Do People With Alzheimer’s Dream

Stage : Moderately Severe Dementia

When the patient begins to forget the names of their children, spouse, or primary caregivers, they are most likely entering stage 6 of dementia and will need full time care. In the sixth stage, patients are generally unaware of their surroundings, cannot recall recent events, and have skewed memories of their personal past. Caregivers and loved ones should watch for:

• Delusional behavior

A Word On Sleep Medication

It can be tempting to say that all the person with dementia needs is to pop a couple of sleeping pills to help them sleep through the night. However, the risk of giving sleep medication to someone with cognitive difficulties may not be worth it. Theyre at increased risk of falls and fractures, confusion and a decline in the ability to care for themselves. Its definitely worth trying some of the other strategies before looking into sleeping pills, and if they are used, they should only be for a limited amount of time, as advised by their doctor.

Alzheimer’s And Hallucinations Delusions And Paranoia

Due to complex changes occurring in the brain, people with Alzheimer’s disease may see or hear things that have no basis in reality.

• Hallucinations involve hearing, seeing, smelling, or feeling things that are not really there. For example, a person with Alzheimer’s may see children playing in the living room when no children exist.
• Delusions are false beliefs that the person thinks are real. For example, the person may think his or her spouse is in love with someone else.
• Paranoia is a type of delusion in which a person may believewithout a good reasonthat others are mean, lying, unfair, or out to get me. He or she may become suspicious, fearful, or jealous of people.

If a person with Alzheimers has ongoing disturbing hallucinations or delusions, seek medical help. An illness or medication may cause these behaviors. Medicines are available to treat these behaviors but must be used with caution. The following tips may also help you cope with these behaviors.

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Drink Plenty Of Fluids Throughout The Day

It is very important that people with dementia stay hydrated. Drinking little and often is the best way to stay hydrated, without constantly needing the toilet. Dehydration can cause added confusion and illnesses such as urinary tract infections . It is best to encourage consumption of most daily fluids in the early and middle hours of the day to avoid getting up for the bathroom in the night. If the person you care for enjoys an evening cup of tea, try switching it for decaf.

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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Stages And Progression Of Lewy Body Dementia

Claudia Chaves, MD, is board-certified in cerebrovascular disease and neurology with a subspecialty certification in vascular neurology.

If you or someone you know has recently been diagnosed with Lewy body dementia, you might be wondering what to expect as the disease progresses. Is there a fairly typical progression like Alzheimer’s disease where it begins in early stages that are fairly uniform, then moves to middle stages and then to late stages? In Lewy body dementia, the answer is a bit more complicated.

What Is Rem Sleep Disorder

Rapid Eye Movement Sleep Disorder is a type of behavioral disease that occurs during the REM sleep cycle. People who have REM Sleep Disorder lose paralysis during their sleep, which enables them to physically act out their dreams. The behaviors can be violent and can include grabbing, jumping out of bed, screaming, kicking and punching, and can, in some cases, cause injury to themselves or their partner. However, REM Sleep Disorder is usually treatable with medication.

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Talk With A Senior Living Advisor

Our advisors help 300,000 families each year find the right senior care for their loved ones.

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.

The Seven Stages Of Dementia

One of the most difficult things to hear about dementia is that, in most cases, dementia is irreversible and incurable. However, with an early diagnosis and proper care, the progression of some forms of dementia can be managed and slowed down. The cognitive decline that accompanies dementia conditions does not happen all at once – the progression of dementia can be divided into seven distinct, identifiable stages.

Learning about the stages of dementia can help with identifying signs and symptoms early on, as well as assisting sufferers and caretakers in knowing what to expect in further stages. The earlier dementia is diagnosed, the sooner treatment can start.

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Links Between Dementia And Sleep Disorders

As we sleep, we go through different cycles, moving between REM and non-REM sleep. During REM sleep, our bodies are temporarily paralyzed except for our eyes, which go through rapid and rhythmic movements. REM sleep is the time in which we dream and also when we consolidate memories. It also is considered one of the more restful parts of the sleep cycle.

For some people, however, REM sleep is not so restful. People with REM Sleep Behavior Disorder often are not paralyzed during this phase of sleep. They may talk in their sleep or physically act out their dreams. While sleep-talking and other sleep behaviors can be humorous or inconvenient, they also may predict serious diseases such as Parkinsons and Alzheimers disease in the future.

This is not the first study to find links between sleep and neurodegenerative disease. People with Alzheimers disease have disturbed sleep, even long before the disease has become apparent enough to be diagnosed. In fact, insomnia is both a symptom of the disease and a risk factor for developing it. Doctors increasingly believe that certain sleep disorders may be a symptom that the brain has already begun a disease process. In addition, the lack of sleep appears to exacerbate neurodegenerative disease, beginning a downward health spiral that can be difficult to stop.

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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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.

Studying Rem Sleep And Dementia Risk

Dr. Pase and colleagues examined a subset of FHS participants who had taken part in the Sleep Heart Health Study for 3 years between 1995 and 1998.

At the time of that study, the participants were at least 60 years old and half of them were male. Sleep stages were assessed using a home-based sleep study, or polysomnography, which is a widely used approach for assessing sleep phases and disorders.

The test can determine sleep cycles and different stages of sleep, such as REM or non-REM, by recording things such as physiological changes and brain waves.

The team followed up the participants for up to 19 years, all the while looking for cases of dementia. During the follow-up period, Dr. Pase and colleagues noted 32 diagnoses of dementia, 24 of which were Alzheimers disease.

Those who developed dementia spent 17 percent of their entire sleep in REM, on average, whereas those who did not receive a dementia diagnosis spent 20 percent, on average, in REM.

