Setting The Scene For Bed
Its important to take into account the preferences of the person with dementia.
Often, the best way to find out the sleep pattern of a person with dementia is to talk to them and ask. We are all different and have varied body clocks and preferences. If the person is unable to tell you, try different things to see what works best. You could try:
- checking the temperature of the persons bedroom, to make sure its not too hot or cold
- making sure their bedclothes are suitable for the season. Being too hot or cold in the night can cause a person to wake up
- finding out if the person prefers to sleep in darkness or would like a night light
If the person tends to get up in the night, to use the toilet or to wander around, you might want to have a light on for them, in the room or in the corridor. Keeping the bathroom light on and the door open can help them find their way to the toilet. Remember to keep the pathway to the bathroom clear.
In the summertime, when the evenings are lighter, it can help maintain a routine by pulling the curtains or blinds at the same time each evening.
Sometimes, medication can aid sleep. But sleeping mediation must be used with caution and under the guidance of your GP.
Lastly, think back to the persons preferences for bed time before they received their diagnosis of dementia. If they liked to go to bed late at night, that preference will probably stay the same, and so it will be difficult to get them ready for bed earlier in the evening.
Do You Want To Create A Dementia Friendly Environment
About Signage For Care
Signage For Care is a sub-brand of Wayfinders, a signage company based in Dublin who has been in business for 40 years. We have been designing dementia friendly signage for care homes since the very beginning. We discovered a gap in the dementia signage market and decided to take matters into our own hands in 2016, which is when Signage For Care was born.
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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Boredom And Dementia Leads To Challenging Behaviors
Many family members who care for a loved one living with dementia experience difficult behaviors. Examples are struggling to get the patient to cooperate with eating and bathing, as well as sundowning-related problems such as agitation, paranoia, repetitive speech, and increased confusion in the afternoon or evening hours.
In a lot of cases, these challenging behaviors are a direct result of the persons unchecked needs surrounding boredom and loneliness, which must be addressed in order to improve their quality of life. Lets review some ways to feed these emotional needs.
Why Dementia Symptoms Fluctuate
The common perception that symptoms come and go is an important area worthy of additional study. From what we know now, here are five considerations when thinking about why your loved one might experience increasing and decreasing signs of dementia.
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Planning For The Future
- Talk to the person with dementia to make sure that they have a current up-to-date will that reflects their wishes.
- Encourage the person with dementia to set up a Lasting Power of Attorney so that a responsible person can make decisions on their behalf when they are no longer able to.
- Talk to the person with dementia about making an advance decision to refuse certain types of medical treatment in certain situations. It will only be used when the person with dementia has lost the capacity to make or communicate the decision in the future.
- If the person youre caring for has already lost the ability to make or communicate decisions but doesnt have an LPA, you can apply to the Court of Protection who can make decisions on behalf of that person or appoint someone else to do so.
If the person you care for drives, the law requires them to tell DVLA about their diagnosis. A diagnosis of dementia doesn’t automatically mean someone has to stop driving straight away – what matters is that they can drive safely. Talking to the person you care for about stopping driving can be very sensitive.
Adjust Their Eating Patterns
Adjusting your loved ones eating patterns may also help reduce their sundowning symptoms. Large meals can increase their agitation and may keep them up at night, especially if they consume caffeine or alcohol. Encourage your loved one to avoid those substances or enjoy them at lunch rather than dinner. Limiting their evening food intake to a hearty snack or light meal might help them feel more comfortable and rest easier at night.
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Knowing The Stages Of Dementia Helps You Plan
Even if the stages arent exact and symptoms can still be unpredictable, being able to plan ahead is essential.
The truth is that Alzheimers and dementia care is expensive and time-consuming. Being financially prepared for increasing care needs is a necessity.
On an emotional level, having an idea of what symptoms to expect helps you find ways to cope with challenging behaviors.
It also gives you a chance to mentally prepare yourself for the inevitable changes in your older adult.
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.
