Stage : Moderate Dementia
Patients in stage 5 need some assistance in order to carry out their daily lives. The main sign for stage 5 dementia is the inability to remember major details such as the name of a close family member or a home address. Patients may become disoriented about the time and place, have trouble making decisions, and forget basic information about themselves, such as a telephone number or address.
While moderate dementia can interfere with basic functioning, patients at this stage do not need assistance with basic functions such as using the bathroom or eating. Patients also still have the ability to remember their own names and generally the names of spouses and children.
How To Get Dementia Patients To Sleep At Night: 9 Tips For Better Sleep
If youre caring for a family member with dementia, improving sleep is probably a priority. Adequate rest can improve your loved ones mood, health, and quality of life as well as your own. Learning how to support healthy habits during the day and how to calm dementia patients at night can help you avoid nighttime dementia episodes. Here are some tips on how to keep dementia patients in bed at night :
1. Treat pain and other medical conditions. Getting to the root cause of chronic pain may help improve your loved ones sleep. If a condition like sleep apnea is the problem, consult with their doctor for solutions. If restless legs syndrome is disturbing your parents sleep, a magnesium supplement may help. Be sure to check with your loved ones doctor or pharmacist before introducing any new supplements.
2. Create a soothing environment. Make sure your loved ones room is set up to promote good sleep. The room should be dark, quiet, and cool. Set the temperature between 60 and 67 degrees Fahrenheit, and consider using a white-noise machine to minimize external noises and agitation.
3. Check for medication side effects and avoid stimulants. Many people with dementia take several medications. Some of these drugs, such as stimulants or diuretics, can interfere with sleep. In fact, stimulants like caffeine, alcohol, sugar, and nicotine are known for disrupting sleep.
Why Dementia Patients Don’t Sleep Well
Depending on the stage of dementia the sleep pattern can change from sleeping too little to sleeping too much. As dementia progresses it is not unusual for the pattern to deteriorate. What makes things a little trickier is that dementia can make it harder for someone to communicate what is wrong. For example, they might not be able to tell you that theyre in pain. This is why it becomes even more important to pay close attention to other types of communication such as facial expression and body language. Below, we have outlined some issues which can cause dementia patients to not sleep well.
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They Wake Up A Lot During The Night To Use The Loo And I’m Worried They May Get Lost Or Confused Should I Wake Up Too To Help Them
It is normal that older people will need to use the loo more often during the night. This can be difficult if a person also has dementia as they might forget why they’re up, where the toilet is or that they should go back to bed. Start by looking at your parents drinking and eating habits. If they are eating and drinking large amounts in the evening this will increase the need for them to visit the toilet. Limit their intake from late afternoon and enjoy a main meal at lunch. Next make the route to and from the toilet as clear as possible by using signs and plug-in nightlights. Try using pictures if it helps. It might also help to make the lights in the bathroom motion activated for when they get there. If you are still worried or you find they still get lost, it may be that you will have to help them. A monitor or bed-exit sensor will help you to wake up when you need to.
What Causes Excessive Daytime Sleepiness
Some people with dementia sleep excessively during the daytime. They may feel like they cant stay awake, and they may take long naps that interfere with nighttime sleep and overall quality of life. Excessive daytime sleepiness is more common in people with Parkinsons disease dementia or Lewy body dementia than in those with Alzheimers disease.
Some factors that may contribute to excessive daytime sleepiness in a person with dementia include the following :
- Insufficient sleep at night
- Damage to brain cells caused by dementia
- Changes in sleep patterns caused by dementia
- Mental health conditions, such as depression
- Other sleep disorders, such as sleep apnea
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What Can Make Dementia Worse
Because dementia is a progressive disease, patients and their loved ones look for ways to slow down the decline as much as possible. While sometimes that means being proactive about choosing medication and healthier lifestyles, other times that means actively avoiding what could hasten the decline.
At our dementia treatment clinic, were frequently asked questions about what can make dementia symptoms worse. Well answer the 13 most commonly asked questions about what makes dementia worse, and well also explain our proactive approach to helping dementia patients.
Our therapists use a combination of aerobic exercise and cognitive therapy to help dementia patients maintain cognitive function and stay independent for as long as possible.
Heres the full list of the questions we answer in this post:
Neural Effects uses the latest evidence-based techniques to diagnose and help dementia patients. We are located in Provo, Utah, and serve anyone in Salt Lake City or the Utah Valley area. We are in network for most types of medical insurance. Schedule your evaluation today.
