Practical Tips On Medications To Manage Difficult Behaviors In Dementia
You may be now wondering just how doctors are supposed to manage medications for difficult dementia behaviors.
Here are the key points that I usually share with families:
- Before resorting to medication: its essential to try to identify what is triggering/worsening the behavior, and its important to try non-drug approaches, including exercise.
- Be sure to consider treating possible pain or constipation, as these are easily overlooked in people with dementia. Geriatricians often try scheduling acetaminophen 2-3 times daily, since people with dementia may not be able to articulate their pain. We also titrate laxatives to aim for a soft bowel movement every 1-2 days.
- No type of medication has been clinically shown to improve behavior for most people with dementia. If you try medication for this purpose, you should be prepared to do some trial-and-error, and its essential to carefully monitor how well the medication is working and what side-effects may be happening.
- Antipsychotics and benzodiazepines work fairly quickly, but most of the time they are working through sedation and chemical restraint. They tend to cloud thinking further. It is important to use the lowest possible dose of these medications.
- Antidepressants take a while to work, but are generally well-tolerated. Geriatricians often try escitalopram or citalopram in people with dementia.
I Care For More Than One Person With Dementia And Wonder How To Keep Dementia Patients Not Sleeping In Bed At Night Should I Put Them To Bed Straight Away
According to the Alzheimers Association, patients can spend up to 40% of their time lying in bed awake, this equates to sleeping too much during the day. If the patient does get up, dont try to get them back to bed. Try to restart a small bedtime routine instead of putting them straight to bed. Keep lights low, take them to the toilet, play relaxing music or read to them for a bit to calm them down.
And Finally Do Everything You Can To Promote Relaxation
Create a restful environment in the evening and stick to a night-time routine. During mid-stage to advanced dementia there is advice that suggests someone with dementia shouldn’t watch TV or read a book as they can find this difficult and become frustrated playing soft music may be a better alternative. You could even try reading to them. The bedroom should be comfortable, not too hot, not too cold and with cosy, breathable bedding.
Find more general tips for elderly parents on how to get a better nights sleep.
If you care for someone with dementia, you may want to consider a system like the CPR Guardian Smartwatch. This light and stylish watch is often preferred by elderly relatives who are used to wearing a watch every day. The CPR Guardian can pair with a carers smartphone, enabling them to find out the wearers GPS location and communicate with the wearer directly through the watch. The watch also comes with an SOS button that alerts the carer directly when pressed. It can even monitor the wearers heart rate! All of these features mean that there is always a way to keep track of your relative with dementia, make sure theyre okay, and be alerted if there is ever a problem.
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The Impending Sleep Disruption Tsunami
Although many experts have been pointing to a post-pandemic mental health crisis, there hasnt been enough focus on the sleep disruption epidemic that is headed our way, says Dr. Creado. This will have dire consequences on mental health, physical health , work productivity, relationships, and more. To avoid becoming a sleep-deprived victim of the second wave of the pandemic, you need to take action now.
Here are some tips to improve sleep quality.
- Make sleep a priority.
- Address any biological issues that rob you of sleep .
- Develop good sleep hygiene.
- Consider natural supplements, such as melatonin, magnesium, l-theanine, GABA, and 5-HTPall found in Put Me To Sleep Naturallyto help to calm the brain and promote healthy sleep.
Sleep disorders, anxiety, panic attacks, depression, and other mental health issues cant wait. During these uncertain times, your mental well-being is more important than ever and waiting to get treatment until the pandemic is over is likely to make your symptoms worsen over time.
At Amen Clinics, were here for you. We offer mental telehealth, remote clinical evaluations, and video therapy for adults, children, and couples, as well as in-clinic brain scanning and functional medicine evaluations to help our patients. Find out more by speaking to a specialist today at 888-288-9834. If all our specialists are busy helping others, you can also schedule a time to talk.
Primary Sleep Disorders And Medical Morbidity
Psychiatric morbidity is also associated with insomnia in older adults with dementia, particularly mood disorders, which can be both a symptom and a predictor of insomnia . Psychotropic medications used to treat conditions such as depression and anxiety can reduce risk for the development of sleep problems secondary to these disorders. However, they are also associated with reduced sleep quality in individuals with untreated obstructive sleep apnea and can have other adverse side effects, including risk for falls and daytime sleepiness in older adults with cognitive impairment.
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Sleep Problems The Gp And Specialists
Speak to the persons GP or nurse if they have sleep problems that last for several weeks or more, and their sleep problem is causing them to become more unwell.
