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Carenotes

Welcome to CareNotes. In this special section we will feature a reader's letter and provide an opportunity for an interactive exchange that will help find some answers and possible solutions to concerns. If you wish to respond to this letter, simple follow the link provided at the end of the letter and add your comments and thoughts to our CareNotes Board.

This Week's Carenote - 011708

I am the opposite of last week's carenote.  I can sleep at nights, if only my 90 year old mother would allow me to.  She just cannot seem to go to bed until the wee  hours of the morning.  I spoke to her doctor who has prescribed/suggested varying meds/methods of getting her to sleep.  Some have worked for a while and then she is right back to square one.

Perhaps as caregivers, you might have some practical suggestions for me that have worked.  How do I get her to go to sleep at a decent hour??? i.e. before  3 a.m.

 
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name: Anita
location: Charlottesville, Virginia
Email: ajbell@embarqmail.com
Date: 17 Jan 2008

Comments

I am caregiver for my 92-yr old uncle. He has sleeping difficulty as well and is on many meds for that. 2 things that I've found work for him are if he doesn't eat late and if he doesn't sleep during the day. It's difficult because they are generally bored or watching TV, but we have much better sleeping success when he doesn't sleep during the day.


name: A. Jane Mades
location:
Email: Gibbyfla511@comcast.net
Date: 17 Jan 2008

Comments

Dear Sleepless; Everything I have to say may well have been suggested before but here goes. Make sure nothing stimulating can happen or does happen after 10:00 p.m. i.e. no TV, bathing or showering, reading, etc. Make absolutely sure that your Mom's place of rest is well ventilated, above all comfortable and listen hard to any complaints with respect to comfort -complaints such as enough blankets, or not; enough or too little light; invest in a white noise machine, a tape player with soothing , made for relaxing music if she can hear well enough, be sure that there are plenty of jars of lavender around the room or a lavender flameless candle, lavender being a natural sleep inducer, sheets sprinkled with a lavender based cologne for example may help, try introducing warmed, (not hot) milk with sweetener at about 10 in the evening, take care that her evening meal is the lighter one in the day and doesn't contain anything at all to upset her digestive system,, make the main meal at lunch for her if you can, add a water feature if her hearing is sufficient to allow that soothing effect, you can find those in almost any drugstore these days. Then carefully check to see if she has any unknown to you fears or anxieties, talk them through with her and reassure her where you are able to, avoid any unusual occurences, (visitors phone calls etc.) after dinner, and keep carful track of the number of naps she takes during the daytime, try to plan something,( once you understand what those times are), that will distract her from napping after, lets say, two in the afternoon, a drive, walk if she is able, a trip to the library anything to interfere with the tendency to doze, if she is ambulatory, make sure the only time she spends in her bedroom is time devoted to sleeping. nothing else. With respect to drugs, I can well understand your frustration, my observations have led me to conclude that yes, a new one may well work for a time, we seem to be able to develop an immunity to them after a while. If her cognitive skills are O.K. explain this new game plan calmly to her before implementing it so she too might consider cooperating with your efforts, if not go slowly. On the other end of the day make sure like it or not, that both of you rise at the same time daily, even if it nearly kills you at first. No staying in bed for example after 8:30. Good luck, let me know in your spare time( ho ho) if any of these things work.


name: David Gillaspie
location: Oregon
Email: deg86@comcast.net
Date: 17 Jan 2008

