Mom is 86 with vascular dementia. She stays up all night talking with people who aren't there. She holds actual conversations with them, sometimes calling out to me to come and help. I have tried playing along by "running them out of her room" and negating what she thinks she sees as well. I don't really know what to next. She is already taking antipsychotics. I have tried light therapy, which seemed to work at first, but no longer. She is confused as to time/space, we moved in with her because we thought it would be easier for her than taking her to a different home. She continuously asks the same questions about deceased relatives. She is one of 17 children, only one other survivor, whom we do not hear from. It gets old, but I can handle it during the day. Any suggestions for helping her sleep better? Melatonin works occasionally, but not always.
Does she do anything physical during the day to burn energy? When my 99-yr old aunt with mod/adv dementia was having problems sleeping we started having her fold a large pile of kitchen towels at least 2x per day; she also did an electric pedal machine 2x a day for 15 minutes each arms then legs. Then we'd walk her out to the mailbox every day. The caregiver has her sorting things and playing card games (Auntie's rules). Once we started doing this she now sleeps through the night without any medication or even melatonin. If your mom's already getting some activity see if it can safely be increased. Things that occupy her mind also burns mental energy and it all works to make her tired.
I would stop the melatonin since it is not a literal sleep aid -- our bodies make it naturally and it's released when it's time to sleep. Taking it tells our minds it's "time to sleep". But if you're giving it to your mom when she isn't sleepy, you may be reinforcing the wrong pattern. It is only a food supplement so is safe to stop taking it, especially when it obviously isn't working. One less med to have to manage. Let us know if you figure out a solution for her! Blessings to you!
I have tried so many brands of melatonin. Some caused stomach upset and others did nothing. The only brand that is half-decent (at least so far but still at times hit or miss) is Spring Valley Adult Gummy Melatonin. I still have to try and get the timing right. Many other prescriptions caused insomnia so get the help of your doctor to see if your loved one can be taken off any med that you find from research that can cause insomnia and is not absolutely necessary,
Dad has gradually gone from 15 prescriptions to a sugar pill morning, half of a 300 mg Full Spectrum CBD Gummy noon, and escitalopram an hour or so before dinner. I'll also add during the night if I happen to wake up and see him tossing a 5 or 10mg melatonin gummy. But I’m still testing because it seems if given late it keeps him awake more than helping with sleep. But so far with this last regimen, one speaking of, (fingers still crossed) no more bad sundowning, agitation, or having those conversations and acting out when should be sleep. He sleeps just enough now that I don’t have to be overly concerned.
While she's up all night talking, I'm guessing that she's keeping you up all night too. This is not good for YOU. And you need to be your first priority. You need good sleep, every night. I would hire someone (with mom's money) to sit with her at least a few nights a week so you can be off duty and sleep. Put on a sound machine, let the helper help and sleep!
Does she have anxiety and panic? She could benefit greatly from a benzodiazepine like ativan (lorazepam) taken as needed. Melatonin might work well for her if used with an anti-anxiety drug.
I'm experiencing the same thing with my mother. She's on 4 prescribed meds, including a "sleeping pill". It's very rare that she sleeps through the night. She does full conversations with all / different voices, and often she yells and screams. (I call it "dinner theater" in my head.).
Fortunately, this doesn't happen every night, but it happens most nights. It's very disruptive, as you know. And it's the same thing - a combination of deceased relatives, invisible people that no one else has ever heard of, miscellaneous babbling. Actually, it was worse a few months ago, because she was cursing, too. At least that has stopped. I think that the improvement came when we made sure that she got ALL doses of her meds, even if that meant waking her up to take them. It's still nowhere close to perfect.
I wish I could tell you something helpful.
I just want you to know that you're not alone.
If she sleeps thru the day. You can't expect her to sleep thru the night.
Try having her stay up all day and she'll have a better chance of sleeping thru the night.
I would give my Dad a 3 mg Melatonin at night.
If she gets up to ge to the bathroom then don't have her drink anything after 6 or 7 PM.
If she deffiently can't or doesn't want to sleep at night then let her stay up.
Maybe watching TV will help her fall to sleep.