You can also speak to the community mental health nurse. A nurse or GP will try to understand whether the sleep problem is being caused by something that can be treated with drugs or other therapies for example, by increasing levels of pain medication, relieving anxiety, or treating urinary problems. Keeping a diary of when a person is having sleep problems can really help a clinician to see whats happening.
Some sleep disorders in dementia may need help from a specialist, such as a consultant geriatrician or old age psychiatrist. The GP can refer the person to a specialist. This may take some time, so try to see the GP as soon as you can.
Sleep medication is not recommended for a person with dementia. However, some doctors may suggest trying it for a short period if the sleep problem is severe, and non-drug treatments have not worked.
If the person does take sleep medication, they may become more confused and more likely to fall over the next day. Take extra care with them.
What Should I Do If Im Taking One Of These Medications
I want to be clear that taking one or more of these anticholinergic medications does not mean you are going to develop dementia. It just means that there is research that tells us that people who take these medications are at greater risk for dementia than those who dont. With that said, the less anticholinergic medication you take the lower your risk so lets talk about steps you can take to lower your use of these medications.
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Faqs About Dementia Sleep Problems
Caring for a patient with dementia and sleep problems is hard work. When the dementia patient is not sleeping well, it is very easy to become exhausted yourself. To give the best care, the carer needs to look after themselves. In addition to the following questions that some people have asked regarding how to get dementia patients to sleep at night, you should visit our guide on caring for someone with dementia.
Support And Care For A Person With Dementia And Sleep Disturbance
Sleep problems tend to become more common and more severe as dementia progresses. They can happen daily, and last for a long time. The growing exhaustion can affect the person with dementia and you, their carer.
Over time the person will need more support, especially if your own sleep is often disturbed. If the person you care for is frequently up in the night, it may be possible to have a night sitter. This is a carer who will look after the person with dementia at night, to help you to have a good night sleep. A person with dementia and severe sleep problems may need to be cared for by a live-in or visiting carer, or in residential care.
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Comfort Them Should They Wake In The Night
If your parent gets up in the middle of the night, try to establish the cause for waking. Sit and talk with them for a while quietly in low light. Keep them relaxed and repeat actions they associate with bed time such as soft music until they are ready to return to their bedroom.
A wireless bed exit pad and alarm can help alert you if someone with dementia awakens and is prone to wandering in the night. A motion sensor pad is placed on the mattress. As soon as someone gets out of bed, a wireless signal is sent to the alarm which can be up to 90 metres away. It won’t go off if they just roll over, only when their weight is completely off the sensor. It is a smart way to remotely monitor whether your parent is still in bed, which can even help you to sleep better – safe in the knowledge that you will be alerted should they get up.
Get Into A Good Routine
If possible, try and make bedtime and wake-up time the same everyday. Try and establish a nightime and morning routine as this will help signal to them what time of day it is. Things that can encourage better sleeping habits include a bath, playing music, brushing teeth, a hot milky drink or even the scent of lavender on a pillow from a scented spray.
A scented pillow spray can help overcome restlessness or trouble drifting off. The smell of the lavender blend naturally encourages sleep. This is particularly helpful to those in the later stages of dementia when it is common for patients to respond to the sense of smell.
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Talk With A Senior Living Advisor
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As dementia progresses, sleep problems along with other difficult dementia symptoms tend to get worse. This may be a good time to evaluate whether you need additional support to help ensure your loved ones health and safety and your own. Learning what to expect at each stage of dementia can help you plan for adequate care.
Heres what you should know when caring for someone with dementia and sleep problems:
- Dont use physical restraints. Many people believe its best to restrain their loved ones in bed at night to prevent wandering. This may do more harm than good. Instead, if you have a bed with guard rails, raise the rails. This may help to deter them from climbing out of bed and wandering.
- Dont do it alone. Consider taking shifts with another family member or looking into respite care. Respite care, or short-term care, gives you a chance to take a break while providing a safe environment for your loved one.
- Reduce stimulation. To allow for a calming, soothing environment, avoid loud noises or a lot of activity during the evening and night.
- Prioritize your health and rest. Taking care of a loved one with dementia and sleep problems may take a toll on your own mental health. Consider getting help from family members or exploring other care options, such as memory care, which provides 24-hour specialized care for people with memory loss.
Do Sleeping Pills Cause Memory Loss
A number of prescription and over-the-counter medications can interfere with or cause loss of memory. Possible culprits include: antidepressants, antihistamines, anti-anxiety medications, muscle relaxants, tranquilizers, sleeping pills, and pain medications given after surgery. Alcohol, tobacco, or drug use.
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Frequent Sleeping Pill Use Linked To Increased Dementia Risk
LOS ANGELES Frequent use of sleep medications may increase the risk of future cognitive impairment, new research suggests.
