What Sleep Disorders Are Common In Alzheimers Patients
Having trouble falling and staying asleep, waking up too early, or getting poor quality sleep are hallmark symptoms of insomnia, which is common in people with Alzheimers. Other sleep disorders most often seen in this population include the following:
Additionally, sundowning is a common phenomenon in which people with Alzheimers disease experience an increase in symptoms such as confusion, anxiety, and irritability late in the day. It tends to begin around the time the sun sets and can last into the night, affecting sleep. Although the exact cause is unknown, sundowning may be due to disrupted circadian rhythm and/or due to fatigue caused by sleep loss.
Emotional Causes Of Dementia Wandering
Wandering is a common response to overstimulation and overwhelming situations. Fear, agitation, and confusion commonly lead to dementia wandering outdoors or in public environments. Some emotional cues that can cause wandering include:
Stress or fear. Unfamiliar or crowded locations, like busy restaurants, sidewalks, or even family gatherings, may lead to confusion or fear in people with dementia this could cause them to wander.
Overstimulation. Loud noises and quick movements can lead to anxiety. Brain changes may cause them to interpret these stimuli differently than you and I might, says Denny. While someone without dementia may tune out the conflicting sounds of television, conversation, and outdoor sirens, these noises may cause a person with dementia confusion and fear. The overstimulation may make seniors want to escape a situation in favor of a quieter, calmer place.
Frustration. Inability to communicate can lead to frustration. When someone cant remember or ask for the things they need, theyre more likely to try to complete tasks by themselves.
Wandering And Dementia: What Caregivers Should Know
Suggestions on what signs to look for and how to make things safer at home.
The Alzheimer’s Association estimates that as many as 60 percent of people with dementia will wander. That is harmless if it’s just aimless walking around a house or nursing home, but it can turn deadly this time of year if seniors go outside alone and get disoriented.
Last week, we wrote about a fatal accident involving a woman who wandered from her independent-living apartment building just north of Philadelphia on a cold night in March 2017. Now, we look at how caregivers can protect seniors who tend to wander.
We spoke with Tama Carey, chief operating officer of Presby’s Inspired Life, a senior housing company Molly Fogel, director of education and social services for Alzheimer’s Foundation of America Robert Koester, a search-and-rescue expert who specializes in dementia patients Paula Lester, a geriatrician at Stony Brook University Medical Center Betty Robison, gerontology educator for University of Pittsburgh Medical Center Joy Shore, vice president of care management at Abramson Center for Jewish Life Danielle Snyderman, a Jefferson Health geriatrician who works frequently at a retirement community Jennifer Tapner, CEO of the Watermark at Logan Square, a retirement community in Philadelphia and Julie Thomas, associate director of clinical services for the Alzheimer’s Association Delaware Valley Chapter.
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Keep The Conversation Going
Even when the patient can no longer talk, just keep talking. Conversation is powerful because it shows the patient that you still care and support them. It is easy to feel helpless when a patient can no longer talk but you must remain strong for them.
Devoted Guardians’ Response to COVID-19
Devoted Guardians is actively monitoring the progression of the coronavirus, COVID-19, to ensure that we have the most accurate and latest information on the threat of the virus. As you know, this situation continues to develop rapidly as new cases are identified in our communities and our protocols will be adjusted as needed.
While most cases of COVID-19 are mild, causing only fever and cough, a very small percentage of cases become severe and may progress particularly in the elderly and people with underlying medical conditions. Because this is the primary population that Devoted Guardians serves, we understand your concerns and want to share with you how our organization is responding to the threat of COVID-19.
We are following updates and procedures from the Centers for Disease Control State Department of Health, local and county authorities, the Home Care Association of America and other agencies and resources. Our response and plans may adjust according to the recommendations from these organizations.
What To Do When Alzheimers Patients Stop Talking
Alzheimers is a horrible disease that eats away a person bit by bit. It causes significant damage to the brain. As the disease progresses, the symptoms become worse and worse to a point where the patient cannot do anything on their own. Activities of daily living like bathing, dressing, cooking, eating, taking medication and talking become impossible to do. It is unfortunate that the condition is irreversible and progressive.
At the first, the patient will start with mild dementia and forget simple things like the date, names of people and objects, recent events and difficulties in analyzing things. It may appear to be age-related problems yet these are the onset symptoms of Alzheimers.
As the disease progresses, the dementia becomes pronounced. The daily life and relationships of the patient are adversely affected. Here, the patient cannot understand what is going on around them and they cannot pay attention easily. Learning new things becomes a challenge for them. They become delusional and lose interest in everything. They will need help in performing tasks like cooking or shopping.
Alzheimers is a life-limiting condition. It gets difficult when the patient cannot communicate or speak. This can be frustrating for a family member or a caregiver who can decide to simply ignore the patient.
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Are They Really Lying
So first off, let’s look at what we are really talking about today!
There are three types of lying that are generally recognized about Alzheimers and Dementia patients. When I started this post I had no real knowledge of the differences and was super mixed up about which Mom was doing.
