Edith woke with a start.
The children needed her. She had to get them dressed for school, and make sure Jeremy washed his face and brushed his teeth after breakfast. Alice didn’t usually need reminding, but Jeremy tried to sneak out without cleaning up. She needed to make their lunches, and after they left, she needed to attack the load of laundry. She swung her legs out of the bed.
Alice woke with a start.
How many times had this happened tonight? She couldn’t remember, but she knew exhaustion would make tomorrow especially hard. She wanted to scream at her mother to go back to sleep, but took a slow breath, let it out, and swung her legs out of the bed.
Sleep disturbances
One of the more distressing behaviours, sleep disturbances can wear you down as a caregiver faster than other difficulties, and it can seem endless and hopeless.
- Start by a trip to your doctor. Hopefully you have a geriatric specialist, or at least a GP familiar with the problems of the elderly. Stress that you are looking for causes as well as solutions, and don’t be talked into medication until much later in the process, if at all. (The exception to this is Melatonin, which is an over-the-counter, natural sleep aid. More about that later.) Some conditions which might affect sleep are: restless leg syndrome, periodic movement leg disorder (PMLD,) REM sleep behaviour disorder (RSBD), sleep apnea and depression. Elders with Lewy-body dementia or Parkinson’s dementia are more likely to experience sleep disorders. 1. If there is a treatable cause for your elder’s sleep disorder, this is the place to start.
Establish a daily routine which involves activities and exercise in the morning and afternoon, some outdoor time/sunlight each day (if possible), regular mealtimes and napping limited to no more than one hour after lunch.- Try to arrange social activity each day in the morning or early afternoon.
- Ask your doctor about effective pain treatment.
- Avoid caffeine in any form, and limit alcohol and smoking. These can all affect sleep.
- Look at your evening schedule. Limit TV to early evening, and use the rest of the evening to help your elder wind down. Quiet conversation, reminiscing, listening to quiet music can all get their body ready for sleep.
- Establish a nighttime routine. You might need to experiment with what helps the most. After regular hygiene, you might try a sponge bath, soft music or white noise like a fan, reading or an audiobook.
- Check the lighting. Complete darkness or shadowed light may cause confusion and stress. Consider a night light.
- Melatonin is a hormone secreted in the brain during sleep, and it plays a role in sleep-wake cycles. Many elders with sleep disturbances find Melatonin to be a natural, useful sleep aid. Although it can be purchased over-the-counter, you should consult your doctor as to dosage.
- For ongoing sleep disturbances, consider hiring a personal support worker one night a week (or more.) It might also be necessary to remove yourself completely to a friend’s or family’s house, or a hotel. This investment in yourself is well worth it.
Repetition
We’re talking about the more difficult behaviours this week. Having the same conversation over and over can try your patience, and turn you into a person you don’t want to be.
- Look for what’s behind the repetition. Is there an unmet need or an anxiety, which could be addressed?
- Try to get the person involved in an activity.
- Asking questions sometimes deflects the conversation.
- Find respite help for an hour or more (a friend or family member to visit, a group for them to attend.) Sometimes, repetition continues for months and years, and the only way to cope is to give yourself breaks.
Care partner, you are doing your best. Even on days when you feel you aren’t your best self, remember that this job is hard. Give yourself breaks, get support, and pat yourself on the back!
Have you tried something which wasn’t mentioned and which worked, even for a short time? Tell us in the comments.
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1. https://www.sleepfoundation.org/mental-health/dementia-and-sleep