How To Get Rest When Sundowning Is Keeping You Awake
If a senior is up at night due to Sundowners syndrome, family caregivers will tend to the seniors needs and may not even get a break. However, this becomes a Catch 22 since family caregivers need their own sleep, space, and time to do something just for themselves. Proper sleep is crucial. Without it, caregivers can continue to be physically and mentally exhausted. A tired body lacks the ability to fight off diseases and infections. A tired mind cannot concentrate or make decisions. Therefore, sleepless caregivers are at a higher health risk. To get more sleep, try these sleep tips:
- Napping earlier in the day
- Registering your loved one in a respite program so that you can have some down time
- Hiring a home care service for backup
- Asking a reliable friend or relative to fill in for you at night, even for one night a week
Learn more about how having a professional caregiver can manage the symptoms of Alzheimers and dementia care here:
Resources
What Are The Types Of Delirium
The two types of delirium are:
- Hyperactive delirium: The person becomes overactive .
- Hypoactive delirium: The person is underactive .
Hypoactive delirium is more common, occurring in up to 75% of people with delirium. But many people, including healthcare providers, may incorrectly assume the person is depressed.
People can experience both types of delirium together. They can be extremely alert one minute and drowsy the next.
How Can You Prepare To Take Care Of Agitated Dementia Patients
Dementia impacts thinking, memory, and behavior, and affected loved ones need increasing support as the disease progresses. Understanding the diseases evolution and how its progression impacts their perceptions can help you manage dementia patients more effectively.
Start by talking to your loved ones physician and asking for guidance and tips to keep dementia patients calm, make routines like dressing and grooming easier, and provide enjoyable and stimulating activities. Health care providers can also orient you on how to deal with choking, make your home and bathroom safer, and prevent falls.
For more information about dementia, the National Institute on Aging and the Alzheimers Association are two credible organizations with books and resources to guide and inform you of caregiving tips and safety information.
Caregivers should also strongly consider having seniors with dementia wear identification bracelets. They can be life-saving if they get lost, and can include some or all of the following elements:
- The persons name
- Your address
- An I.C.E number or names and numbers of who to call
- A directive that tells others what to do. E.g., Dementia Patient. My name is John Smith. I get confused or agitated easily. Please call my children.
Also, be sure to register dementia patients in the Alzheimers Associations Safe Return Program to make sure loved ones always make their way back to you.
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What Side Effects Do Delirium Treatments Have
Antipsychotic drugs come with some side effects, although researchers are working on developing drugs that cause fewer side effects. Side effects are more common in older adults and can include:
- High illness and death rates.
- Stroke.
- High-than-normal pulse rate with irregular heartbeats .
Benzodiazepines can cause:
Common Changes In Behaviour
In the middle to later stages of most types of dementia, a person may start to behave differently. This can be distressing for both the person with dementia and those who care for them.
Some common changes in behaviour include:
- repeating the same question or activity over and over again
- restlessness, like pacing up and down, wandering and fidgeting
- night-time waking and sleep disturbance
- following a partner or spouse around everywhere
- loss of self-confidence, which may show as apathy or disinterest in their usual activities
If you’re caring for someone who’s showing these behaviours, it’s important to try to understand why they’re behaving like this, which is not always easy.
You may find it reassuring to remember that these behaviours may be how someone is communicating their feelings. It may help to look at different ways of communicating with someone with dementia.
Sometimes these behaviours are not a dementia symptom. They can be a result of frustration with not being understood or with their environment, which they no longer find familiar but confusing.
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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.
Aggressive Behaviour In Dementia
In the later stages of dementia, some people with dementia will develop what’s known as behavioural and psychological symptoms of dementia .
The symptoms of BPSD can include:
- increased agitation
- aggression
- delusions
- hallucinations
These types of behaviours are very distressing for the carer and for the person with dementia.
It’s very important to ask your doctor to rule out or treat any underlying causes, such as:
- uncontrolled pain
- infection, such as a urinary tract infection
- side effects of medicines
If the person you’re caring for behaves in an aggressive way, try to stay calm and avoid confrontation. You may have to leave the room for a while.
If none of the coping strategies works, an antipsychotic medicine can be prescribed as a short-term treatment. This should be prescribed by a consultant psychiatrist.
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What Stage Of Dementia Is Incontinence
Toileting & Late Stage Dementia Loss of bladder control due to an inability to get to the bathroom or use it properly is defined as functional incontinence. Late stage Alzheimers is marked by the loss of ability to respond to the environment as well as a loss of ability to communicate and express needs.
What Can You Do To Help Dementia Patients Sleep Better At Night
Sleep disturbances are common in dementia patients. Some studies report that as much as 20 percent of Alzheimers patients start getting agitated, anxious, and confused at nightfall. Others may become restless or have changes in sleep patterns. Below are some suggestions to help agitated dementia patients have an easier time getting restful sleep.
- Speak to a doctor: Health care physicians should always be your first stop when you have questions regarding medical conditions or are looking for credible, science-backed information. Theyll let you know about helpful prescriptions and over the counter remedies, as well as other things to do at home.
- Keep the lights on: A well-lit home in the evening can make loved ones feel less agitated because they can see and recognize their surroundings.
- Develop a nightly routine: Having a predictable nightly routine cues dementia patients that bedtime is coming. Their body can then prepare as well by lowering cortisol levels and ramping up melatonin production. An equally important part of winding down is avoiding stimulants and stimulating activities after sunset. If your loved one is sensitive to caffeine, consider restricting coffee morning hours.