Comments

Great question. On the light side, your 90 year old mother seems to keep the same hours as a twenty year old college student on break. On a more practical note, keep a log on morning wake up times. Does she stay up late and get up late? Or does she stay up late and get up early? Since you've talked to her doctor about meds for sleep, did the doctor review her med schedule for possible conflicts that might be keeping your mom awake? Did the doctor check for possible issues between the sleep meds prescribed and her regular meds? A doctor may explain how your mother's sleep habits are normal for this time in her life, that it's up to you to adapt. By quizzing him about the meds you are helping him do a better job, as well as letting him know you are looking for better results. At home you need to remember the first entry in The Caregivers Bill of Rights: take care of yourself. Is your mom alert? Can you explain things to her in a way she understands? Remind her of how many ways she cooperates with your caregiving efforts. Then explain the late night problem. Finish by telling her how important she is to you every day you spend together. This is called a reinforcement sandwich in some circles. I learned it from a John Wooden inspired coaching clinic, positive / negative / positive. (John Wooden is the famous college basketball coach who's teachings reach far beyond the hardwood court.) In a real sense you will coach your mom toward victory over your sleep loss. Remind her how well she's doing every day. Start by trying to reset your mom's biological clock. Circadian Rhythm Disorders can be adjusted by behavior modification, Chronotherapy, that adjusts the bedtime to manage sleep. You've done that, and it's a temporary fix? Have you tried Bright Light Therapy? I bought a Happy Light and used it to some effect. Finally I used physical activity during the day to change my care recipient's sleep schedule. If your mom can move her arms, put your hands in front of her and have her touch them. When she is sitting, put your hands above her feet and have her kick up to them. If she can't move on her own, lift her limbs for her. Play some quick tempo music while you give the workout. Count the repetitions and cheer her on. If she tires, step back so she can see you and move your arms and legs energetically while complaining how hard it is to do it alone. Then do more repetitions with your mom, thanking her for keeping you motivated to do more. Make her feel like she is your trainer. At night play soothing music while talking about how hard you worked out together, how important it is to get enough rest because you need her help for your next workout tomorrow. If she doesn't go to sleep before 3 a.m. take it as a sign that she wants another workout and lift one arm ten times, move to her leg, then the other, finishing with her other arm. Eventually she will tire enough to sleep. The earlier you get her to bed and give her the bed workout, the sooner you and your mom will get a good night's sleep. The side benefits of the activities are you feeling more engaged and empowered with the solution to the sleep time issue, making a new connection with your mom as your trainer, and getting in better shape.


name: Erin
location: Sturgeon Bay, WI
Email: eszakala@co.door.wi.us
Date: 17 Jan 2008

Comments

I facilitate a caregiver support group and this issue has come up a number of times. My co-facilitator, a nurse, suggested Melatonin as an option. It is an over the counter supplement and is a synthetic version of a chemical produced naturally by our bodies to help us sleep. Natural melatonin decreases as we age - hence, one reason your mother may not be able to go to sleep. Once you've gotten the green light from your mother's physician (to ensure that it will not conflict with any of her medications, etc.), this can be given 1/2 hour before a desired bedtime. It has worked for several of our caregivers' loved ones and also works for my husband who works until 10:00 p.m. and was having trouble going to sleep before 2:00 a.m. Hope this helps. Erin


name: Priscilla Pittman
location: Arkansas
Email: priscilla.pittman@alzark.org
Date: 17 Jan 2008

Comments

Sleep:1 sometimes 15 minutes or so out of doors in the sunshine helps reset the body clock if the person has been inside most of the time. 2 often a warm bath or warm milk helps the person relax 3 raising the person's serotonin levels by providing a few saltine crackers may be helpful 4 aromatherapy (lavender) may help


name: Heather
location: Fresno, CA
Email: jandhbrackett@sbcglobal.net
Date: 17 Jan 2008

Comments

I agree with, Erin, that a melatonin supplement can be helpful. Our mom's sleep cycles were disturbed due to strokes, and melatonin has helped. It comes in liquid form, among other forms, so it can be easy to put a dropperful under the tongue. You can buy it at many drug stores, but I order products like Sleep Assure from vitacost.com. Another option is to get her up at a reasonable hour and use a full spectrum light box for like the first 1/2 hour to hour in the morning. This can help reset one's sleep cycles. Also, does your mom get out much during the day? If there is an adult day program in the area, that extra stimulation may help her to sleep better at night.


name: Chris
location: Perrysburg Ohio
Email: ccremean@atozhealth.org
Date: 18 Jan 2008

Comments

Many times everyone is so focused on the night time schedule that we forget the impact that daytime has on sleeping patterns. One suggestion is to increase the activity levels during the daytime so that the need for rest is increased at night. This doesn't have to be incense or lengthy, start with small increments and build it up. This will also help with other issues, medications, digestion, strengthening, etc.


name: dawn lorah
location: risingsun ohio
Email: dawnwalker1966@aol.com
Date: 09 Apr 2008

Comments

Well first I have a question -  does she sleep in a bed? In my years of experience I have found that they sleep very well in a reclining chair. It seems very uncomfortable to us but they seem to have difficulty in a bed. How about leaving the tv on ? So often they are just afraid to go to sleep thinking they will not wake up. Have you tried lying in the same room or staying in there with her? A lot of times they are just afraid to be alone. Hope this helps some.


 


 







 

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