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How Does Sleep Affect Dementia Risk

Experts suggest that sleep and dementia may share a bidirectional relationship. This means that while sleep could affect dementia risk and symptoms, the presence or absence of dementia also affects sleep quality. For example, one of the first Alzheimers disease symptoms in the brain is the accumulation of a protein called amyloid-beta, which eventually forms clumps called amyloid plaques. Animal studies and a small study in people have shown sleep deprivation to increase the levels of amyloid-beta in the brain. At the same time, Alzheimers patients with amyloid plaques have been shown to have worse sleep quality than Alzheimers patients who do not have amyloid plaques.

Additionally, sleep is known to be critical for our cognitive functioning and memory formation. Observational studies have shown that sleep issues are associated with cognitive decline and dementia. However, these studies do not prove a cause-and-effect relationship. Although more research is needed to better understand sleep and dementia risk, there are many proven steps you can take to improve your sleep.

The Connection Between Rem Sleep Disorder And Alzheimers

Does your loved one act out dreams in their sleep? Besides being a dangerous sleep syndrome, REM Sleep Disorder may be a predictor of Alzheimers disease. A new study out of the University of Toronto shows that as many as 80-90% of seniors who have REM Sleep Disorder eventually develop brain disease.

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Common Sleep Problems In People With Dementia

Sleep changes are common in older adults with and without dementia. Many seniors experience changes in the quality of their sleep, the number of hours they sleep, and how much time they spend awake at night. In fact, older adults total sleep time decreases by about 30 minutes per decade starting in middle age.

Sleep problems are even more common in people with dementia. The type and severity of sleep disturbances may vary depending on the cause of your loved ones dementia and the stage of their disease. Sleep problems associated with dementia tend to get worse as the disease progresses.

Your loved one with dementia may experience the following sleep problems:

• Difficulty maintaining or falling asleep, which can be caused by insomnia, problems with the sleep cycle, side effects of medication, or other factors.
• Sundown syndrome, which is common in people with Alzheimers and other forms of dementia, can contribute to problems with sleep. Sundown syndrome refers to increased confusion, agitation, anxiety, and aggression in the evening or during the night.
• Problems with movement during sleep, such as restless legs syndrome which is characterized by an uncomfortable urge to move the legs during periods of rest or rapid eye movement sleep behavior disorder, which makes people act out their dreams.
• Breathing disorders during sleep, such as sleep apnea, which affects about 50% of people with Alzheimers.

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.

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Memory Loss Is Linked With Sleep Disturbances

The most common sleep disturbances among seniors with memory loss conditions are nightmares. These disturbances are often accompanied by violent movements as they try to act out their nightmares, hitting or yelling in fear. Known as rapid eye movement sleep behavior disorder, the prevalence of this condition is significantly higher in adults with dementia than the general population. Additionally, older adults with Alzheimers who take donepezil in the evening are also at a higher risk of experiencing nightmares because the drug activates the visual association cortex during REM sleep, which is the sleep stage associated with dreaming. Although they may not remember exactly what happened in the nightmare, they may still feel a sense of fear and dread from it, leading to feelings of agitation and confusion.

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Keep It From Happening Again

You can do some things to help make hallucinations and delusions less likely:

• If your loved one needs glasses, a hearing aid, or dentures, try to make sure they wear them. Check that their glasses are clean and the right ones for the distance. Make sure their hearing aid works and is turned on. Have their eyes and ears checked regularly.
• Make sure all rooms are well-lit. Turn on lights to get rid of shadows and reflections. Shut off sounds that might confuse them, such as noise from a TV, radio, furnace, or air conditioner.
• Keep their home and routine as close to what theyâre used to as you can. Have them be with people they know as much as possible.
• If the same thing always causes them to have problems, change it or take it away if you can.

Alzheimerâs Association: âHallucinations, Delusions and Paranoia.â

Alzheimerâs Society: âSight, Perception, and Hallucinations in Dementia.â

Mace, N., & Rabins, P. The 36-Hour Day: A Family Guide to Caring for People Who Have Alzheimer Disease, Related Dementias, and Memory Loss, Johns Hopkins University Press, 1981.

UpToDate: âApproach to the Patient with Visual Hallucinations.â

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Stage : Mild Cognitive Impairment

Clear cognitive problems begin to manifest in stage 3. A few signs of stage 3 dementia include:

• Getting lost easily
• Noticeably poor performance at work
• Forgetting the names of family members and close friends
• Difficulty retaining information read in a book or passage
• Losing or misplacing important objects
• Difficulty concentrating

Patients often start to experience mild to moderate anxiety as these symptoms increasingly interfere with day to day life. Patients who may be in this stage of dementia are encouraged to have a clinical interview with a clinician for proper diagnosis.

What Is Rem Behavior Disorder

REM behavior disorder is a parasomnia that is associated with sleep behaviors that occur out of REM sleep. In this state, the muscles are usually paralyzed so that dream enactment cannot occur. In some individuals, it becomes possible to act out the content of dreams as muscles are no longer adequately relaxed in REM. This is usually achieved at the level of the brainstem, but changes may lead to a failure to interrupt the signals between the sleeping brain and body. Those afflicted are typically older than age 50 and are more commonly men.

The resulting behaviors are often violent and can include hitting, kicking, jumping out of bed, and other actions. There may be vocalizations such as laughing, talking, or yelling. The movements are often associated with an associated dream and the content can be recalled promptly upon awakening. These dreams are often action-packed and may involve fighting off an attacker. The precise content varies widely but the recalled dream corresponds closely with the observed action.

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