I'm so tired that I get upset with her. We've ruled out anything medical and tried so many things......from white noise, not drinking anything starting in the early afternoon, staying up later, going to bed earlier, eating less, eating more, melatonin/natural sleep aid, different types of bedding (everything cotton), excerising each time we get up, not talking at all, just going to the bathroom and getting back in bed, I'm out of ideas and I'm exhausted all of the time. She broke her hip about 3 months ago and has recovered so well, but this night time thing is awful for her, and for me. I hate to admit it but the lack of sleep is making me impatient with my Mom, whom I love so very much. She lives with me and is a wonderful lady...such a great attitude and so postiive 99 percent of the time. I feel like such a rotten daughter for not just dealing with this 'one' thing, when everything else is so good. I want to stop being impatient at night when we have to get up, so I go into another room and cry and then come back and lay down to try to get some sleep. Tonight I'm writing this note to see if anyone has any other ideas or things that you've tried that may work for us. Oh, and Mom is 94 and has short term memory dementia. Prior to her fall and broken hip, she stayed in her own room so I have no idea if she was getting up so many times during the night before. I guess I feel even worse because there are so many other people out there with such worse situations than me, that I should be happy that we have it so good.
The reactions to drugs of older people is different than that of a younger person. Our geriatrician is very aware of that, and she also is very careful about drug interactions. A pediatrician has to know how children's bodies are different than adults. A geriatrician is very aware of how our bodies change as we age.
I'm sure not all geriatricians are created equal, just as there are average and exceptional internists. But, yes, I highly recommend that elders have a geriatrician as their primary doctor. As primary care provider, her or she may also refer to other specialists. For example, if the hallucinations might be the beginning of dementia you might be referred to a geriatric psychiatrist or a behavior neurologist who specializes in dementia treatment.
About the hallucinations. One common cause is a uti. Did the doctor check for that?
I don't mean to scare you, but hallucinations are often one of the earliest symptoms of the disease my husband has -- lewy body dementia. I just mention this because I think that sending a patient home with a sedative may be a useful first step, the help the patient at least get some sleep. But I don't think that should necessarily be the end of the matter. Realize that I have NO medical credentials. But if your gut tells you that you want a second opinion, go for it!
I would definitely encourage you to see a Geriatic specialist. The Geriatic doctor is better educated regarding aging and all of its ramifications. A few days after I became my mother's POA I changed my mother's primary physician to a Geriatic doctor. Unfortunately, the doctor's PA prescribed a higher dosage of her medication without consulting me while my mother was at her AL which might've caused her to be dizzy because she fell three times in two weeks, the last fall resulting in a broken back. So be careful that you ask questions of the Geriatic doctor before you change, and put it in writing that if they want to increase a dosage of your mother's medication to consult with YOU first, especially if you are responsible for her healthcare. Now we have a new doctor and my mother is in a SN. He only works at Conv./Rehabs. He took my mother completely off of two medications and decreased the dosage of another. She is more alert and more content now that she is at the NH, as the staff encourages mom to she eat regular meals, and drink more fluids. The NH has taken her completely off of caffeine and they monitor her sweets. They took her foot rests off of her wheelchair so she needs to use her feet and hands/arms when she moves about in the NH. We could not be happier. I'm so sorry your mother has been enduring hallucinations and hope you can get that resolved soon. Our Geriatic Doctor came highly recommended from someone in our church--hopefully you can find the same SOONER than later. Please keep us updated.
Please keep us updated!
Pls. review the need for the "water pill"...I assume it's Lasix. Generic: Ferosemide. Perhaps the dosage can be reduced or eliminated altogether.....new studies on this just recenty in JAMA and The Mayo Clinic Newsletter....If he takes Norvasc or some other BP pill, it may cause water retention in the lower legs....no cause for alarm if this is the case.
No Foley Catheter....it's only for the convenience of the caregiver....glad that he pulled it out. Ouch.