Investigators Yue Leng, PhD, and Kristine Yaffe, MD, University of California, San Francisco, found that older adults who reported taking sleep medications often were more than 40% more likely to develop dementia over 15 years than their peers who rarely, or never, took sleeping pills.
“While we don’t know the exact mechanism underlying this association, we hope this research will raise caution among clinicians when prescribing sleep medications to those at high risk for dementia,” said Leng.
She reported the results during a press briefing here at the Alzheimer’s Association International Conference 2019.
The Trouble With Sleep And Anxiety Meds
Anti-anxiety medications are benzodiazepines that are quick-acting and can be beneficial on a very short-term basis for acute anxiety. However, they have several drawbacks. Brain SPECT imaging studies show that benzos reduce overall blood flow and activity in the brain and are harmful to brain function. They can cause memory problems, daytime drowsiness, confusion, addiction, and severe withdrawal syndrome if they are abruptly discontinued, says Dr. Creado, who does sleep consults and who is the creator and host of an online course called Overcoming Insomnia.
Trying to go off these drugs can increase anxiety to higher levels than before you started taking the medication. Benzos are also dangerous when combined with alcohol or other sedating drugs. From 1999 to 2013, overdose deaths quadrupled, according to research in the American Journal of Public Health.
Sleep drugs, such as Ambien and Lunesta, have similar risks. To understand how they work, its important to know that insomnia is not the lack of sleep, but instead, excessive wakefulness of the brain, according to Dr. Creado. These drugs are effective because they calm an overactive mind and causing you to become unconscious, but they also have many downsides.
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What Kind Of Research Was This
This was a cohort study which aimed to look at the association between benzodiazepine use and risk of new onset of dementia in a group of elderly people followed for six years.
A cohort study is a good way of looking at whether a particular exposure is associated with the risk of developing a particular disease outcome over time.
Some potential limitations of this study are that, despite the researchers attempts to take into account potential confounders, it is difficult to ensure that all of these have been taken into account and to establish that early dementia was not the cause of insomnia.
The researchers tried to offset this by making sure they selected recruits who did not start taking sleeping tablets until at least until the third year.
This helped to minimise the potential for what is known as reverse causation from distorting the results of the trial .
Despite the best efforts of the researchers, as little is known about the early stages or pre-symptoms of dementia, it is unclear whether the three-year gap was long enough to offset this potential completely.
Could I Use Sleeping Tablets For A Limited Time Just To Help The Person I Care For With Dementia Get Back Into A Routine Of Sleeping Throughout The Night
However tempting this may be, the use of sleeping pills for dementia patients can be just too dangerous as they are at risk of falling. The morning hangover effect that sleeping medication leaves a person with can exacerbate the dementia patient’s symptoms of confusion, anger and irritability. Try promoting better sleep strategies and sleep aids for dementia instead. If the person with dementia constantly wakes and gets up, and is at high risk of falling, then a doctor may decide that sleeping pills for a dementia patient can be used for short period of time. Always talk to a GP first as they are used to being asked how to get dementia patients to sleep at night.
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My Dad Has Dementia And Is Moving Into Residential Care Are There Any Care Homes With Dementia Units
Yes, there are. These residential units will allow your dad to live in a home environment with the benefit of trained staff on hand to help care for him. It may also be worth considering finding a care home in the right location to enable friends and family to visit regularly. This may be more fitting for your dad and ease the transition.
If your parent/partner suffers from restless leg syndrome they move or twitch their legs uncontrollably, especially during the evenings and night-time. They may also experience tingling, burning and fizzing sensations in their legs too. Symptoms can be relieved by rubbing and stretching legs – but it can be so bad that it wakes the person up. If you discover that your parent/partner has either of these medical conditions, its wise to see a GP and ask for help.
Dementia And Sleep: Tips For Helping Your Loved One With Dementia Sleep Better
Dementia and sleep problems often go hand in hand. The connection between dementia and sleep is a common source of stress for family caregivers. When your loved one with Alzheimers disease or another form of dementia doesnt sleep well, you probably dont get enough sleep either.
Read on to understand the causes of sleep problems in people with dementia and get tips for better sleep.
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My Mum Suffers From Dementia And Excessive Sleep She Sleeps During The Day And Sleeps Very Little At Night Is It Ok To Let Her Sleep All Day
If possible we recommend encouraging her to take fewer and shorter day time naps, at the same time and place if possible . Keeping to a routine full of activities can help keep her awake during the day, and work some way towards night-time sleep problems. Try regularly getting her up for short walks and maximise daylight in rooms. Sensitively wake her up if she does fall asleep outside of a routine nap time.