My dad has mild dementia and has just been prescribed Melatonin, as he too has a very erratic sleep pattern. He is only on it two weeks, and so far I don't see much change. I'll review it at the end of the month, before I refill prescription. I suppose it might depend on each patient.
I tried to 'knock out' 94 year old mother in law out with the Ativan that the hospice nurse gave, but that just made her WILD! One night I gave her Ativan at 10PM, then at 1AM I gave her a hydrocodone dose, then at 3pm because she was still wide awake and I had to be a work by 7AM I gave her .2 mgs of liquid morphine. Well, that morphine finally knocked her out and the old gal slept for probably 24 hours. I felt terrible about it, but she did awake pretty much rested and hungry. I thought that was the end for her, but she rallied! The next time she was restless? I gave her benadryl and it worked better than the prescription drugs did.
Yes, Doctor's advice is always the first place to go. My Experience with this: Mom 96 and taking Ambien. Why? Because it is Humane...it is peaceful, it allows her (blind) to sleep soundly and not roll out of bed and fall onto the floor because rails on beds are illegal in CA AL, because, what - at 96 she is going to become "dependent"? Decisions when a loved one is headed to 100 years old and is severely compromised by body and mind ARE different than if a person is 30 years old. Medicare charges a fortune for Ambien, but if you use the free GoodRX site, it is very cheap (coupon for local pharmacy - cash purchase, no insurance needed, just a prescription from her doctor) at 1/10th the price of the co-pay that many insurance plans charge.
Ativan had the completely opposite effect on my mom than what is intended. We had to experiment with medications to find out what would work for her. Check with the doc to try something else.
Yes, great advice here. Any elder person (even young) need a good night. There are several natural sleep aids. Melatonin , Valerian & L Trytaphane (the stuff in Turkey that's makes you sleepy) I actually just got my Mom off Ambien, she would sleep all day and take her meds then STILL not sleep.... Her sleeping pattern is messed up. Her Doctor agreed. She is now on Melatonin and doing much better. It's hard to keep someone active who doesn't want to be bothered. It's complicated but a work in progress as she ages.
Talk to the doctor, then watch her response to any meds. Some sedatives can have a negative impact and/or worsen cognitive ability. However, so will lack of sleep, which also feels just awful. Its a balancing act between the two - - but keep trying and find an option which ultimately improves her quality of life.
Mirtazapine is an anti depressant that has some useful side effects for people with dementia SM3008, including use as a sleep aid and helping to increase appetite. Like all such meds it takes a while for them to build up in the body and become fully effective. My mom was also helped with mirtazapine, not only did she sleep better but she was more herself during the day, although I'm not sure if that was directly attributed to the medication or was just a consequence of being more rested.
Defiantly talk with her doctor, My mom's neurologist was Awesome. My dad would call and talk with nurse and meds she needed would be called in or if a more drastic health issue would make appointment immediately for them.
My mom ( no dementia) uses mirtazapine for sleep. It helps immensely. She was first prescribed 1 pill (of whatever the standard dose is) at night. It completely zoned her and was way too much. Now she takes 1/4 pill at night and it really helps!! She also says she is worrying and fretting less, which was always a problem for her.
As many have already answered and I just have to also endorse. Sedation for the dementia patient makes them worse in many cases. It increases the chance of falls, adds to the aggressiveness, and if they are sedated too much the respiratory rate drops and they are suffering reduced oxygen levels which then adds to further problems
I used Drift Off (available without an RX) from Zhou Nutrition that I found on Amazon.com. I found that it worked but she seemed to have gotten inured to it so I stopped using it. It does have the ability to make one "drift off" (including me) but there's no guarantee that they'll remain asleep for the duration of the night, which is what a caregiver needs when they must be somewhere (like work) bright and early. Elderly people just don't sleep the way people in their middle-age do. It seems they either sleep too much or too little. My Mom is currently (93 y/o) in the sleeping too long phase, which is a bit worrisome; and she isn't taking anything for that. I think it is just a natural part of her aging and eventually dying process. Just a few months ago she was in the sleeping too little phase, hence the reason for the Drift Off. But I think it's quite safe. It has Melatonin and Valerian Root and some other herbs and is reasonably priced and of good quality. I would recommend it.