As a caregiver, I see a lot of different ideas thrown around in support groups and really wanted to dig down and figure out what was going on.
Can Dementia Come And Go
Nearly everyone who cares for someone with dementia has a story like this:
Just yesterday, mom spent most of the day sitting quietly and barely said a word. When I brought her lunch, she looked at me like I was a stranger. This morning, she greeted me cheerfully and called me by name. A few minutes later she was working on a crossword puzzle. Could it be that shes getting better?
Dementia once it has been officially diagnosed does not go away, but the symptoms can come and go and the condition can manifest itself differently depending on the person. The symptoms and signs of Alzheimers or dementia progress at different rates. There are different stages, but it doesnt ever go away.
Dementia progresses rapidly for some people, while it takes years to reach an advanced stage for others. People with mild dementia may still be able to function independently, with memory lapses that have a minimal impact on daily life, such as forgetting words or where things are located.
While Alzheimers and other common forms of dementia are progressive in nature and cannot be reversed , sometimes symptoms fade and individuals can enjoy periods of relative stability. This happens for a number of reasons.
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Be Prepared For Dementia Wandering
Some wandering is likely even with preventive steps. Making a plan and knowing what to do in advance will help you find your senior loved one more quickly in case of dementia wandering. Follow these four steps to ensure youre ready for an emergency.
1. Prepare important documents. Make copies of these documents and share them with home care aides and other family caregivers:
- A recent, close-up photo of your relative
- Up-to-date medical information to give police in case of emergency
- A list of people to call for help, like friends and neighbors
- A list of places your loved one with dementia may wander former homes, jobs, favorite restaurants, or places of worship
- A list of places and people theyve mentioned while experiencing dementia symptoms
- A wandering information sheet tracking your loved ones symptoms and behaviors over time
2. Dont be afraid to ask for help. Having all possible resources available can be necessary in case of emergency.
3. Be aware of your surroundings and your loved ones condition. Knowledge of your neighborhood and your aging relatives wandering habits can save time in an emergency.
Risk Factors With Dementia
There are different personal risk factors that cause people to fall, however, people with dementia are at greater risk because they:
- are more likely to experience problems with mobility, balance and muscle weakness
- can have difficulties with their memory and finding their way around
- can have difficulties processing what they see and reacting to situations
- may take medicines that make them drowsy, dizzy or lower their blood pressure
- are at greater risk of feeling depressed
- may find it difficult to communicate their worries, needs or feelings
Each person will experience dementia in their own way, and may experience all or none of these risk factors.
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Dont Forget The Children And Teens
With so much focus on the person who has dementia, sometimes younger family members donât get the attention they need, or the illness is not explained in a way they can understand.
Children often experience a wide range of emotions when a parent or grandparent has Alzheimerâs disease. Younger children may be fearful that they will get the disease or that they did something to cause it. Teenagers may become resentful if they must take on more responsibilities or feel embarrassed that their parent or grandparent is âdifferent.â College-bound children may be reluctant to leave home.
Reassure young children that they cannot âcatchâ the disease from you. Be straightforward about personality and behaviour changes. For example, the person with Alzheimerâs may forget things, such as their names, and say and do things that may embarrass them. Assure them that this is not their fault or intentional, but a result of the disease.
Find out what their emotional needs are and find ways to support them, such as meeting with a counsellor who specializes in children with a family member diagnosed with Alzheimerâs disease. School social workers and teachers can be notified about what the children may be experiencing and be given information about the disease. Encourage children and teens to attend support group meetings, and include them in counselling sessions.
Here are some examples that might help you cope with role changes within the family:
Warning Signs: Whos At Risk For Dementia Wandering
Wandering can happen to anyone experiencing dementia whos mobile, whether they walk or use a wheelchair. It may begin in the early stages of dementia, even before a diagnosis. Many caregivers I speak with doubt that their loved one is at risk for wandering, says Denny. But its good to be at least aware this is an issue early on, so appropriate precautions can be taken. Monitor these warning signs if you believe your loved ones at risk. They may be:
- Discussing former obligations, like going to work or caring for a child
- Trying to go home, even when at home
- Pacing, making repetitive motions, or repeating phrases
- Behaving oddly or acting nervous in public or crowded areas
- Taking longer than usual completing regular walks or drives
- Forgetting directions to familiar places, or insisting on repeating directions throughout a trip
- Having trouble finding familiar places, like the bedroom or bathroom
- Failing to complete a full activity or chore for example, getting out multiple pieces of bread without making a sandwich, or repeatedly opening and closing a book
- Incorrectly judging the distance between objects
- Perceiving two-dimensional objects as three-dimensional
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Everyday Activities Can Lead To Wandering
Seniors with dementia may become disoriented trying to follow old routines and complete daily tasks that were once common for them. Some activities that can lead to wandering include:
- Following past routines. With Alzheimers and other forms of dementia, people may cognitively revert to times past. Trying to follow familiar routes like driving to work, going on long walks, or returning to an old neighborhood can result in disorientation and dementia wandering.
