Moms co2 is thru the roof. We had to take her to the hospital again and they had to restrain her to tolerate the CPAP. We finally took it off and the restraints. We can't see putting her through this viscious cycle over and over. She deserves better. Can anyone think of a better way to tolerate the CPAP or a very light med to sleep (that wont kick her @ss for days) to tolerate it at night .. Im pretty sure shes going into hospice almost immediately and this can only lead one way if she won't tolerate it. I think we have done all we can ...but im asking you all if we missed anything ...thanks for any help.

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About 30 % of the population do not tolarate cpap and dementia confounds it. It may be time for hospice. The advantage of a high CO2 retainer is that CO2 acts like a narcotic in itself so the patient feels no pain.
You probably already know it if she has the revolving door hospitalizations. Her high CO2 also indicates and I suspect that she is on very high pressures and a rate that increases mask intolerance by requiring a very tight fitting mask.

Restraints are an absolute contraindication. Imagine aspirating vomit in a mask you cannot pull off. No hospital in their right mind should do this and I am angrily surprised this was done.

No, CO2 retainers cannot have any light medications as it can cause death.

I am a respiratory therapist. I have one suggestion but I will not be surprised if it does not work because it will require someone to be hired at night or someone (trying to sleep nearby). Your report on her hospitalizations indicate that no one wants that responsibility. Home CPAP machines do have a built in alarm that can be programmed to sound, although the volume may not be loud. Ask the DME provider to unlock the settings to set it. You may be able to call around and bring the machine to them. The bottom line is that someone will need to be her human monitor while she sleeps
My experience with dementia patients is that they took the mask off within 5 or 10 minutes after going on or they sleep 2 hours then fight with caregivers for the rest of the night.
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Reply to MACinCT

Given her age and condition I’d not go with restraints or likely the CPAP at all. Of course I can’t say for sure, but what you describe sounds torturous for her. I’d get hospice going and get meds to her help be calm, not out of it completely but calm. My dad had a CPAP, couldn’t tolerate it at all, even after trying every possible mask and mouthpiece. He finally sent it all back and told the doctors they were just trying to ruin his plans of dying in his sleep! That was over 2 years ago. Sorry you’re dealing with this...
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Reply to Daughterof1930

I'm sorry about your mother. That is a tough situation. I have encountered similar situations with patients working at the hospital. I'm not a fan of restraints personally but sometimes they are necessary. Fortunately we usually have meds we can give to help them relax and sometimes that's all it takes. Hospice should have access to many different things that will help. In the meantime, maybe try an over the counter sleep aid? I used to use nighttime alka seltzer and it worked wonders for me.
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Reply to Caregiverology

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