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We moved Mom to a nursing home a month ago. They are having a lot of trouble with her being awake all night and trying to get up every five minutes. Is this part of the sundown syndrome, or is it just because she is still adjusting? The tranquilizer the doctor prescribed obviously doesn't get her to sleep. They end up having to put her in a recliner in front of the nurses station all night. When sis got there this am, they had put her to bed, finally to sleep at 6am.
Since she was in IL and AL until then, we have no way of knowing if she was up all night for years because she had her own room or apartment.

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JoAnn: I can relate! You poor dear!
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I know Mom is up at times and she is safe gated in. 3 sets of steps in my house. If I don't get my sleep at night I cannot make it up during the day. Just as I get to sleep the phone rings or she calls for me. She has woke me from a dead sleep to ask where her clothes are or to tell me its time to get up. This is usually 4 or 5am.
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Hooray for those who allow elderly to stay up all night if they need to. I remember when I was young wishing I didn't have to sleep. I live with my 89 year old Mom & when she panics because her vision is almost gone & she gets disoriented, she gets sundowners syndrome. I do my best to help her get oriented again & if she prefers to stay up until she realizes her internal clock says it time to sleep, I put her in front of the TV & let her stay there & tell her I will be sleeping in my bed. I wake up periodically to check on her since I am retired, I know I am ABLE to loose some sleep & catch up later next day. Sometimes when I check on her, she has already gone back to bed. I hope & pray when I am old & needing care someone will do the same for me. Don't think I am perfect or my situation is perfect. I still get frustrated & angry, but usually ending up eating my thoughts & words in those moments. My thoughts & prayers are for caregivers everywhere, including nursing home, assisted living, & other caregivers. If you do it as a job, I appreciate your special calling. I hate commercials that lawyers put out making nursing home employees look neglectful. I'm sure there might be a few, but anyone who cares for someone elderly knows it can be, at times, stressful. Blessings on those who do care!
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Buster57, if you google "can Melatonin cause aggression" you will get some hits. No drug, natural or not, affects everyone the same way and some herbs, drugs, vitamins do have undesirable reactions. (One friend found out he was allergic to garlic, for example, so he could not use it for high blood pressure treatment and another found that honey put him to sleep so he could not use that as an alternative to sugar!) So while melatonin has helped a lot of people sleep naturally, you do really have to be careful with it, especially anyone dealing with a person who has the kind of dementia that makes them more prone to aggression to begin with. (I don't know if your patient does or not.)
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The elderly often get their days and nights mixed up. I would come home after work at 6:30 at night and find my mother (and this is when she was still fairly with it and caring for my Dad) serving him breakfast instead of supper and she would be surprised that it was 6:30 at night and not 6:30 in the morning. Being exposed to natural daylight has a big factor in this, just like treating jet lag. So in addition to adjusting the meds and orienting to a routine (like maybe watching a favorite TV show before bedtime, that sets the stage that it is in fact bedtime because "Look, 'Everybody Loves Raymond' is on and it's 9 pm at night because as you know that show isn't on in the daytime" or whatever) perhaps sitting near a sunny window in the daytime (and going out for a walk in good weather, if mobile) would help too.
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Google the words "reverse Alzheimers" you will get your answers. In the meantime, go to the local health food store and pick up a newsletter and get a nutritionist and an alternative or integrative or put in the words longevity or anti-aging medicine.
You can reverse at least 50% of the symptoms and get a doctor that knows how supplements interact with medications. My dad went from 8 medications down to 4! And we are out now sipping lattes at a fashion show! They are forgetting but can function better than before. No nursing home for my folks!
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Are there any side effects or drug interactions with Restoril or Melatonin? My Mom has a multitude of problems and is on lots of medications. She has trouble sleeping and staying asleep.
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There are better ways of caring for the aging population and our country is quite young at this. Never in the history of humanity has the elderly been put away to age away from familiar loved ones except once industry became the way a society is designed. Now our families are isolated and we have to hire one single caregiver instead of sharing the work of caring for a loved one with the whole family. Insomnia happens when we find ourselves with the reality that we can live years and years trapped in boredom. HUmans use to have vitality and rich productive lives until the very end of life. They were useful. Grandparents had kids to care for our vegetables to gather or meetings with other friends. Watch Blue Zones to see how to age gracefully. This night waking and roaming and peeing is NOT the way to age. Dementia is not the norm. Usually if you test the urine, it will be positive for a UTI. If you give electrolytes and or coconut water and change the diet, you will see immediate improvement in the behaviour and personality. Sometimes the person will become independent again. I am going through this right now and experimenting so I know first hand that the symptoms of dementia depend on many factors. There are 30 things you have to do all at the same time to reverse Alzheimers. THere are university studies that are duplicating these activities and protocols and are doing so with success. .
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I know the answer to this because I am immersed in this right now with my own mom. I am getting assistance from a scientist and he says our body's ph reveals our ability to wind out for the evening. Our body naturally becomes more alkaline in the afternoon to prepare for the evening. (don't quote me but instead read up on this topic and google it because it is cutting edge apparently) Doctors will know this stuff in about 20 years so don't wait. Meals, sun exposure, exersize all take part in setting the ph of the body... Get some of those litmus papers and start testing morning urine, and everytime your loved one pees throughout the day. After 5 days, you will see a pattern.
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You loses melatonin as you age and it will affect everyone as they age. My mom always had to take sleeping pills. She'd be given prescription ones, but she was scared with how hard they made her sleep and she felt groggy the next day. So over the counter ones wound up being the way to go for her.
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Seroquel should put her down to sleep. It's a sedative.
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Antipsychotic medications are not generally given to those with Alzheimer's. They can worsen symptoms. Seroquel is for bipolar disorder and should not be given to elders.
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Amy, since our Moms seem like they are on a parallel route. There are days when I visit her in the afternoon that she is sound asleep so I just let her sleep and leave.

