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Alzheimer`s Disease/sleeplessness/Sundowner's syndrome


My mother was diagnosed with Alzheimer's over 10 years ago. She is still at home but recently became more than my father and I could handle. She is awake almost every night and my father has been unable to sleep. Sometimes she stays awake for days on end, with only little 1-2 hour naps. About a month ago she wandered off and the police had to be called to find and bring her home (doors now have locks). Also around that time she started becoming physically threatening to my dad (who is partially paralyzed and defenseless). She often doesn't know him at night, and her thinking was becoming more and more delusional. So we hired a visiting caregiver service to come in every night from 9 pm to 9 am. I go over and help during the day. Also, along with her doctor, we made the decision to start pulling meds, in hopes that she would become less energetic and more docile. (She is 88 and still physically fit.) We have now stopped namenda, zocor, celexa, and numerous supplements that had kept her going well for many years. The affect was pretty immediate and dramatic. She now often babbles in incoherent, incomplete sentences...but nothing has helped the sleeplessness.
After having them for less than 2 weeks, the professional caregivers are already wearing out. They want to send two girls in instead of one each night, and the expense for that would be the same as a nursing home... which may soon be our only option. Tranquilizers and sleeping pills make Mom more delusional and hallucinatory, but don't make her sleep. She still has lucid times though, with good communication, and I'm convinced she's not having pain that keeps her awake. The doctor is now trying Haldol but after 4 nights she's still been up all night. She gets no caffeine and we are now locking her OUT of her bedroom during the day, at the caregivers' advice. In your experience, is there ANYTHING that helps with a dementia sufferer who won't/can't sleep at night?

Hello Kathy:  I'm so sorry to hear of your mother's very troublesome sleeplessness.  I know it is having a huge negative impact on your entire family.  I'm glad to hear her doctor is trying different medications--as well as removing meds. This is more than just a symptom of the AD--my guess is that the area in her brain that controls her sleep is being disrupted and that is why nothing appears to work at this time.  In the end, it's always just a guessing game with these medications and elders with dementia.  What works well now may not work at all a few months down the road and vice versa.  That's all because of the progressive damage in the brain.  The only suggestions I have are as follows:
- You may have already tried this, but I know that exercise does help relax the body for sleep, so getting her heart rate up for about 15 minutes at least 2 hours before bedtime may help;
- Be sure there are no white lights on--including night lights.  Switch them out for red lights that won't wake up the brain like white lights do;
- Ask to try Melatonin at 3 mg. EVERY night;
- Have the night time care giver come in at 10 or 11 p.m. to help save a bit of money;
- Check out other in-home care providers so you won't have to double up--a company should be able to provide a worker who knows they likely won't be sleeping at all and who is experienced with elders with dementia; the company should also have enough staff so they can switch them out to prevent burnout; This is like any other night shift job and workers should not be expecting to sleep during their shift.  
- Be sure to have quiet activities ready for the nighttime caregiver to do with her when she can't sleep;  relaxing music (her favorites), photo albums and reminiscing -- all using the red lights if light is needed; Don't keep pressuring her to go back to bed once she's up--just gently do some calm activities and be prepared for her to maybe become sleepy again on the sofa or in the recliner rather than going back to bed;
- As her brain damage progresses, this behavior will likely go away, but keep experimenting with different medications;  If her doctor says he has nothing more to try, I would suggest round the clock Tylenol.
Those are my suggestions Kathy--I wish I had more.  I hope something works for you and your family SOON! Cindy  

Alzheimer`s Disease

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Cindy Keith, RN, BS, Certified Dementia Practitioner


As a nurse and dementia consultant, I can answer most questions on all types of dementia. If I cannot answer your question, I will attempt to find someone who can. My passion is to help caregivers of people with dementia, which in turn helps all those wonderful elders with dementia live better lives. When caregivers are better educated, they are able to better care for themselves and their loved ones, so education is key to decreased stress levels and healthier, happier families.


I have worked as a nurse in various disciplines of nursing for over 20 years, most of which was with the elderly. I was a health care coordinator in a dementia dedicated assisted living facility for 4 years before I started my own business (M.I.N.D. in Memory Care) as a dementia consultant six years ago. As a dementia consultant, I help families nationwide through phone conference calls as they struggle to care for their loved ones with dementia.

Alzheimer's Foundation of America Geriatric Interest Network Sigma Theta Tau International

Published "Love, Laughter, & Mayhem - Caregiver Survival Manual For Living With A Person With Dementia" which is a collection of stories about people with dementia I have known, loved and worked with. Every story has a lesson to teach and this book gently teaches family caregivers lessons about how to better care for their loved one, as well as themselves during their caregiving journey. Published "Love, Laughter, & Mayhem In Eldercare Facilities: The Master Key For Dementia Training" Created "Bringing Nurturing To Memory Care" staff dementia training video Created Ebook: "Hair Stylist's Helpful Tips For Working With People With Alzheimer's & Other Dementias"

Registered Nurse with Bachelor's degree in Nursing; Certified Dementia Practitioner; Author of 2 books and an ebook

Awards and Honors
Sigma Theta Tau National Honor Society of Nursing

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