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Music And Art Activities
Faqs About Dementia Sleep Problems
Caring for a patient with dementia and sleep problems is hard work. When the dementia patient is not sleeping well, it is very easy to become exhausted yourself. To give the best care, the carer needs to look after themselves. In addition to the following questions that some people have asked regarding how to get dementia patients to sleep at night, you should visit our guide on caring for someone with dementia.
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What Support Is Available For Me If I Care For Someone With Dementia
When youre caring for someone else, its easy to overlook your own needs. But looking after your health and making time for yourself can help you feel better and cope better with your caring role.
Caring for someone with dementia may lead to feelings of guilt, sadness, confusion or anger. Unlike with other conditions, it can be difficult to share these feelings with someone with dementia, leaving you feeling very isolated.
Its important to acknowledge these feelings, and theres no right or wrong way to feel. If youre feeling anxious, depressed or struggling to cope stressed, talk to your doctor who can let you know about help and support available to you.
Understand The Person With Dementia
In late-stage dementia, persons often communicate less. Many stop talking. You have to guess what they need based on the way they move their body and on what you know about their habits, likes, and dislikes. Is the person hungry now, or should you give food later? Is the person frowning at the soup or spitting it out because the soup has carrots, or the salt is less, or is the soup is too spicy? When sitting next to the person, which topics should you chat about? What would the person like to hear? Which photo album will cheer the person? Is the person bored? Because all such care depends on understanding the person, it is better if the same family members and trained attendants continue to give care through this stage.
Some families share the care work by moving the person with dementia from one home to another every few months. This may not be possible or comfortable for someone in late stage dementia. Think about this aspect when planning care.
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Do Eat A Healthy Diet
Promoting a vitamin rich diet for your bedridden patient can be extremely beneficial for them, as well as for you! Taking the time to explain to your patient the importance and wonderful effects of a nutritious diet can immensely increase the quality of their life, thus making your job just a little bit easier.
Maintaining a healthy diet can improve the quality of your patients life by strengthening memory, increasing bone density, cardiovascular health, reducing inflammation, and many more amazing benefits.
Colorful and leafy greens are filled with magnesium, iron, manganese, potassium, and fiber. These and so many more vitamins in healthy food can provide not only symptom relief but increase overall health. There are countless delicious healthy options to share with your patient!
We recently wrote an article highlighting the top healthy foods for anti-aging. Learn about some of the super foods that can help your bedridden patient or family member live a healthier and happier life!
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.
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Working With Hospital Staff
Remember that not everyone in the hospital knows the same basic facts about memory loss, Alzheimers disease, and related dementias. You may need to help teach hospital staff what approach works best with the person with Alzheimers, what distresses or upsets him or her, and ways to reduce this distress.
You can help the staff by providing them with a personal information sheet that includes the persons normal routine, how he or she prefers to be addressed , personal habits, likes and dislikes, possible behaviors , and nonverbal signs of pain or discomfort.
Help staff understand what the persons baseline is to help differentiate between dementia and acute confusion or delirium.
For more information on dealing with dementia and hospitalization, see the University of California, San Francisco, Memory and Aging Centers Tips for Hospitalization.
How Hospice Can Help With End
In addition to helping you in recognizing the signs of dying in the elderly with dementia, bringing in hospice care will help with the physical and emotional demands of caregiving. Nurses will be able to adjust medication and care plans as the individuals needs change. Aides can help with bathing, grooming, and other personal care. Social workers can help organize resources for the patient and family. Chaplains and bereavement specials can help the family with any emotional or spiritual needs. Additionally, family members can contact hospice at any time, and do not need to wait until it is recommended by the patient’s physician.
To learn more about the criteria for hospice eligibility or to schedule a consultation, please contact Crossroads using the blue Help Center bar on this page for more information on how we can help provide support to individuals with dementia and their families.
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Seek Cooperation From Your Parents Doctor
It is important early in the process to obtain the cooperation of their doctor. Without your parents permission, the doctor will be unable to discuss medical affairs. If youre unable to get permission, you may still be able to communicate with the doctor.
One of the ways you can interface is to write a letter to the doctor. If things become out of hand or your parent is becoming abusive and erratic, a signed letter from your family may allow the doctor to consider an appropriate evaluation. The doctor may even find luck in persuading your parent.
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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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.