Hospice has changed my Mom's morphine schedule from once a day to now twice a day, as Mom is very fidgety as probably she is uncomfortable being either in bed so much or being in her Geri recliner, her back much hurt.

My Mom also spends quality time near the nurses station/common area where the Staff can keep an eye on her as she is a high fall risk. It seems like the same 3 patients are there every evening after 8pm, the rest are already in their rooms.
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Seroquel didn't do anything for my mom, even combined with 10 mg of melatonin and some valium to boot! A doctor took her off all of those and restarted her on Zyprexa and that worked better. We are still tweaking here and there. Nothing works for everyone and nothing works forever.
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You know, lack of physical activity can actually make you experience insomnia. I know this from experience, on some nights I have actually had to get up and do something physical such as a walk or bike ride in order to get to sleep. You may try putting the patient on a treadmill to try to burn off some energy before going to bed, because physical activity really does work.
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My Mom has had insomnia for decades (she's 95 and in her own home with CNAs during the daytime). Because of history of falls, she can't/won't take sleeping pills. She has to get up during the night to use the bathroom (she can do this on her own). She has the luxury of sleeping late in the morning, though the CNA arrives at 9 am. Lately, the CNAs tell me she's been reporting dreams about her parents (deceased, of course) and when she was younger. I think this is normal aging. She knows if she goes to bed too early she'll wake up in the middle of the night and not be able to get to sleep for hours. Before she had a few falls that required a NH stay and then home care, if she couldn't sleep, she'd go downstairs to the family room and read for several hours or watch late night Tv I have the same problem, but at 64, I've been taking Zolpidem and other meds for frequent insomnia.
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Don't worry about it. Mixing day and nighttime is common with dementia sufferers. The NH will handle it. If they complain to you, then take your mom to a psychiatrist who will prescribe stronger medication
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It's probably both adjustment and sundowning. My SIL was put in front of the nurses station. One night she even answered thier phone when they left her alone! She would eventually settle down and get back into the routine.
When she has had health issues and gone back to the hospital, it started all over again until she settles in.
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i am seventy four years old and have had insomnia off and on for fifty years. when i was young and worked outside the home it was a problem but now that i don't work and have no children at home it isn't as troubling. there's no fighting it. i sleep when i can and get up when i can't. any time of the day or night you'll find me doing research on the internet, working on hobbies, writing poetry, writing books, reading, designing miniature houses, and working on my collection of dollhouses. i have designed and built a five by six foot Victorian dollhouse that's on my kitchen table, and a a three by four foot mid century modern ranch style dollhouse that's on my coffee table, and have started plans for the twenty first century dollhouse i want to build. sometimes i wash the dishes that i was too tired to wash the day before. i am in no way demented and i take no medications. in care facilities why not put all of the insomniacs together at night and have a night nurse aid or activity director with them and let them stay up. let them sleep during the day and stop fighting it. many people are in nursing homes simply bcs they are incontinent and in my opinion are otherwise not sick or disabled if they aren't drugged into oblivion. anyone in long term care is certainly paying enough for their care.
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We give a half a Seroquel around 6pm after dinner, she sleeps all night but still is awake by 0600 most days.
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Benzo-type drugs often have the opposite effect on the elderly and recent studies have shown the hasten the effects of ALZ. Anxiety and having days and nights mixed up was the reaso my mom didn't sleep at night. The psychiatrist gave her Remeron and took her off the Abilify another doctor had put her on and she started sleeping at night.
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My mom did the same thing. Until they changed and increased her meds. Explain to the Dr what is happening, and they should give her something to help her sleep. Good luck.
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I would really advocate for her and work with doc to get effective med. that is an awful experience for her. It happened to my dad and we tried different mess until one worked. Sometimes you really have to urge doctor. Good luck!
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I agree. I assume the nurse contacted u. You could call the doctor or if he is the facility doctor the nurse could call him. I'm surprised they haven't.
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I hope that you and the nurses are in contact with the doctor. They need to try a different med, or a different combination of meds. Are they given her an actual tranquilizer, or are you just using that as a generic term for any med that calms her? There are specific sleep meds; there is melatonin, there are anti psychotics like Seroquel which have powerful sleep producing effects in many people. Find out what the doc is prescribing and ask for her/him to review its effectiveness.
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If my moms seroquel was not given before she started to feel afraid, it was useless and she stayed awake all night. The doctor suggested a half a pill at 8pm and the other half at 9 or 10. My mom would say there were people in her room all night. Slept with a light on many nights but we were fortunate to be able to keep mom home so we have more control over the situation. As the years progressed, we would just get into bed at 8, but still split the dosing of the seroquel because mom became harder to move with the medication in her. I found that talking about what she was seeing really did help. Made it a point to acknowledge what she was seeing because it was real to her, telling her otherwise just upset her more. Did everything I could not to give more then one seroquel because she would be too groggy the next day. Good luck, this one is not easy.
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My mom is 81 and she has had a terrible time trying to get to sleep and staying asleep. She is now taking a sleeping pill (Restoril) 30 mg and 5mg of Melatonin. It seems to work the best with the combination.
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It could be that her internal clock is mixed up. I've never heard of someone who can stay away on Seroquel though. I know that is sometimes prescribed for sleep issues. If she sleeps all day, then I can see why she may not sleep at night, if she sleeps all day.
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