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Why Do Dementia Patients Talk In Their Sleep

What Do Elderly People Think About Life And Death

How to improve sleep in dementia

As we get older, death seems to be nearer than when we are younger. In as much as anyone can die regardless of age, for an older person, it seems like it is more likely to happen, especially when dealing with different health conditions that the body does not handle as it used to in the younger years.

For older persons, death does not always spell sorrow and terror, as is the case with younger people. Many of the older people are contented with what the short-term future has for them. You may think that people may get anxious as they become older, but this is not the case. Older people do not have much sadness and anxiety, especially related to death. They are actually more positive about life and death.

As we grow older, our perspective shifts. This is when you realize that things are not as they always seem. Most people fear death because they feel that they will lose the things that they have been working so hard to get over the years. However, for older people, this attachment to things acquired is not really pronounced. This is how some of the fear of death actually melts away.

When you look around you and you realize that there are things that are a part of you that will outlive you actually help in a major way. This could be the legacy we have in children or gardens planted. There are yet others who place value on their country, their religion, or families that live on even after they are gone.

What Are The Signs Of End

It is important for caregivers to know when an individual with dementia is close to the end of their life, because it helps ensure they receive the right amount of care at the right time. It can be difficult to know exactly when this time is due to the variable nature of dementias progression, but understanding common end-of-life symptoms of seniors with dementia can help. Below is a timeline of signs of dying in elderly people with dementia:

Final Six Months

  • A diagnosis of another condition such as cancer, congestive heart failure or COPD
  • An increase in hospital visits or admissions

Final Two-to-Three Months

  • Speech limited to six words or less per day
  • Difficulty in swallowing or choking on liquids or food
  • Unable to walk or sit upright without assistance
  • Incontinence
  • Hands, feet, arms and legs may be increasingly cold to the touch
  • Inability to swallow
  • Terminal agitation or restlessness
  • An increasing amount of time asleep or drifting into unconsciousness
  • Changes in breathing, including shallow breaths or periods without breathing for several seconds or up to a minute

Patients with dementia are eligible to receive hospice care if they have a diagnosis of six months or less to live if the disease progresses in a typical fashion. Once a patient begins experiencing any of the above symptoms, it is time to speak with a hospice professional about how they can help provide added care and support.

Sleep For People Who Have Dementia With Lewy Bodies And Parkinsons Disease

The type of dementia you have can affect your sleep.

People who have dementia caused by Lewy body disease, such as Parkinsons disease or dementia with Lewy bodies are often sleepy by day but have very restless and disturbed nights. They can suffer from confusion, nightmares and hallucinations. Insomnia, sleep apnoea and restless legs are common symptoms.

A person affected with these types of dementia may often unknowingly act out their dreams by shouting and moving around in bed.

They can even cause injury to themselves and/or their sleeping partner. This is called rapid eye movement sleep behaviour disorder or RBD, and tends to happen from the earliest stages of the disease onwards.

This can be exhausting and often leaves the person feeling like they havent slept at all, so they are very tired and sleepy during the day.

It can be hard to stay awake during the day after a poor nights sleep but, if possible, its best to try to limit sleep during the day to small bursts or catnaps. Otherwise the persons body clock can become very confused and this makes sleeping well during the night even harder.

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Sleep Aids For Dementia Patients

Sleep inducing medications can cause negative side effects in dementia patients. These include worsened cognition and an increased risk of falling. Therefore, recommended sleep aids for people living with dementia are non-drug based and aim to improve sleep routine and the sleeping environment. You can find a full list of dementia products on our dementia products page.

Normal Sleep Pattern Changes In Older Age

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Research has documented a number of sleep changes that occur in healthy aging adults. These include bedtimes and wake times shifting 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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Need More Information About How You Can Sleep Better

At Sleephub we understand the struggle people endure with sleeping problems which is why we have created a comprehensive FAQs page with information for those seeking information about sleep disorders and potential solutions.

Check our resources or take our Sleep Wellness Quiz for a free assessment of elements that may be keeping you from a good nights sleep.

What Does Sundowner Mean In Dementia

Sundowning is a symptom of Alzheimer’s disease and other forms of dementia. It’s also known as late-day confusion. If someone you care for has dementia, their confusion and agitation may get worse in the late afternoon and evening. In comparison, their symptoms may be less pronounced earlier in the day.

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What Sleep Disorders Are Common In People With Dementia

People with dementia are frequently affected by sleep disorders. The following sleep disorders are found most often in older adults, but they are seen at even higher rates in people with dementia.

  • Restless legs syndrome : RLS is characterized by an overwhelming desire to move the legs, especially at night. RLS is common in people with a type of dementia called Lewy body dementia.
  • Periodic limb movement disorder : PLMD causes uncontrollable movements of the arms and/or legs at night. Many patients with PLMD also have RLS.
  • Obstructive sleep apnea : OSA is a condition marked by nighttime airway collapse leading to brief lapses in breathing. OSA is particularly common with Alzheimers disease, occurring in 40% of patients. Having OSA also increases ones risk of developing dementia.
  • REM sleep behavior disorder: REM sleep behavior disorder causes individuals to act out their dreams, sometimes in dangerous ways. It is most often found in individuals with Lewy body dementia and is sometimes the first symptom that arises with this type of dementia.
  • Depression: Although depression is a mood disorder, it is associated with insomnia and other sleep disturbances. Depression is common in people with dementia, and it is seen at increasing rates as dementia progresses to more severe stages.

How To Cope With Common Changes In Behaviour

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Although changes in behaviour can be difficult to deal with, it can help to work out if there are any triggers.