Normal Sleep Pattern Changes In Older Age
Research has documented a number of sleep changes that occur in healthy aging adults. These include bedtimes and wake times shifting Trusted SourceNational Library of Medicine, Biotech InformationThe National Center for Biotechnology Information advances science and health by providing access to biomedical and genomic information.pubmed.ncbi.nlm.nih.gov to an earlier hour, taking longer to fall asleep once in bed, experiencing fragmented sleep, sleeping fewer hours per night, and spending less time in slow-wave and REM sleep. Although these changes parallel some of the sleep challenges seen in people with dementia, the sleep pattern changes in dementia patients tend to be more dramatic and disruptive.
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What Can Help Someone With Dementia Sleep Better
Sleep hygiene is the primary treatment for sleep concerns in people with dementia. Sleep hygiene is a collection of practices and environmental considerations that promote good sleep quality. The following sleep hygiene tips may help a person with dementia improve their sleep patterns:
Some of these sleep hygiene practices may be difficult for someone with dementia. For example, it may not be possible to control the bedroom noise level in a nursing home or assisted living facility. Consider adding a white noise machine to mask outside noise. A person with dementia may also have a difficult time maintaining a regular bedtime due to napping or varied daily activities, but keeping wake time consistent can still help to stabilize the circadian rhythm. A physician or sleep specialist is in a good position to provide individualized sleep hygiene recommendations for a specific situation.
Can Treatment At Neural Effects Help Dementia Patients
A way to counteract some of these factors and delay the progression of symptoms is to receive treatment for dementia at Neural Effects.
We offer a combination of physical exercise and cognitive activities, which can slow down cognitive decline from most forms of dementia better than exercise or cognitive therapy separately. We know this approach works because, after aerobic exercise, patients experience a post-exercise cognitive boost which makes the brain more receptive to building new connections during therapy. As a result, the brain is more flexible and better able to benefit from therapy.
Before treatment starts, our patients undergo a complete neuropsychological exam to find out what kind of cognitive issues theyre experiencing.
This examination includes a series of tests to assess reasoning, memory, attention, reading comprehension, executive function, and language, as well as signs of depression and anxiety. In practical terms, the tests involve some writing and drawing, solving puzzles, and answering questions. Its normal for patients to find some questions easier than others, depending on which areas of the brain are affected. All patients need to go through this neuropsychological assessment, even if they already have a diagnosis of dementia from their doctor.
Once your examination is complete, we will meet with you and your loved one to discuss the results and suggest possible treatment options.
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Develop A Daily Routine
Maintaining a schedule throughout the day helps orient patients and alleviates anxiety that may arise during twilight. Washing up for dinner and putting on pajamas can be helpful indicators that the day is winding down.
Plan more activities during the day such as walks, crafts, and visits to keep your loved one awake and engaged. A person who naps most of the day is likely to be more awake at night. If your loved one is tired and less lucid by the afternoon or evening, plan simple and soothing activities during those times to keep them occupied so they dont want to nap. An upbeat movie or TV show or some pet therapy can have a calming effect while keeping them awake. If they dont wish to participate, dont argue with them. Instead, continue trying to appeal to their interests to find something that eventually works.
Try to prevent excessive commotion during the times they normally become more agitated. Be aware of certain times, people, places, or activities that seem to trigger difficult dementia behaviors. Notice patterns in your loved ones sundowning to help you avoid these triggers and adapt their routine to support a peaceful environment.
Tips For Reducing Sundowning
- Sometimes what seems like sundowning could be the person trying to communicate a need. This could be needing the toilet, feeling hungry or being in pain.
- Think whether something thats happened during the day has affected them. If they seem agitated, try to calm them by distracting them, perhaps talking about a favourite memory or event they enjoy thinking about.
- If they remain agitated, it could be that they have a need that is not being met. For more information see Communicating.
Read about other sleep problemsRead about other sleep problems .
Get advice on other sleeping problems, as well as what support and care is available for a person with dementia and sleep disturbance.
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Can Moving Make Dementia Worse
After a dementia diagnosis, many families think about moving when planning for the future. You might look for a home with more easily accessible rooms, something closer to the hospital, or a place in a care facility.
However, relocation can be a complex process for dementia patients, often leading to trauma known as relocation stress. Relocating may cause confusion, anxiety, depression, and withdrawal. Its not uncommon for the patients behavior to become out of character until they get used to the new home.
Patients also struggle to find their way around the house their brain is already affected by the disease, so mapping a new location is complex and may take some time. Sadly, this often means increased mortality rates after moving, especially in patients with severe dementia.
Patients in the early stages of the disease may find it easier to adapt to a new home, particularly if they feel involved in the decision-making process to relocate. This increases the quality of life and reduces stress.
