Looking for advice from any of you who have had a similar problem. Dad, age 95, is getting very hard to wake up. We have tried Trazodone in two dosages and none at all. He is currently taking 50 mg of Trazodone to help him sleep through the night. (Without it he's wakeful for several hours in the middle of the night and rummages through things, some of which he breaks or puts away in new places.) He goes to bed around 9 pm but is hard to wake up before 1 pm the next day.
We started trying to get him up around 11 am, but he is grumpy and insists on staying in bed. He lives with Mom in an assisted living facility. She is up early, dressed, goes down for breakfast. When he finally does wake up, he is confused and wants to know where she is.
We'd like to have the nursing aides make a plan to wake him up for sure at 11am, make sure he gets dressed, and joins Mom for lunch. But he is very angry about being wakened by anyone. I (daughter) am usually able to cajole him, but it takes a good hour or more. Any advice from anyone who's had this issue would be appreciated!
* Give him a foot massage. He will wake up and may feel 'good' being touched / massaged.
You do what you can.
You expect him to be grumpy (disoriented)
Ask MD to re-consider other / amounts of medication.
I am not sure why this is a problem for you / family / staff.
No, I haven't had this experience personally although hopefully these suggestions may be helpful.
Gena / Touch Matters
If that doesn’t work then Dad in memory care section and Mom goes in to enjoy lunch or dinner with him and she enjoys activities in the facility. Unfortunately it’s pretty common that there conditions will not be equal and care needs to be given as their needs dictate.
Check for dehydration and monitor blood pressure. Proper hydration is critical. And not just water. Body also needs combination of water and natural liquids (real juices, no caffeine, no artificial sweeteners…).
my husband was sleeping into the noon hours also. I called PCP.
We went to Urgent Care on recommendation. Blood tests and urine test showed dehydration, and his BP was alarmingly low (82/54).
Water, Gatorade x3 in the urgent care and within a two hours his BP was back to normal. I would have needed to take him to hospital for a 0.9 saline IV drip if the natural hydration did not work,
I learned that a person is most dehydrated in the morning bc no fluids in all of those hours. Proper daytime hydration can carry through night until morning.
Now my husband sleeps “regular” hours and I’ve become better hydrated too!!! And we both drink a full glass of water before getting out of bed.
Also agree regarding check dosing and timing of Trazadone with your PCP or Neurologist.
i hope that this helps.
Sleeping a lot is very normal for patients with ALZ. It bothered me at first with my mother, but I finally realized that if she's asleep, she's not frightened, confused, agitated.
Look at it this way. If you don't give him Trazadone, he may be wakeful at night, but that's on the staff to deal with but he'll MAYBE be awake during the day. If you give him the meds to sleep, he's going to sleep well into the day OR he's going to be horribly grumpy to deal with.
None of us wants to just step aside and let the disease to progress, but be honest - there is no stopping it, only slowing it down (maybe). It makes the most sense to me for everyone's state of mind to work with the progression instead of against it, and simply understand that as time goes by, he WILL start sleeping a lot, until he eventually sleeps nearly all day..
Let the guy rummage a bit and sleep when he wants , if it works for him. If he’s calm and not in distress when he’s up at night , let him be . I worked where certain residents had nightly behaviors they did and then they went to sleep . One woman used to empty her drawers , refold it all and put it back .
My mother slept up to 20 hours daily in her final six months of life and passed away at age 95.
1. We use melatonin 10 mg. instead of trazadone. That works well for sleeping through the night. So you might want to try a variation on the meds.
2. Why insist he get up? Is this for him or for you? Why put rules on an elderly person like having to get up, get dressed, go to table? Leave him alone and give him the respect you want when you need to sleep in. Let him live out his life in peace.
Sometimes we have ideas how things should be. That is so wrong. Let things be as they are. Let a person be themselves. Stop pushing societal norms on anyone. There should be no expectations. Just love him and leave him alone.
You may want to search for a geriatric pharmacy consultant. Don't rely on the typical pharmacist because they are often giving textbook advice without taking into consideration the patient's age, other prescriptions and OTC meds and vitamins. I have found even some doctors are not aware of the full insight that may be needed. When we use the consultant, we are given a printed list of suggestions and he even called the provider directly on one occasion. On some occasions our consultant simply advised giving certain meds on a different time schedule so not to interfere with something else. Definitely don't rely on advice given by assisted living staff without asking his doctor first. Like someone else has said, they often suggest what is convenient for them and they definitely are not qualified to provide medication advice... suggestions yes, but never make a change on their advice.
Below are some websites where you can get more information. I did not use any of these to find our local consultant so I am not giving a recommendation for using them except for insight to help you find the best one locally for yourself. There may be one behind the counter where you shop, but verify their credentials before you totally trust their advice on solving medication issues for a senior. They may be able to refer you to someone who specializes.
https://bpsweb.org/geriatric-pharmacy/
https://www.geriatrx.org/home
https://explorehealthcareers.org/career/geriatrics/geriatric-pharmacist/
https://www.ascp.com/
https://www.americangeriatrics.org/geriatrics-profession/training-requirements/training-geriatric-pharmacists
If you want him awake in the day cut the Trazodone in half or discontinue.
We gave Mom 400 mg of magnesium glycinate at 8:00pm or 6:00 pm so she would sleep through the night and it stopped her getting up and going through things but she wasn't hung over in the morning.
Glad your mom is not waiting around on him to start her day.
It takes over an hour to get him up and ready for late afternoon doctor's appointments. Any appointments, outings, are always after 1pm. He simply does not function well if he has to be up before 9am.
It's easier to work with his schedule than to enforce what doesn't. There are so many other issues to deal with now, best to be flexible.
If he's sleeping through the night but also sleeping too long in the daytime, then talk to his doctor about either reducing the trazodone again or finding a different med (like melatonin or gabapentin).
If he ISN'T sleeping through the night, you still need to talk to his doctor about other options.
Sleeping longer is one of many signs that Hospice will use when a patient is recertified for Hospice.
With increased sleep he may miss meals so keep things like fruit, yogurt and other snacks in the apartment. Monitor for weight loss.
If you think he may qualify for Hospice I would have him evaluated. (Hospice is not just end of life my husband was on Hospice for almost 3 years)
At 95 and with Alzheimer's he deserves to sleep as long as he wants. He will eat if and when he wants.
You are making this harder than it needs to be.