- Searching. A senior may be looking for someone or something not in their present environment for example, a childhood friend or a room in a home they used to own.
- Navigating the home. Sometimes, a trip to the mailbox, restroom, or kitchen can lead to disorientation.
- Attempting former chores or responsibilities. Responsibilities like caring for a child, cooking dinner for the family, or gardening can lead to wandering. Trying to find a young child or go to the grocery store can put seniors in unfamiliar environments.
Where Do They Get The Lie Ideas
Let’s just start with this like I said before as rational human beings we want to be able to hook point A to point B and figure out where the stories are coming from. But unfortunately dementia and Alzheimers don’t work that way.
Our loved ones have a disease that has drastically changed how their brains work and there is no rational anymore. Guessing and diagnosing problems is probably not the most effective use of time.
But let’s do it anyways!
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Too Few Patients Getting Comfort Care
Geriatrician Laurel Coleman, MD, of the Maine Medical Center and the Beacon Hospice tells WebMD that the study will help physicians and family members understand what to expect.
Coleman is a member of the Alzheimerâs Association national board of directors.
âThe fact that the study is in such a prominent journal means that it will reach a wide audience,â she says. âThat is a very good thing. These are conversations that families want to have. Families want to know how to limit burden and discomfort.â
Mitchell and colleagues found that family members who understood their loved oneâs poor prognosis were much less likely to agree to medical interventions designed to prolong life.
Economics help explain why so many advanced dementia patients get these medical treatments, Sachs says.
When a patient gets sick with pneumonia, fever, or some other illness, they become more difficult and expensive to care for.
âThe economic incentives pretty much all line up in favor of transferring patients from the nursing home to hospitals,â he says. âThings are really set up to favor burdensome, aggressive treatment and not enough patients are getting treatments that focus on making them more comfortable at the end of life.â
Why Do Dementia Patients Sometimes Sleep So Much
Some people with dementia, especially patients in advanced stages, spend a lot of their time sleeping. As dementia progresses, the brain impairment becomes greater, causing the person to become exhausted with activities of daily living and other daily tasks and sleep more both during the day and night. For a person with advanced dementia, even a simple task like eating may be draining.
Also, some medications may contribute to your loved ones sleepiness. These include antidepressants, antihistamines, antipsychotics, and sleeping pills that may contribute to sleepiness.
Devoted Guardians’ Response to COVID-19
Devoted Guardians is actively monitoring the progression of the coronavirus, COVID-19, to ensure that we have the most accurate and latest information on the threat of the virus. As you know, this situation continues to develop rapidly as new cases are identified in our communities and our protocols will be adjusted as needed.
While most cases of COVID-19 are mild, causing only fever and cough, a very small percentage of cases become severe and may progress particularly in the elderly and people with underlying medical conditions. Because this is the primary population that Devoted Guardians serves, we understand your concerns and want to share with you how our organization is responding to the threat of COVID-19.
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Pneumonia Fever Eating Problems Common
Pneumonia, fever, and an eating problem were the most common complications in the final months of life, and 41% of patients had at least one aggressive treatment including hospitalization, a visit to the ER, intravenous treatment, or a feeding tube.
âThere is a lack of recognition that dementia is a terminal illness and this has a big impact on the quality of care patients receive,â Mitchell says. âWe found that a high percentage of patients had distressing symptoms toward the end of life.â
More than 5 million Americans suffer from Alzheimerâs dementia, and this figure is expected to triple over the next four decades as baby boomers reach old age. Alzheimerâs is the most common cause of dementia.
In the late stages of the disease, patients are often bedridden and can no longer communicate their needs, recognize close family members, or perform basic functions like feeding themselves and going to the bathroom.
In an editorial published with the study, geriatrician and dementia researcher Greg A. Sachs, MD, of the Indiana University Center for Aging Research, recalls his maternal grandmotherâs struggle with advanced Alzheimerâs disease.
Her final months in a nursing home included repeated courses of antibiotics for infections and restraints to control her agitation. Her condition so distressed Sachsâ mother that she stopped taking her children when she visited.
What I Wish I Knew Before My Mothers Alzheimers Death
Pages: 12
As with many Alzheimers patients, it was the family who suggested my mother get her memory tested. She was 68 years old, repeating herself, losing things and occasionally paranoid and combative with my father, something we had never seen from her before. We thought she might be depressed, but the notion that she might have dementia crossed our minds. She was diagnosed with mild cognitive impairment, the earliest stage of forgetfulness, in 2008, but was not officially given the diagnosis of Alzheimers until 2010, when she had an epileptic seizure. After that, her memory and cognitive faculties deteriorated sharply.
This is not the story of an Alzheimers patient swinging between the ignorance of their forgetfulness and the panic of watching their own ongoing decline come into focus, nor the story of the fear, the bouts of irritability, and the deep sorrow felt by family members watching their loved one slowly disappear before their eyes. We went through all that, yes. But this is the story of the last three excruciating months of my mothers life. She died in her familys arms at the age of 76, having battled Alzheimers bravely for more than eight years.
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