Expert: Michalene Peticca - 7/23/2008

Question
I read a lot of the answers in your forum and I have a better understanding as to why things are happening to my 87 year old mother with Stage 7 Dementia, and I thank you for providing this type of information for those of us (caregivers) that are out here desperate in seeking answers or at least understand what's going on and why.  My mother raised 9 children and was very active through out her entire life prior to a heart attack and several strokes in her early 80s.  The problem that I'm having with her is that she is very agitated all of the time, it doesn't matter what kind of medicine she is or being on (Ativan, Aricept, Respidal).  During the day she's ok because I have PCA(personal aides) that stay with her while I'm at work-I went from Adult Day Care to Nursing Homes to no avail.  The BIG problem is at night, 2:00 a.m. comes around and she's up and ready to go. It doesn't matter what we've done, keeping her up late, feeding her a little later than normal but before 8:00 p.m. Desyrel given to her at 8:30 p.m. My family and I takes turn sleeping on the floor next to her bed but because we are so exhausted there are times that we don't hear her get up and eventually she falls.  She manages to get out of her hospital bed (rails up) and literally walk over the person that's sleeping on the floor, gets to the dining room where eventually she falls.  She have had uncounted falls.  The doctor says that sleeping meds is not really an option because with dementia patients they rarely work.  I've tried natural teas, soaps, lotions(chamomile, lavender) and they may work for about 5 mnts and that's it. She has no interest on watching TV, and any other activity that I've come up with only keeps her occupy for no more than 5 mnts(Coloring, reading to her, puzzles, dressing dolls, folding towels, etc). Any suggestions are welcome.  I truly hope you can relief some of this stress.

Answer
Jan,

Thanks for your nice comments and thank you for writing me.  I hear the BIG task you and your family are having caring for your mother. And i also see that you all are very committed to having your family take care of her instead of being in a nursing home.  I applaud you for that...that is a very difficult road to go; although i do know many, many good nursing facilities that have given families peace of mind for their loved ones' safety and they've enjoyed wonderful visits with them.

Nonetheless, i agree with your doctor when he/she states that sleeping pills are not good for a dementia individual.  They actually make the dementia "worse" by altering their present "reality".  

The best sleep aide that most folks have found is pure, intense exercise.  Walk until she cannot walk anymore...dance, clap, chair exercise.   This is best started around 7:00pm. until 8:30pm.  and then nightime bathes or massages (foot & hand massages are great).

Don't forget...Dementia is an "unraveling" of those things learned.  So, in the later stages that your mom is in...she is much like a newborn child in terms of sleep.  How many newborns sleep 8 hrs?  Not many....my daughter slept MAYBE 4 hrs. at one time and then i'd have to walk around with her...feed her, etc.   

This "stage" will eventually pass and your mother will sleep more and more.  

I know it is real difficult now...but, knowing what the future will probably be like for her....i'd take those opportunties to "sneak" outside at 2:00 am., on a full moon night and look at stars or the moon while she still can.

Hope this helps.
Best Regards,

Michalene Peticca, MA