Ultimately, you need to find something that works. I would start with the Melatonin first (which is OTC, by the way), then try some relaxing teas such as Sleepytime or Valerian Root. Many people have paradoxical reactions to sedatives - and it makes them "wild" instead of "sleepy" - so they are not for everyone.
Often very young children and very elderly people react the opposite of what the medication is used for. Example; Ritalin is a stimulant but, when given to hyperactive kids, it calms them down. Weird, I know. My ex used to get "hyped" on narcotics (for migraine) while they put everyone else to sleep. Every body is different.
It's unfortunate that you will probably be going through a few over the counter meds (on MD approval) and a few prescription meds until you find the right one. Each one should be given a fair chance to work (like 2-3 weeks) before you stop it and try something new.
When my 94 year old mother lived with us, we never got any sleep. I would try to keep her awake all day but to no avail. We had to hire a night time caregiver but we still woke up when we heard them moving around, going to the bathroom, etc. She had an obsession with going to the bathroom . (no bladder infection). She would want to get up and move around so going to the BR was a good excuse. She's still having problems at the new memory care facility. It will be trial and error.
It's a horrible problem for everyone involved with no easy answer.
I give my Aunt with Severe Alzheimer's Dementia a 10 mg Melatonin Time-Release bought at SAMS Club. It works and also reduced her nightmares and hallucinations. I do keep her awake during the day and she receives some caffeine during the day first thing in AM but this works for her to keep her sleep pattern somewhat normal. Up for 12 hours and sleeping for 12 hours other than to go to restroom. The only other change I made was moving her Donepezil to the AM dose even though it causes drowsiness. It has not made her more drowsy but did reduce her waking up screaming HELP for unknown reasons. I highly recommend this treatment.
At the end of the day you have to do what's best for you and your family you can take the suggestions suggested or you can refer to her doctor's recommendation and most definitely you have to do the research yourself. Just remember this is a part of life with our loved ones because they grow old and someone has to care for them. Be patient. I have experienced the same with my dad and it was trial and error. I just tried to make him as comfortable as possible. Take one step at a time. I prayed a lot that helps.
Seewell, I am going to try Tart Cherry Concentrate from Pure Planet. Amazon has it, but Vitacost seems (haven't looked at shipping costs yet) to be a little cheaper. I read the customer reviews and they were overwhelmingly positive for sleep as well as inflammatory conditions, such as arthritis. Gonna tell my sister about it, too. Thanks :)!
Its a balancing act between the two - - but keep trying and find an option which ultimately improves her quality of life.
My mom was also helped with mirtazapine, not only did she sleep better but she was more herself during the day, although I'm not sure if that was directly attributed to the medication or was just a consequence of being more rested.
Sedation for the dementia patient makes them worse in many cases.
It increases the chance of falls, adds to the aggressiveness, and if they are sedated too much the respiratory rate drops and they are suffering reduced oxygen levels which then adds to further problems
It's unfortunate that you will probably be going through a few over the counter meds (on MD approval) and a few prescription meds until you find the right one. Each one should be given a fair chance to work (like 2-3 weeks) before you stop it and try something new.
When my 94 year old mother lived with us, we never got any sleep. I would try to keep her awake all day but to no avail. We had to hire a night time caregiver but we still woke up when we heard them moving around, going to the bathroom, etc. She had an obsession with going to the bathroom . (no bladder infection). She would want to get up and move around so going to the BR was a good excuse. She's still having problems at the new memory care facility. It will be trial and error.
It's a horrible problem for everyone involved with no easy answer.