By Micha Shalev
Persons with Alzheimer’s disease often appear to sleep less or sometimes, more. Sleep problems may be caused by pain, medication, lack of exercise, a particular environment or too much daytime napping.
Sleep problems frequently observed include:
- Individual is afraid to sleep alone.
- Individual becomes confused and frightened by dreams.
- Individual’s sleep is disturbed by adverse reactions to medication or the need to go to the bathroom.
- Individual night-day sleep pattern is reversed.
- Individual refuses to get ready for bed early or late.
Goal:
Create conditions to help each Individual get the sleep he requires.
Suggested approaches:
Assess individual for physical problems which may cause pain or discomfort.
Evaluate continence pattern. Is the individual getting up at night to go to the bathroom, resulting in confusion, agitation and loss of sleep?
If so, provide a night light for the person who is afraid of the dark. Fear, hallucinations and confusion may be worse with darkness. Allowing the individual to sit for a while near the nurses’ station may calm him.
Also, consider providing a light for the person who has difficulty finding his way to the bathroom or provide a bedside commode.
Check with family. How much sleep did the person require before becoming ill? Is this a major change?
Evaluate the environment: Are bed sheets free of wrinkles? Are bed clothes comfortable? Is the room temperature conducive to sleep? Remember, what is comfortable for you may not be comfortable for an individual with Alzheimer’s.
Use touch and a gentle tone of voice. Move slowly. Do not approach from behind or in a manner which may appear threatening.
If an individual becomes angry or upset frequently, watch for triggering incidents. Are there certain activities, certain persons, or a particular time of day that seems to make him restless or upset? Does the person become agitated only at night when it’s time to go to bed? Be very specific in trying to determine what the problem is.
If the individual consistently becomes angry or combative during personal care tasks, seek help with these tasks, Also, try a different caregiver. A male, for example, may be more amenable to a male attendant helping him with personal care.
If the individual grabs your hair or arm, try to relax and talk soothingly to calm and reassure him. Ask him to hold something for you. He may have to let go of you to take it.
Try to determine the cause of the behavior. The person may be responding to an internal trigger such as pain, fatigue, or fear. He may be unable to express the cause of his discomfort. Noise, crowds, and clutter, too much activity are all possible triggers which are easy to correct.
Limit demands. Often the agitated individual is responding to directions that are not clear or too many or too complicated requests. He may simply need more time to respond. Don’t rush or present a new request before he has had time to respond to previous instruction.
Limit choices. Too many choices can overwhelm the individual and lead to catastrophic reactions.
Offer tasks and activities at which the person can succeed. He is less likely to become angry and frustrated when he feels good about himself.
Try to keep the environment as routine and as predictable as possible. Consistent staff and activities provide security for the memory-impaired person.
Micha Shalev, MHA CDP CDCM CADDCT, is the owner of Dodge Park Rest Home and The Adult Day Club at Dodge Park located at 101 Randolph Road in Worcester as well as the new state of the art Oasis At Dodge Park which is scheduled to open fall 2015. He is a graduate of the National Council of Certified Dementia Practitioners program, and well known speaker covering Alzheimer’s and dementia training topics. The programs at Dodge Park Rest Home specialized in providing care for individuals with dementia and Alzheimer’s disease. The facility is holding a FREE monthly support group meeting on the 2nd Tuesday of each month for spouses and children of individuals with dementia and/or Alzheimer’s disease. He can be reached at 508-853-8180 or by e-mail at m.shalev@dodgepark.com or view more information online at www.dodgepark.com.
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