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Taking care of an elderly patient with dementia.

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My husband had started to wake up at 2:00, 3:00am and would wake me up to say something like he's happy that we have our dog or that it's very dark out. Like "judypanama", I also stay up until 2am to get that alone time, so my sleep was being disrupted multiple times a night. Our PCP gave him Klonopin to help him sleep through the night. This med does not stay in the system, so you don't have to wait for it to build up. It can be taken on an "as needed" basis and can be increased if needed. It's been about two weeks and my husband sleeps straight through until about 7:30. I can live with that, until the next phase.
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My FIL is another of those retirees with nothing to do and all day to do it. Has OCD as well as vascular dementia, so he lives by the clock time. We covered digital clocks on TV, stove and microwave with cardboard the size of a business card, taping only the top.We can flip it up to set temperature and cook time as needed. All other clocks except one in Liv Rm above fireplace were removed or batteries pulled. We change the time on the clock when FIL isn't looking when it's 'late enough' for bed, then move it back the other way subtracting more hours when he gets up to bathroom around 2 or 3 am. This way it's always 'too early' to get up until WE are ready and able to deal with him. His watch was taken away last year because he kept tearing arm and hand skin with it and bleeding all over the house. When he asks what time it is, "it's time to sleep" His illness is advanced enough that he can't connect daylight or nighttime to clock times and stays in bed when we remind him. Motion sensors placed around the bedroom and hallway alert us to whereabouts or when he is awake. I agree w/ suggestion to get used to napping instead of sleeping at night. We take turns addressing his nighttime needs, just like new parents do with babies. Everyone gets more sleep this way, he is none the wiser and the days are much calmer. After trying nearly every sleep med and then some we gave up. They all worked great for HIM short term. He quickly got tolerant to meds or the side effects outweighed the benefit. The only thing that helps him sleep is opiates. I think chronic pain drives most of his restlessness and wandering, as he can't tell us what he needs. Good luck in your quest for rest...
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Try an OTC, akin to Benadryl.
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I don't know your situation but...I have the problem with my husband. There are some nites he is up and down 5-10 times...thankfully last night was 3 times. I try to keep him awake and active during the day but it doesn't seem to make much difference. It seems he just gets "antsy". Luckily after one of these horrendous nites, he sleeps better the next one. I have been awakened at 1AM and kept up until 3-4 AM trying to get him to sleep//calmed//whatever??
His neurologist has recommended Melatonin because he won't give him sleeping pills and he said to take it about 3-4 hours before bedtime. (I was giving later)....
Don't really have an answer for you ... just know I feel for you....been there, done that!! I've sat by his bedside for 1-2 hours trying to keep him settled, gotten less than 3 hours sleep per night...........I just keep on...and pray a lot!
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Just had this with Mom today. Husband got up to play golf and she was up and dressed. He came up to say goodbye and told me. He had told her she should go back to bed but gave her the paper to read. I went down and told her to go back to bed it was too early to get up. She has a big number clock next to her bed. I tell her if the first number is not an 8 don't get up and especially when its dark. I am not an early riser. If my husband hadn't gotten up, I may not have known she was up. But she is safe in the area of the house she is in. She has her own bath. I gate her in so she doesn't go up the steps and wander the house.
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trying to keep the person awake during the day, and active! active and engaged. also, mild sleeping aids can help if they don't interfere with any other meds they are on.
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You can start your day there and take naps in the afternoon. Also going to bed earlier in the evening helps.Being a caregiver is not easy (even for a retired nurse). Just do the care and give it your best shot. In the end we all want to have a clear conscience.
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Elena, I, too, send a hug and my sympathy. My husband was always a late riser, his doctor advises against sleep medicine, and my husband is both incontinent and unable to get up on his own. So ,needless to say, I am very sleep deprived. Wish there was an answer for some of these problems. The only thing that the advice I receive reveals is that the advisor is not really listening to me.
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I checked out trap adore and one of the possible side effects is a higher risk of bleeding, which is something you do not want to do for a person with multiple ischemic strokes. But thanks for the suggestion.
Also we go to bed around 10:30. If he had had enough sleep he wouldn't be falling asleep by 10 am. Funny he did grow up on a farm but never had to milk the cows. He did say one early morning it was time to milk the cows😀. He does still have a sense of humor once in awhile.
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It sounds to me like this particular patient is a former farmer. Sometimes farmers get up that early to take care of livestock such as milking cows. Of course, sometimes people and other professions also start their day very early and when they get older, there is an automatic behavior of getting up early that continues throughout the rest of their lives. Despite their current condition, it sounds like the patient's inner clock is already set, which will be near impossible to change. The best thing to do is to let it go and just go with the flow. No matter what this patient used to do for a living, they automatic behavior of early rise sometimes has a tendency to stick with a patient since the body is already trained to rise early.
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Trazadone helps some people sleep better and wake up fresh. It was intended to be an antidepressant years ago, but it wasn't very effective. It was better as a mild sleeping aid.
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I think there are medications that allow one to sleep now that do not involve drugging you up. Some are not addicting either. I would discuss it with his doctor. Since the dementia patient is not able to reason with regard to when they get up in the morning, I don't think them making it a choice is really an option. I think sleeping issues are pretty common. However, if the patient is going to bed pretty early in the evenings, they may be fully rested by 4:30 a.m.
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Morning! I could have written this question. But I know now the answer is nothing. My husband is 75 and has vascular dementia. Although he used to get up early for work, I often had to wake him up at 8:45. Now he pops up at 4:30. I try to keep a regular schedule during the day including bedtime. I have tried logic - no go. I have tried bribery, begging, yelling - everything. No go. But I have learned that this is part of dementia and nothing to be done. I found I miss my alone time. So I got some motion sensor LED lights so he can get out to the living room safely. Once I know he is up so early (it doesn't happen every day) I close my bedroom door and try to get back to sleep. The lights come on automatically at 6, so he just has to sit in the dark. Hoping he goes back to bed 😁. It really louses up the day as he is ready to go back to bed by the time we have appointments. I refuse to medicate him (melatonin doesn't help). I would rather have him awake and ok than drugged, disoriented and task falling. So I guess I figure this is another phase in the disease and it's tons better than being bedridden. Looking forward to other comments!
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You're lucky. I have to get up at 4. So I just go to bed earlier. He would get up later if he went to bed later, but then I would lose my alone times in the evening. I will endure the 4 a.m. wake ups to give myself that time at night.
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Elena, was the patient always an early riser? If yes, then that would be difficult to change their inner clock. Many local news stations will begin their news broadcast at 4:30 a.m. [they do where I live], so maybe the patient could spend time watching the news in their own bedroom until the rest of the household wakes up. If the TV has an inner clock, set it to come on at 4:30 pm.

My parents, who are in their 90's, get up with the roosters, so to speak... they always have done that. To them sleeping until 6 a.m. is over sleeping :P
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I think this really depends on what the patient can or can't do alone. Could you provide more information on her/his abilities, limitations, etc.?
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