- Tire them out: People who spend most of the day resting wont feel tired at night. This can make it difficult to fall and stay asleep. Encouraging more physical activity and discouraging napping can ensure dementia patients are ready for sleep at bedtime.
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How To Prevent Or Reduce Sundowners Syndrome
Provide Comfort And Familiarity
Think back to the last time you were sick. Chances are you wanted to be surrounded by comforting thoughts, things, and people. For someone with dementia, the world can become a scary place. Comfort and familiarity can help them cope with this difficult time in life.
Help fill your loved ones life and home with things they find comforting. If they move into a hospital or assisted living facility, furnish the space around them with cherished items. For example, bring their favorite blanket or family photos to the new facility. This may help ease the transition and curb their sundowning symptoms.
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What Can I Do To Help My Dad With Dementia Sleep Better At Night He Suffers From Sundowning And Often Won’t Sleep Until Extremely Late
From late afternoon its important to remain calm and stick to the bedtime routine, as your dad may pick up on your stress causing him distress. Try to find a balance between your dad not being over-tired while still being tired enough for bed. This might mean experimenting with naptimes. Natural daylight is wonderful for helping to reset a disrupted body-clock, so you should consider simply sitting outdoors or next to a bright window when your dad starts to show signs of agitation or restlessness. Find more tips on how to deal with Sundowning here.
What Sleep Problems Can Be Caused By Dementia
Insomnia
Insomnia includes a wide range of sleep problems, such as taking a long time to fall asleep, waking up often during the night, having nightmares and waking up early in the morning. These result in the person not getting enough good-quality sleep.
Insomnia is a common problem for people with dementia, and different causes include the following:
- The person may be struggling with pain or discomfort.
- They may have other health conditions that make sleep more difficult, such as heart or breathing problems, heartburn, constipation, urinary tract infections or incontinence.
- They may be feeling anxious, stressed or depressed.
- They may be taking medications that cause insomnia as a side effect. This is common with drugs prescribed to improve dementia symptoms, such as donepezil, rivastigmine, or galantamine.
These drugs can also lead to very vivid dreams or nightmares. If this happens, they may find taking their medication in the morning rather than at bedtime helps.
There are drugs that can help a person get to sleep more easily. However, most have unpleasant or potentially dangerous side effects, such as dizziness and an increased risk of falls. This makes them less safe for a person with dementia to take. They tend to only be prescribed for very short-term use when the person has severe sleep problems.
Excessive daytime sleepiness
For more information on hallucinations and delusions see Changes in perception.
Sleep-disordered breathing
Restless legs syndrome
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What Are The Signs Of Skin Picking Disorder
Its hard to say exactly when skin picking changes from a mild, nervous habit to a serious problem that needs treatment. It may help to ask the following questions:
- Does picking at your skin take up a lot of time during the day?
- Do you have noticeable scars from skin picking?
- Do you feel upset when you think about how much you pick your skin?
- Does picking at your skin get in the way of your social or professional life? For example, do you avoid the beach or the gym because people might see your scars? Or do you spend a lot of time covering up sores before work or social events?
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Repeating The Same Question Or Activity
Repeating the same question or activity may be a result of memory loss where the person cannot remember what theyâve said or done.
It can be frustrating for the carer, but itâs important to remember that the person is not being deliberately difficult.
Try to:
- be tactful and patient
- help the person find the answer themselves, for example, if they keep asking the time, buy an easy-to-read clock and keep it in a visible place
- look for any underlying theme, such as the person believing theyâre lost, and offer reassurance
- offer general reassurance, for example, that they do not need to worry about that appointment as all the arrangements are in hand
- encourage someone to talk about something they like talking about, for example, a period of time or an event they enjoyed
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Calming Medication For Individuals With Dementia
If you are working with a relative or friend with dementia whos using medication to handle their condition, what medication should you expect to come into contact with? What drugs are used to calm dementia patients? Most of the medications used to fall into a few categories:
- Medications that help with pain or constipation
- Antipsychotics
- Medication that helps with seizures
- Anti-depressants
- Medications designed to help with memory and clouded thoughts
Whether youre caring for someone with Alzheimers disease or another dementia diagnosis, medication can help keep individuals calm and reduce their stress and anxiety. Lets take a closer look at the different types of drugs that are used in Alzheimers care and other dementia cases.
Why Do Dementia Patients Not Sleep
Dementia experts arent exactly sure why dementia patients dont sleep well at night. However, there are some potential causes for sleep problems in elderly adults with dementia.
A good practice is to monitor your loved one and keep a journal to help track different habits and changes.
Here are some of the top causes of elderly adults with dementia not sleeping at night.
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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.
How Will The Provider Decide What Treatment Is Best
Other medical conditions usually cause delirium. Its important to treat those conditions to treat the delirium. The provider will review the persons:
- Medical history.
- Lab results.
- Drug use, including over-the-counter drugs, illicit drugs and alcohol.
The person may not be able to answer questions about themselves. So providers may ask the persons family member or loved one:
- Did the confusion begin suddenly or gradually?
- How quickly did it progress?
- What was the persons mental and physical state before this?
- Is the person taking any drugs or dietary supplements?
- Did the person stop or start any new medicines or drugs recently?
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Frequently Asked Questions About Sundowners Syndrome
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