AboutMary Gordon Expertise Several years direct experience as caregiver for family member who died of end stage AD. Did lots of research and dealt with a lot of health care professionals and caregivers over the 7 years from diagnosis to the end. Used various care options from community based resources to increasing levels of institutional. Mother of three, two born during our loved one's decline, so I know what it is to be the ham in the sandwich, taking care of the older generation and the younger at the same time and trying to balance everyone`s needs. Ask me, I`ve probably been there, done that. We made lost of mistakes and learned everything the hard way - but you don`t have to! If I can`t answer your question, I`ll steer you to a place or person who can.
Experience Currently a program manager for a large utility company. My Alzheimers experience comes from having the illness in our family. Out of necessity, we did a lot of research in order to understand the disease, plan for what might come next, and make the right decisions to help and support our loved one. Please note, I am a Canadian living in Toronto, and therefore am not the best person to ask about US regulations and insurance rules!
Question My dad is 85, has moderate Alzheimer's and dementia. At home he would sleep 20-22 hours each day. Can that be due to not getting enough deep sleep? At the nursing home, they put him in a large chair without head rest, where he's slumped over sleeping. Is there a need to have patients sitting up for long hours during the day? Can't they allow him to lie down most of the day? He gets daily physical therapy.
Answer Hi Carl,
Many people with progressive neurological damage will experience excessive sleepiness and lethargy - and as Alzheimer's progresses, most people will sleep more and more, and be less and less alert and active. It's a function of the brain injury. A lot of people with Alzheimer's will also have disturbed sleep patterns - their circadian rhythms are disturbed so they are often not sleeping well at night, but can be very drowsy during the day. A significant portion have breathing problems - the estimate is 30-70% having some sort of sleep disordered breathing patterns such as sleep apnea. This can mean the person doesn't get good quality of sleep at any time, leading them to sleep more and more.
There is no specific reason to have him sleep in a chair vs. a bed. The big concern is that he be repositioned frequently so he doesn't develop pressure sores from not moving around enough. It's also important that if they do have him in a chair, it be one that he is not going to fall out of. They might want to consider some sort of gerichair, or other chair with a headrest including side panels.
They may have him upright in a chair for periods following meals to prevent him from choking - sometimes a person will develop swallowing problems and can chipmunk food in their mouths, so it's often a good idea not to let them lie flat right away.
You might want to ask staff how he is doing during the night. If he is awake a lot and sleeping poorly at night, the facility might want to work on helping him improve his sleep patterns - by that I mean, trying to get him into a regular routine that supports sleeping well at night and being up more during the day.
Call a care conference with the staff and discuss your concerns with them. At the same talk, you might want to ask to review all his medications to make sure they are all still necessary and appropriate, and none of them might be contributing to this sleepiness. They should be willing to answer your questions and discuss anything they have been observing or are aware of that you may not have seen yourself. It's always worth checking in with them every few months in a semi-formal way. It is also a great time to discuss what might happen next as his illness progresses, so you can be prepared and have done some thinking about how you want things managed.