If you are planning to move to a new home or your loved one is going to a care facility, consider the following:
- Keep the new home as familiar as possible by using furniture or decorations from the old house. This could also include painting the front door to match the old one to make it more easily recognizable.
- Use nightlights to help the patient find their way through the home at night.
- If possible, allow the patient to visit the new location several times before moving.
Can Stress Make Dementia Worse
Patients with dementia are likely to experience stress at times, especially as the disease progresses and patients lose cognitive function.
There are many reasons why chronic stress makes dementia symptoms worse. For example, a key hormone released when youre stressed known as cortisol can cause memory problems. Stress also forces the nervous system to be in a constant state of alert, which may cause dizziness and fainting, increased risk of falls, difficulty digesting food, and constipation in dementia patients. Lastly, stress especially if long-term can also cause psychological and emotional issues, such as depression and anxiety, which are factors that worsen dementia.
If your loved one becomes increasingly anxious or irritable, re-engage their attention with another activity.
- Light exercise, like gardening or going for a walk, is a great way to eliminate stress.
- Playing some music can improve the mood of a dementia patient.
- Find a hobby that your loved one enjoyed before their diagnosis this would be a good distraction for when theyre stressed.
- Play board games . Card games or bingo are good options.
- Ask the patient to do simple household chores, like dusting or folding towels. This helps them feel useful and reduces fidgeting.
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How Is Vascular Dementia Diagnosed
In addition to a complete medical history and physical exam, your healthcare provider may order some of the following:
- Computed tomography . This imaging test uses X-rays and a computer to make horizontal, or axial images of the brain. CT scans are more detailed than general X-rays.
- FDG-PET scan. This is a PET scan of the brain that uses a special tracer to light up regions of the brain.
- Electroencephalogram . This test measures electrical activity in the brain
- Magnetic resonance imaging . This test uses large magnets, radiofrequencies, and a computer to make detailed images of the brain.
- Neuropsychological assessments. These tests can help sort out vascular dementia from other types of dementia and Alzheimer’s.
- Neuropsychiatric evaluation. This may be done to rule out a psychiatric condition that may resemble dementia.
At What Stage Of Dementia Does Sundowning Occur
Sundowning in dementia patients can occur at any stage of the disease, however it most commonly starts during the middle stages. If sundowning symptoms do occur during the early stages of dementia, theyre typically mild and inconsistent. Sadly, the symptoms of sundown syndrome tend to get worse as dementia progresses and usually dont completely go away.
Note that its possible for an aging loved one to experience symptoms of sundowning without a dementia diagnosis. Conversely, not everyone with Alzheimers or other dementias will experience sundowning.
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Minimize Their Stress At Night
Try to help your loved one stay calm in the evening hours. Encourage them to stick to simple activities that arent too challenging or frightening. Frustration and stress can add to their confusion and irritability.
For example, try to avoid noisy groups and loud noises if possible, as well as doing any chores that might be overwhelming for them. Older adults are more sensitive to noise, according to a 2018 study.
If they have mid-stage or advanced dementia, watching television or reading a book might be too difficult for them in the evening. Instead, consider playing soft music to create a calm and quiet environment. Some people also enjoy looking at photographs. It might also be a nice time for them to snuggle with a beloved cat or other pet.
Your loved one might experience sundowning as the result of changes in their circadian rhythm, which is their sleep-wake cycle.
Thats why adjusting the light in their home might help reduce their symptoms. For example, a 2011 research review found that light therapy can help reduce agitation and confusion in people with dementia.
So consider placing a full-spectrum fluorescent light about 3 feet away from your loved one for a couple of hours each morning.
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.
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Tips For Behavior And Sleep Problems
Having a daily routine may help. Calmly reassuring and giving cues to orient the person who has dementia is also helpful in the evening and closer to bedtime. Try to keep the person going to bed at the same time every night.
Calm activities at the end of the day and before bedtime may help the person with dementia sleep better at night. If they are active during the day, these calm activities can make them tired and better able to sleep.
Avoid loud noises and activity in the home at night, so the person does not wake up once they are asleep.
Do not restrain a person with dementia when they are in bed. If you are using a hospital bed that has guard rails in the home, putting the rails up may help keep the person from wandering at night.
Always talk with the person’s health care provider before giving them store-bought sleep medicines. Many sleep aids can make confusion worse.
If the person with dementia has hallucinations :
- Try to decrease the stimulation around them. Help them avoid things with bright colors or bold patterns.
- Make sure there is enough light so that there are no shadows in the room. But do not make rooms so bright that there is a glare.
- Help them avoid movies or television shows that are violent or action-packed.
Take the person to places where they can move around and exercise during the day, such as shopping malls.