When I've had a catheter in the hospital I had no problems with it. (Of course, I understood what it is for, not something all dementia patients could do.)
The first time I was pregnant my neighbor, mother of 7, told me that after each birth the nurses wanted her to get up and walk, "or else we'll have to use a catheter." Well, she told me, after the seventh birth she was a little weak and instead of urging her to walk, they put in a catheter. She said, "If I'd have known that that is all there was to it, I would have stayed in bed an extra day all 7 times!"
Obviously it is not a solution for all situations, but I wouldn't dismiss it out of hand just because it is a convenience for the caregiver. Depends are a convenience to the caregiver. So what?
It's a known fact that the catheter can cause a UTI, but more importantly, it enables the pt to rely on it without controlling his/her muscles, or awareness.
In the case of a 94 year old, however, I would guess that any help would be a good thing. I am still in favor of the Overnight Diapers....their absorbancy rate is 99%. No need to get up during the night with them on .
it is not like a straight jacket:). hugs to you
I can relate much to your desire for a good night's sleep, and appreciate your sincere efforts to be of assistance to your mother. My husband needs lot of assistance,as he has progressive supranuclear palsy, lot similar to Parkinsons, but rarer, poor balance, stiffness, affects with speech and throat/eating, and needs assist up from chair or bed, and has urinary frequency/bladder problem that keeps him up several times each night, so I am up with him most of those times to ensure his balance is ok, and assist. Lack of sleep is very detrimental to anyones health. As I know the road ahead is a long one, I have decided to just find ways during the day to get more rest, and I could tell in recent months that my own health was suffering, so I have made it a priority to find ways to get exercise and rest during the day. And when bedtime comes I try to relax as much as possible and make it easier for myself to go to sleep. I read that we do not necessarily need to get a full 8-9 hrs sleep in a row, all at one time, as it stated that if we at least get 1 1/2 hrs (90 min) at a time, that is good, gives us time to get in most of the cycles involved with good sleep. So I try not worry so much about it. Also, I make it a point to be honest with my husband and let him know when I really need some rest or space, (uninterrupted time and space). We all have to remember that when being a caregiver, we need to ensure time for patient, and time for the caregiver....Seems to me you have all the expected and natural feelings and concerns that come with caregiving. Sounds pretty normal to me. What we have to remember is to do things and find solutions which will help us also. I had even considered hiring a private duty person to just sit with my husband thru the night so i could get some sleep, but getting a bit of rest during the day, having decent/cofortable place to sleep (I have twin bed beside hubby's hospital bed), and making the awkenings for bathroom for the hubby as short a time as possible, so we both get right back to bed, seems to be working ok for me. Will your mother use a portable potty beside bed, which could shorten length of time for getting up at night?
We utillize a urinal bottle beside the bed , and hubby stands beside bed when has to. Because his focus, and balance not always good, i assist him with that, but try to make the time we are up as brief as possible. God bless you, and above all, take time for yourself.......You are not alone, and we others do understand,and hope that you can find some simple things to make it easier for you and your mom.
The general's wife (general is nickname for my hubby)
Thanks so much for sharing. The two things that seemed to have worked for us so far is wearing 'nighttime undies' (depends) and leaving the TV on for background noise. I explain each night to Mom that wearing the nightime undies with a pad build right in, are just in case we can't get up fast enough. She seems fine with that and has never had an 'accident. She is sleeping up to 4 and 5 hours now at a time. Yeah! The bathroom is right outside our room (I too have a twin bed in the same room as my Mom's hosptial bed) so getting up and back to bed takes only about 3 minutes. Both of us are getting pretty good at going back to sleep quickly too. As long as the TV is on, there are less questions/discussions about the 'ice dropping into the freezer container', the air conditioner/furnance coming on and off, etc. I also have a wonderful brother that is coming over at least 2 nights a week to spend with Mom so I can sleep in my own bed. (he's the best!!) The kidney specialist that we were referred to said that she doesn't think Mom's kidneys are causing the issues, and, I'm still in the process of looking for a geriatric specialist to help us. Thanks again for the message and best wished and HUGS to both you and the General. KJ
Here is what I did and after about 4 weeks I think I have finally got a starting point this week.