Try Music Therapy and let her listen to calming music all night.
Prayers
*I'm not a doc, just an observation about the potential risk. I've thought about trying the THC tincture at my local smoke shop to see if it helps my sleep issues.
If medication she is taking is not working, it should be changed. Rarely is a General Practioner going to have the specialized knowledge to help her.
BIL is on 30mgs of melatonin at night within about 2 hours of taking it he is down for the night. He sleeps now from 9 to 12 hours. His best time where he can function during the day is 10 hours of sleep. If he gets longer sleep he is confused during the day. The dosage is what the sisters at a nursing home would give their patients with dementia to sleep.
She could be sundowning that is what dementia people do they get active at dusk. BIL has done this too. At certain times of the night he gets his quarters out and counts them he maybe at this for 30 minutes or 2 hours.
The way is to take their mind off of the questioning change the subject we do this with him.
Prayers that you find something that works for you and her.
the delusional states you refer to are common side effects of the meds given to treat dementia
Have the case dr reduce her meds to an absolute minimum with a goal to stop then altogether.
Dr Christophers Relax Eze caps and Goats Colostrum have helped my grandfathers mental stability and got him sleeping so much better
catnip tea with honey
Epsom salts on a hot washcloth applied to neck shoulders & down the spine while bathing
give her only distilled water to drink & cook with. This will make a Big improvement
Sage & Rosemary tea are very beneficial for brain function & overall health
Nowadays she's confabulating wild stories about the Memory Care staff taking her out to different restaurants for dinner and then to a show afterward. Then they drive her home in a different car, and all sorts of other complicated scenarios that she feels are 'scams'. She's now 'losing little little baby teeth' at least once a week, so as you can see, the delusions and delirium is ramping up quite a bit all of a sudden.
No, she doesn't have a UTI either.
She's just been accepted in hospice so I'm curious to see what they'll give her, if anything, to calm her or help these delusions she's having. They're already taking her off of all supplements & vitamins which they feel is contributing to her chronic stomach issues and vomiting.
Her sleeplessness has been an ongoing issue for ages; Ambien was a very bad idea for her and caused her to sleepwalk and break her foot back in 2009. So yeah, sleep issues and dementia go together like peanut butter and jelly. I don't know that there ARE any iron-clad fixes for it either. Some elders get their circadian rhythms mixed up and wind up sleeping during the day & staying awake at night.
I particularly like bevthegreat's suggestion about 'letting her stay up all night' if she doesn't want to sleep. Uh, how about the rest of the household? Bet you'd all like to sleep so you can get up and FUNCTION the next day, huh? Just a hunch. Naturally you should speak to mom's MD about ideas for better sleep, but throwing more meds at VD can be a tricky thing, I know.
Wishing you the best of luck.
If possible, help her take a warm shower after the evening meal/snack as a wind-down. If this is too difficult, bring her warm wet towels, like “finger towels” for clean up and give her a quick hand or foot massage.
if tolerated well, use aromatherapy. Depending on her preference, use plug ins or scented lotions such as products from Bath and Body Works or Aveda. You can also use essential oils from a health food market (but mix-in/dilute with other products as they can be strong. A little goes a long way.
Introduce soft music or a pleasant (to her) television show, such as Lawrence Welk, as a bedtime “falling asleep” ritual. The end of Lawrence Welk had a “good night” song and dancing that my mom found very calming. Get complete series on DVDs or download from YouTube.
Relaxation videos or cooking shows may be helpful in calming her. Play “nature sounds,” “relaxation,” “meditation,” or “spa” background music using an Echo Dot or similar “Alexa”-type device.
Make sure her bedroom is warm and comfortable.
When all else fails, sit with her and listen to the conversations. Is she speaking to a deceased relative? Bring in a notebook and ask her questions during the conversations. Take notes. During my experience as a caretaker I did this and later learned that many of the tidbits from these conversations held truth. A relative was pregnant (even, it turned out— before she knew it herself). Another relative was hospitalized (no one in the family knew at that time). The conversations with deceased relatives actually were not ramblings after all, but a bit of a miracle to me, as a confirmation of my faith (that had been waning).