MIL will get up in the middle of the night and will wander around the house. She has even come into our bedroom without knocking. I know that if I lock the door, she would pound on it until we open the door. She gets up dresses for the day and then usually lay down on the sofa in the living room. This means that when I get up to get my day started, I have to be as quiet as a mouse or the grunting will begin (and I mean grunting). We've bought an alzheimer's clock and told her to look at it to see the time, we've told her to go back to bed ("I am in bed!") and nothing. I know this is disease process but last night was the worst! Hub (oh, it's his mother) had to take 1/2 day as she woke us up 3 times. She was afraid he would oversleep for his job? I told her that I took care of him and that we had an alarm clock for that.
We are at our wit's ends. Any advice? Or is it back to when we had babies and have to deal with the lack of sleep? Thanks in advance.
It worked for awhile . . .
There is no reasoning with him, you take him back to his apartment, he either throws a fit or comes right back out.
Giving her sleeping pills will only increase the potential for her to fall. Many here suggested either a night caregiver of a facility which is better equipped to handle what comes next.
Best wishes
Tiring her during the day while she's still strong enough to do activities might help, as posters here have suggested. I'm not sure about the medications, you will have to discuss that with her doctor.
If you can have aides watch her at night so that you can get some rest, that would be a great help. Take any measures you can to get sleep and rest, or you will not be much help to her, and that doesn’t help the situation any. Dealing with sundowning is very hard for caregivers. Loving and healing energies to you.
IF she sleeps during the day she WILL wander at night. Short naps during the day are okay but don't let her sleep for any length of time. Keep her going! I also took her out during the daytime whether in the mall or just another stroll outside.
I gave mum coffee in the morning which helped get her going for her morning exercises and moved her bowels! In the afternoon she loved Mountain Dew sugar free (she was insulin dependent diabetic). That kept her up during the afternoon. Ironically it was caffeine that prevented sundowning. And exercise. My mom never had a single narcotic or psychotropic, and she lived to be 90 years even with insulin-dependent diabetes and had end-stage Alzheimer's. She was bedridden for 2-1/2 months. only because she could no longer focus how to stand or walk. Her daily walks improved the quality and quantity of her life. She loved her routines. And yes mom was on hospice for 2 years.
NO caffeine after 3 pm!
Keep them active
Many people who experience sundowning syndrome have trouble sleeping at night. In turn, fatigue is a common trigger of sundowning. This can create a vicious cycle.
Too much daytime dozing and inactivity can make it harder for your loved one to fall asleep at bedtime. To promote a good night’s sleep, help them stay active during the day. For example, go for a walk together or clear some space to dance. This might help improve their sleep quality and reduce their sundowning symptoms. It can also help them enjoy better physical health.
Late afternoon and early evening can be difficult for some people with Alzheimer’s disease. They may experience sundowning—restlessness, agitation, irritability, or confusion that can begin or worsen as daylight begins to fade—often just when tired caregivers need a break.
Sundowning can continue into the late night, making it hard for people with Alzheimer’s to fall asleep and stay in bed. As a result, they and their caregivers may have trouble getting enough sleep and functioning well during the day.
If you ever seen true sundowning, melatonin is not going to do anything. If her doctor said 50 mg is okay, I would be getting a new doctor.
Cochran reviews stated, "The five melatonin trials included 253 participants. We found no evidence that melatonin improved sleep in people with dementia due to Alzheimer's disease."
https://www.cochrane.org/CD009178/DEMENTIA_medicines-sleep-problems-dementia
EVIDENCE further stated regarding melatonin for the elderly, "Safety concerns, especially among elderly patients, are residual daytime drowsiness, tiredness upon rising, and increased sleep disruption" This is a 2018 study so it is current.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6699865/
My concern is FALLING and confusion...and headaches.
As Taarna and Liz have said, ask the doctor about sleeping tablets. They are usually addictive, but many nursing homes (and hospitals) dole them out as standard. Addiction for the elderly is not going to lead them into an abuse culture, it's not the worst thing in the world. For me, Garden Artist’s turkey would keep me awake with indigestion! The black mat might be worth a try, perhaps just outside her door. If the kitchen is dangerous, get a lock. A bolt or hook-and-eye catch at the top of the door out of sight might work, and would be easier to fit than a lock. Don’t let her watch it being fitted, keep it a secret.
Sympathy, and good luck..
I’m sorry you are having this problem,
Lock her bedroom door at night and ignore her pounding on it and hope she quiets down.
Give her sleeping medication at night that will keep her from getting up.
Placement in an AL, memory care, or nursing home.
1 - Talk to her doctor about a sleep medication since has problems staying asleep at night. Make sure she doesn't get more than 30 minute naps during the day. This one might work.
2 - Professional help. Hire a sitter to stay in your mother's room with her throughout the "sleep hours" and to redirect her to bed as often as needed. The only fool-proof version of "professional help" is admit that your MIL has reached the point where she needs 24/7 care in a memory care unit. Find her placement so the rest of the family can get a good night's sleep.
AD disease may be messing with her internal clock - especially since she dresses for the day. It will be like having an infant in the home. You should consider having an in-home aide during the night or look into MC for your mother. While it something you and hubby may not want to consider - MC is staffed 24/7/365 and are trained to handle nocturnal wanderings.
Good luck to all of you and be safe.
The other thing is that it doesn’t seem she’s going into a deep REM sleep. Like her internal clock is messed up. Perhaps speaking to her doctor about her taking a GRAVOL before bedtime. They’re very safe, as even pregnant women can take them. She more than likely just needs a bit of help going into a deep sleep.
So I, too, was not only frightened by my wife's wandering episodes, I finally decided that I couldn't safely care for her anymore and started looking for an MC facility.
Your MIL's wandering throughout the house is, in itself, a safety issue, especially when the family is asleep. Her next step could be leaving the house during the late hours. As Daughterof1930 has mentioned, and to which I can attest, those with dementia can be very resourceful, and securing both the doors and the windows can present a significant fire hazard. If needed, this should only be a temporary solution while you look for a care facility.
Wandering can occur for many reasons including just wanting to get out, or being confused where they are. It may occur as the result of a delusion that the person is experiencing. On one occasion, I found my wife a few blocks from home with a pad of paper and pencil. She was making sure all the kids were safely on the bus (she was a teacher).
So your MIL's change in behavior is significant and dangerous. Time to consider an MC facility.
Turkey contains tryptophan which can contribute to sleepiness (think of all the people who nap after a Thanksgiving dinner!). A bit of turkey at night might help allay the overnight activity.
Meds can maybe help with the anxiety that keeps her up, but there’s no way to truly stop it or talk her into staying in her room.