Expert: Mary Gordon - 3/31/2008

Question
My mother in law has moderate Alzheimer.  She is a very sweet lady and I, as well as other family members and caregivers are caring for her 24/7.
My question is, we have one caregiver (we will call her Mary) that insist that my mother in law sleeps 4-5 hrs during the day.  This caregiver has the day shift and works 3 days a week.  We as the family come to relieve Mary at 7pm, my mother in law looks like a wet pup that has been into trouble.  The days that Mary isn't working , we don't see this problem.  The nights when we relieve Mary, my mother has very restless nights.
I sleep over 2 nights a week and my mother in law sleeps very well because I don't have my mother in law the days Mary is there.  She may get up 2 times at night but a majority of the time it's only to void.  
The other caregivers have told us that my mother in law only takes an hour to 2 hr nap a day.  I know they keep my mother in law busy with her exercise, helping with folding towels, brain games, reading etc. etc.
We have talked to Mary many times about this problem but she always seems to argue with the fact my mother in law has Alzheimer and this is what she will do due to the illness.  My mother in law doesn't seem to sleep well when someone takes over Mary's shift.
Truthfully, I think my mother in law is bored and has nothing else to do but sleep.
What are your thoughts?
Thanks,
JS

Answer
Joyce, you've hit the nail on the head. Absolutely, your mother in law should not be sleeping that much during the day - in fact, for everyone's sake, the best thing for her is to keep a routine as much as possible, so that her sleep patterns are regulated. Heck, if I sleep 4 or 5 hours during the day, I'D have trouble sleeping at night.  

If Mary is not prepared to follow instructions, I'd suggest she be replaced. I suspect life is easier for her if your mother in law is sleeping. Her job is not just to take care of your mother and keep an eye on her safety, but keep her moving around and awake - whether that is taking her for a walk, getting her to help with some simple household task (even if she isn't good at it), she might be able to vacuum, fold laundry, anything to keep her hands occupied. Here are some great ideas for things to keep their bodies and minds busy http://www.activitytherapy.com/alzh.htm

Have you considered adult daycare? I ask because a good one will have programs to keep your mother busy - whether its socializing or some simple craft or activity. Many older people like daycare -  often the same people who might not have liked it at all when they were well - and look forward to getting out to attend it.

Your mother in law may well want to sleep, but it's Mary's job not to let her. It may be kindly meant, but its having an impact on everyone who loves her, is not letting your mother in law get proper rest at night, and is all around not good for anyone involved - other than Mary. What does she do while your mother sleeps? Whatever it is, it isn't as important as keeping your mother in law stimulated.

The Alzheimer's unit my mother in law was in in Stage 6 actually banned TV watching during the day for just the same reason - because residents would zone out in front of the TV, not moving, getting very little stimulation or activity, and drowse half the day - and then (like your MIL) be up half the night.  

Good luck with this. Mary may be a nice lady, but she either has to follow instructions or be replaced - whether with another carer, or daycare.

Mary G.