experiencing seems to be situation normal for many with dementia. I have come to believe that they are choosing sleep/rest as an alternative to whatever is going on in their minds: noises, fog, confusion...all sorts of things. And also extreme fatigue. It is just easier to lay down and sleep/rest.

And, get ready for it: there is an upside to this. I know wives whose husbands have dementia and do NOT sleep all day. Instead they are up wandering around getting into things, getting into mischief, getting lost. Those wives cannot leave the house. I am grateful to have this situation over that one, and take advantage of it. I know when my husband will be immobile and use that time to go out! Go shopping for groceries (or clothes!), bank, post office, go out for coffee with friends, go to my women's meetings, etc.

Things could be worse.

As for the bathing, I have started hiring help for that. A big strong, young person comes twice a week and helps him to shower and shave. That way my husband cannot fall and knock us both down--which would truly be the end. It is working out very well.

So there you go. We are not alone! Hang in, look on the positive side of this, and many hugs!!!!!!!!!!!!!!!
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JColl7 Aug 2018
I agree with you Salisbury. I’ve posted on here about my husband staying in bed all day and what to do. You can read my post. I’ve since realized that I am lucky in a way, as you say, that he doesn’t wander and constantly get into stuff. I am free to do the things I need to do, attend meetings at my church, shopping etc. As long as I can get him to eat and take his meds, I’ve stopped “fighting” with him to get up. He does get up for the bathroom and will bathe and shave so that is not a problem so far. When that becomes a problem, I plan to hire an aid a couple times of week for help with that. Right now, I’m thankful for little blessings.
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Personal opinion he might be a bit past the "mild cognitive impairment/early dementia" stage.
To shower takes MANY steps.
Undress, turn on the water, adjust the temperature, get in the shower, close the door or curtain, wet yourself, get a washcloth, wet it, soap it, wash, rinse, wet your hair, wash it, rinse it, turn off water, get out of shower, dry off......
And I am sure that I have missed a few, I don't have to think about what I do it is automatic. The problem with dementia is you don't remember the steps or you are afraid you will forget the steps or the order of them.
I have not shaved but I am sure there are as many steps, not to mention you may be doing it with a sharp implement.
Getting someone in 2 or 3 times a week to shower and shave him might be a good idea.
Everyday tasks become a challenge since you become afraid you will do them wrong. or worse someone will realize you did something wrong. (I think my Husband stopped talking for that very reason, he was pretty much non-verbal the last 4 years of his life.)
Advice for you..
Pick your battles. If he does not shave it is not a big deal. Showering is important but not every day, State of Illinois only requires showering or bathing 2 times a week in a facility. (I found that out when my Husband was in rehab, that was a shock to me)
See if you can get him into an Adult Day Program.
Do not try to do a lot all in one day. It can take a while for his brain to process what he is doing. He can become exhausted just taking a drive, he has to try to recall where he is, has he been there before, what is expected when he gets where he is going.....
Remember that even walking is a process for him, lift a foot, move it forward, set it down, lift the other foot, keep your balance.... So if he sleeps most of a day he probably needs it. Were you worried if an infant slept most of the day? Same process that an infant goes through processing is what your husband is doing.
Get to a GOOD support group. Your current friends will drop off and you will need a good support system, people that know what you are going through.
And when friends call and ask if they can do anything for you say .."YES" and if nothing else ask them to stop by and have a cup of coffee or tea with you. You will need the company.
Start thinking now about what your plans are. How much can you do physically and emotionally. Can you or will you place him in Memory Care? Can you keep him at home? Is your house set up for it? Is he a Veteran? If so there may be programs that will or can help you.
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Of course meds or other illness such as infection could be a culprit and should be checked but if there seems to be no reason, as in my husband's case, he too did the same sleeping. I was concerned enough about it I consulted his neurologist. The Neurologist explained it as the body's way of coping with the shutting down process. It was a normal and natural process. After he explained that, in more detail, I never worried about it afterward. I learned to accept it and if my husband needed to sleep, I just let him.
I liken it to how we feel when we are ill, we want sleep to try and recover. My husband’s body and brain were trying to figure out how to deal with his Lewy Body Dementia as it was shutting down his system. Sleep was it's best defense against itself.
Helpful Answer (10)

I agree about having his medication reviewed with his doctor. Sometimes, it might need adjusting or changing. But, there is also something called Loss of Initiative. It comes along with dementia. I read up on it, researching why my LO didn't seem to have any incentive to do the things that she used to love doing. Sometimes, it might be depression, but, it also could be the dementia progressing and be Loss of Initiative. You can read about it online.