For example:

  • Do some behaviours happen at a certain time of day?
  • Is the person finding the home too noisy or cluttered?
  • Do these changes happen when a person is being asked to do something they may not want to do?

Keeping a diary for 1 to 2 weeks can help identify these triggers.

If the change in behaviour comes on suddenly, the cause may be a health problem. The person may be in pain or discomfort from constipation or an infection.

Ask a GP for an assessment to rule out or treat any underlying cause.

Keeping an active social life, regular exercise, and continuing activities the person enjoys, or finding new ones, can help to reduce behaviours that are out of character.

Read more about activities for dementia.

Other things that can help include:

  • providing reassurance
  • activities that give pleasure and confidence, like listening to music or dancing
  • therapies, such as animal-assisted therapy, music therapy, and massage

Remember also that it’s not easy being the person supporting or caring for a person with behaviour changes. If you’re finding things difficult, ask for support from a GP.

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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.

What Causes Alzheimer’s Disease

The exact cause of Alzheimers is not known. However, several factors increase the risk of the disease.

The risk factors of Alzheimers include:

  • Age: Risk increases with age, affecting 15% of people older than 65 years and 50% of people older than 85 years.
  • Family history: Family member with the disease increases the risk. Inherited gene mutations also increase the probability of developing the disease.
  • Gender: Women have a higher risk than men.

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Understanding What Keeps Dementia Sufferers Awake At Night

April 12, 2001 — Sleep disturbance is a very common and very problematic symptom of dementia. New research indicates that causes of this sleep disturbance may differ in different kinds of dementia. Hopefully, understanding these causes will lead to better treatments.

Dementia is a term used to refer to a loss of thinking abilities. Although there are many causes of dementia, it is most often associated with aging. The most common cause of dementia associated with aging is Alzheimer’s disease, which affects approximately one in 10 people over age 65 and nearly half of those over age 85.

If You’re Looking After Someone With Dementia

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Your needs as a carer are as important as the person you’re caring for.

To help care for yourself:

  • join a local carers’ support group or a specialist dementia organisation â for more details, call the Carers Direct helpline on 0300 123 1053 lines are open 8am to 9pm Monday to Friday, and 11am to 4pm at weekends
  • call Dementia UK’s Admiral Nurse Dementia Helpline free on 0800 888 6678 to talk to a registered specialist dementia nurse lines are open 9am to 9pm Monday to Friday, 9am to 5pm at weekends

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Does Dementia Change Your Personality

Dementia can change a person’s personality and their behavior. They may act very differently than they used to, and say or do things that they would not have normally done. Family and friends may feel very uncomfortable with these changes, and be confused about why the person is behaving this way.

  • I told you
  • What do you want to eat?
  • Come, let’s get your shoes on and get to the car, we need to go to the store for some groceries.
  • Get The Lighting Right

    To aid a more restful nights sleep the bedroom should be as comfortable as possible. Using blackout curtains are a good idea during night-time to eliminate outside disturbances. Research suggests that light therapy can reduce restlessness and confusion for people with dementia. Should you wish to consider light therapy, it has been proven that violet coloured light promotes drowsiness and a full-spectrum fluorescent light used for the first two hours of the day can be settling. Light therapy that follows a regular pattern can also help with disturbed body clocks.

    Safety – if night wandering is a problem, or frequent visits to the loo, you will need to consider some sort of low light to prevent your parent falling in the dark. You may want to invest in a motion sensor night light. A motion sensor light automatically turns on when motion is detected within three metres. It then turns off after 30 seconds of no activity. This means that people with dementia can use the bathroom in the night or get out of bed with less risk of falling. The light is gentle and warm in order to not interrupt sleep.

    • Hard to stay awake during the day and taking frequent naps
    • Sundowning, sometimes referred to as late-day confusion.

    Sundowning is a dementia-related disorder where a person becomes increasingly anxious and unsettled in the late afternoons and evenings. Sundowning is more often experienced with mid-stage to advanced dementia.

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    Stage : Mild Dementia

    At this stage, individuals may start to become socially withdrawn and show changes in personality and mood. Denial of symptoms as a defense mechanism is commonly seen in stage 4. Behaviors to look for include:

    • Difficulty remembering things about one’s personal history
    • Disorientation
    • Difficulty recognizing faces and people

    In stage 4 dementia, individuals have no trouble recognizing familiar faces or traveling to familiar locations. However, patients in this stage will often avoid challenging situations in order to hide symptoms or prevent stress or anxiety.

    Can Dementia Patients Sleep At Night

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    Dementia patients may act out their dreams, wake easily or nap during the day. Sleep is an essential part of a healthy lifestyle and taking steps to get a good nights sleep will help in managing dementia symptoms. Establish a routine Alertness levels can vary, so some patients may fall asleep during the day, making them restless at night.

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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.

    Other Sleep Issues In People With Dementia

    Sundowning is a phenomenon in which individuals with dementia experience increased agitation later in the day and in the evening. The symptoms of sundowning include confusion, anxiety, wandering, and yelling. Sundowning can contribute to insomnia and other sleep problems when these behaviors continue into the night. Possible causes of sundowning include the circadian rhythm changes that occur in dementia, as well as fatigue, depression, and pain.

    People with dementia may also talk, yell, or cry out at night if they cannot sleep. Some dementia patients have a tendency to wander away from their homes, which can be especially dangerous at night. In dementia patients with REM sleep behavior disorder, shouting, grabbing, jumping, and other behaviors are related to dream enactment during sleep.

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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.

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