My wife did not have the problem as bad as you but there were many times I would have to get up in the middle of the night to change the sheets because she had soaked through her Depends. I took her to a urologist and he prescribed some medicine that did not work.
Somebody told me when the drank milk, the milk would go right through them. So I eliminated milk from her diet and there was a tremendous improvement but I still was having nights and even days when she would be soaked through in a matter of hours so I asked our GP about it. She sent me to an allergist because I believed at the time it was the food that was causing the problem.
The allergist helped me set up a list of what was being eaten every day and we used a scale from 0 to 5 as to how the incontinence was during the period. The problem was that the food might take 12 or more hours to react.
As I eliminated different foods she got better but I never completely got it where she was dry for any length of time. I figured if I just had one garbage sack full of wet depends for the week, that was good.
I have been giving her oatmeal/quinoa for breakfast for quite a few months now. I added soy butter and about a teaspoonful of honey each morning because I am trying to get her as many calories as possible. A couple weeks ago I added the soy butter and honey to a sweet potato I had fixed her for supper. Lo and behold, she had an unusually bad night so I had the brilliant thought that maybe it was the honey. I switched to putting coconut milk on her cereal in the morning and for the first time in years she was dry for about 3 days straight, then she had about 3 days she was soaked. Monday of this week, it dawned on me that I was still using the soy butter so I eliminated that and for most of this week she has been relatively dry, maybe using at the most 2 depends a day. This morning I incorporated a spoon of honey into her cereal and had to change her 3 times in 2 hours. That was about 7 hours ago and she has been good since then.
Just figuring out this one little thing makes me feel like a genius. I have had people tell me that maybe I had taken her as far as I could but I believed it was the food doing it.
I mentioned earlier the milk was the first thing I eliminated. Then I started eliminating processed foods, like bleached flour, artificial coloring in food, etc. Some times I would eliminate things and try them later to see if they still worked.
It would have been nice to have somebody like a dietician to help me out but I have no idea how to go about getting one. I probably could have gotten there much quicker with a little guidance, just did not know what I was looking for, just a feeling it was the food doing it.
One thing I did find was things like cranberries, thyme, etc that are supposed to be good for the kidneys, exacerbated the problem instead of helping it. I do not know if it might work for you, but I would discuss it with your doctor and see what direction she/he can lead you in. Fortunately, my wife's doctor is very into nutrition so was able to help us quite a bit.
I so appreciate your message. It's been so nice to hear what others are trying and what's working and what isn't. I have thought about diet and how it may be impacting Mom. I haven't done nearly the extensive exploration that it sounds like you've been doing, but I have started her eating 'activia' yogurts to keep her more regular and that seems to be helping some. I have a question, probably a dumb one, but do you use the 'maximum' strength depends? The reason I'm asking is because I really hadn't paid attention, and didn't realize that they came in different levels of absorbency? Just a thought. I think it's great what you are doing for your wife. Unless someone has been in this type of situation, they don't understand that you'll be looking for new and better things to help all the time because we just 'know' that it can be better for them. I know what you mean about feeling like a 'genius'. I'm sure not one, but I've learned alot through this process with my Mom and will not just accept that 'this is the way it will be'. There are different things that will work for different people and this website and all of the supportive messages that I've received from my one simple question are proof of that. Hugs to you and your wife!! Hope you have a dry as can be night. KJ
hugs.
karen
Ok so what do you eat???? I'm thinking I have to have my 200 calorie Digorno Pizza and WWatchers mac & cheese. :) Seriously, what do you eat? I'm game for trying to eat healthier, but I don't really cook and it has to be easy....really easy. I"m glad you are having a better end to your week and hope it takes you into the next. You said it much better than me; I say getting old sucks, espeically for them. Hugs to you. KJ