I might also consider that when people stop doing normal things, they may have forgotten how to do them. My LO resisted making a sandwich, bathing, doing laundry, etc., but, she had forgotten how to do these things. Her brain just didn't allow her to. Planning, organizing and working through projects are skills that are lost with dementia. So, it may be something other than him just refusing to do things.
Helpful Answer (7)

I have the same problem and with a little experimenting, I found out that his lethargy was due to his decrease activity. There wasn't much he could do during the day except sit in front of the TV which wasn't helpful since he has macular degeneration and can hardly see plus hard of hearing and gets lost in the conversations on television. I need to go shopping and run errands and it is difficult to take him with me because after breakfast he always said he didn't feel good and wanted to go to bed. So now, I let him go to bed for a couple of hours and wake him up, get him dressed, shave and brush his teeth. He becomes alert after his 2 hour nap and I now can put him in a wheelchair and take him shopping and run some errands. He can't get out of the car but enjoys getting out and going for the ride. When we get home after an hour or so, he has lunch and goes to bed for another couple of hours, gets up for a snack and a little TV and may doze off in front of the boob tube but at least he has had a good day. I am concerned about skin breakdown and worry about bed sores so for the second nap, he has to lay on his side for those 2 hours. So far this has worked for us.
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I don't allow my mom to nap more than 1/2 hour during the day. She is doing extremely well. And I make her get 1/2 hour of sun in the morning. This rebalances the carcadium rythem. At night I make sure the room is dark. And I don't allow any t.v after 9pm. All these things allow the brain to slowly concentrate on what day and night is. Her brain can distinguish day and night. An important part of it is eliminating stress. The brain in this weakened state cannot separate stress from function. My opinion.
Helpful Answer (7)
TekkieChikk Aug 2018
Excellent advice that could apply to any one of any age, especially that part about getting sunlight whenever possible... vitamin D deficiencies are known to cause depression and fatigue. And it just plain feels good to have sun on your face.
Grandma54 had good thoughts. My hubby has been sleeping lots since beginning 11 yrs ago. Much more now. When he goes to daycare home at 3 which is the time he usually wakes when no daycare so I lie down w him so he will sleep. Makes up for his loss of sleep & is ready to do something which is jigsaw puzzles & dot to dot. The prim care doc said whats the matter w sleep. We all know whats ahead so let them enjoy themselves. Gives us time to get things done too alone. Have a feeling this could last 8 more years. Save yourself by getting out. Would not be good if you went first & believe me it could. Happened to gentleman in my support group so kids not realizing what dad was cooplng with. They immediately put her in memory care which is what my daughter said they would do w dad. I have been looking into prices/places of memory care. Looking ahead but may never happen. Our 4 kids know all our finances & all legally in order. Have signed up for free cremation for us & as he is Vet bury in their cemetery. I say think ahead to save stress. Know your first phone call in end. Hopefully hospice will be working w you. My husband is happy & thanks me lots. Has 30 second memory. I remind him he is safe & im here. He thinks I'm a worker not wife of 64 yrs. Even tho he holds my hand in bed. If I'm calm he's calm & enough sleep for his happy life is very important.
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Thank you, each and everyone of your replies has given me deeper insight into my husband's illness and the reality of this disease. We are headed to his doctor today for a med review and I have made an appointment with a new neurologist in October. Because both of his medications cause drowsiness I chose to wean him off of one (aricept). So far no difference.
I have reviewed our options and choose to keep him at home as long I can physically keep him clean and fed. I have contacted assisted living facilities to get familiar with the costs and process, reviewed our finances with our accountant and started the process of making our home more handicap friendly. Also hired a home companion to check in on him when I am planning to be away more thsn 3 hours...can ramp that up as needed. It is a brutal thing to watch him decline. I totally get an earlier post from the woman who wants to run!!! But won't , it's not the stuff I am made of. This group is an awesome reservoir of hands on experience and I am grateful to have the opportunity to be a recipient of your collective experiences. May God bless all of us with copious amounts of strength, understanding, patience and and love.
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You need to get him back to the doctor. Poor hygiene can promote urinary tract infections, and in the elderly, they can cause them to become combative and really off the wall.

Sometimes it takes more than a few tries before the right anti-depressant is found. And there are other meds for dementia he could be on. Share with his doctor that you’re concerned about his extreme lethargy. There may be a physical reason.
Helpful Answer (4)

My husband with Parkinson's experiences fatigue much of the day. He was prescribed ritalin by his geriatric psychiatrist and supported by his neurologist. This mild stimulant is used primarily for children with attention deficits, but seems to have a paradoxical effect on adults. It certainly is not a magic pill, but has been mildly beneficial, with no adverse effects. Hoping you find a combination of medication and behavioral interventions that work. You both deserve it!
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