Expert: Mary Gordon - 7/28/2010

Question
QUESTION: Mary my Mom is being feed 3 times a day by caregivers and they also make sure she drinks. Here is the question though reecently she will go into a very deep sleep and it is getting very tough to get her to wake up is this common?

Thank You
Jerry

ANSWER: Hi Jerry, you don't mention what stage she is in.

In the later stages, particularly Stage 7, sleeping a lot is normal.  They become less and less aware of their surroundings. They sleep more and more and become less and less responsive. Sadly, it is just a product of the brain damage.

Does she appear to sleep well at night? In the mid to later stages of Alzheimer’s, individuals spend about 40 percent of their time in bed at night awake and a significant part of their daytime sleeping. In extreme cases, people may have a complete reversal of the usual daytime wakefulness-nighttime sleep pattern.

You may want to talk to her doctor about this to see if there anything you can do. If the sleepiness is around the clock and due to very late stage changes, you may not be able to do anything. However, you should see if this might be due to medication side effects or timing, or other health issues, or perhaps from poor sleep at night.

If she is still able to move around, there are strategies to help her sleep better at night. This include regular meal times and sleep schedules, avoiding alcohol, caffeine, and nicotine use, and daily exercise (but no later than 4 hours before bedtime). It can help to give Alzheimer's drugs at bedtime if they cause drowsiness. I'd also discourage watching TV or staying in bed during wakeful periods, to reduce napping.

Hope this helps.

Mary G.  

---------- FOLLOW-UP ----------

QUESTION: You are right I did forget tell you the stage. The doctor said she is in the final phase of the diasese. She sleeps the entire night and the doctor went ahead and removed her from all meds. The caregivers do have her on a riid routine for feeding her. They started home hospice on her about 1 year ago.
Thanks again

Answer
Hi Jerry, thanks for clarifying. I know this is very difficult to watch this stage. My mother in law died from end stage Alzheimer's and I have walked a mile in your shoes. It is a long hard journey up a rocky, thorny slope, and just when you think it can't get worse, it does. All of us ask ourselves how long can this continue - both because this is not what our loved one would have wanted, and because it is so hard on everyone who loves the person.  

I think you did the right thing opting for palliative support via a hospice care team. Sounds like she is very well cared for, and they are doing everything possible to keep her weight up. Perhaps it is a mercy she is sleeping - at least you know she is comfortable and not troubled, or in pain.  

I'm thinking of you.

Mary