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He is confused and doesn’t know why he is up or what he is doing. He was sleeping at least 3 hours at night before waking. We get up with him take him to restroom, change his depend to avoid bed messes, and put him back to bed but an hour later he is up. He sleeps in a calm room with no noise or other activity going on. Please help with any suggestions.

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Talk to his PCP and see of there is something mild that can help him to stay asleep. I take Seroquel and while I still wake up a LOT during the night, I can go back to sleep.

The doc can no doubt give you many options.

You need your sleep! I imagine dad sleeps/dozes all day long and so his circadian rhythms are all off.

I'd like to give you MY problem, or a least a portion of it. My DH (pretty healthy at age 68) and if he is not actively working, he is asleep. I've seen him sleep 22 hours straight, more than once. Then he gets up, eats something, goes to the bathroom and is back in bed for another 22 hour 'nap'. He gets in cycles where he will do this for up to 5 days. Somehow he manages to still work 70+ hrs a week, but he does nothing else.

I wouldn't want your problem, but I'm not a fan of MINE!

Good Luck. This must be exhausting!
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zzzzzzz

YOU need sleep. I agree with talking to his doc ASAP and seeing if a med can help him sleep more, for your sake. Is he waking up from pain? To pee? Or just who knows why? Maybe try melatonin?

Is there any noise that could be waking him? If so, maybe put a white noise machine in his room? Works for my grandkids!
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jacobsonbob Dec 2020
And a white noise machine can be created by turning on a radio and putting on a setting between stations such that there is nothing but white noise-like static. I used to do this with a clock radio I had, and it served the purpose well.
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Please have him checked for a urinary tract infection. My mother has chronic UTI's and confusion is one of her first systems.
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Thank you all for your suggestions. Yes. He dozes off and on for short times throughout the day. He does not complain of pain while peeing and pisses like a horse. I think he would say because he says “ouch” with the pressure of the blood pressure machine. He moved in with us a month ago from my sister who lives out of town. He goes to his new dr on Monday and I definitely will have him checked for UTI and possibly sleep aids. Heaven help us all with caregiving and Thankful I have a place to come to here.
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againx100 Dec 2020
Does he take any diuretic meds at night? At least Monday is right around the corner. Have a list of things to cover and specific examples.
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One of the big issues for AD caregivers is getting enough sleep. If you're up at all hours of the day that will eventually take a toll on you if it hasn't already. Be mindful that if he gets up without your knowing, he could begin to wander and that would be a serious safety issue. Your best bet is to discuss this with his PCP to see if he can prescribe a drug to help your dad sleep. Do not buy any over the counter sleep aids (except melatonin). They all contain a drug that has negative side efects on an AD patient. If your dad is currently on any drugs, make sure you take those with you to the appt. so the doctor doesn't prescribe a sleep aid that would interact act with what dad's already taking.
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"He does not complain of pain while peeing and pisses like a horse. I think he would say because he says “ouch” with the pressure of the blood pressure machine."

Yes, you're getting that UTI check, but ask for a culture, if possible. When I first joined the forum and saw all the suggestions for UTI test, I was a skeptic. Mom's first UTI at MC resulted in major sun-downing! No pain, none, just every afternoon/early evening she HAD to get out, she had guests coming and had to go home! She set off every door alarm. In the morning, she was fine. Any relatively sudden change in behavior, habits, demeanor, do check that first. It's easy and cheap, just to rule it out. UTIs (and apparently other infections) can really wreak havoc on elders, without the usual symptoms. This seems to be especially true for those with dementia.

That said, mom's second UTI showed up as night time bed wetting. SOAKING! They would have to change her nightgown, briefs AND bedding! Despite briefs with another pad inserted. Once treated, no more bed wetting.

For the sleep issue, maybe if he has a UTI and it is treated it will resolve. If it doesn't, during mom's first UTI episode they Rxed anti-anxiety, mildest dose. I'm not a big fan of medications, but this worked first time, every time and there's no need to wean off if it doesn't work. It was just enough in the evening to take the "edge" off, but it also helped to keep her asleep. They do warn it can be a fall risk, but mom was still mobile at that time and never had any issues. The only tumbles she ever had there she wasn't taking it - it was only used during the UTI treatment, then kept for "as needed", but they didn't need it.

Hopefully it is a UTI. If not, there should be something they can prescribe to help him sleep. If he still pees like a racehorse, you'll want to add some extra padding on the bed to protect the mattress. Meanwhile they should do more investigation to find out why he goes so much. Definitely need to resolve this so you can SLEEP!
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If the if the sleeping issue is a new problem of short duration, then certainly check for a UTI. Seniors manifest UTIs differently. They don't always feel pain and burning during urination. Sometimes they experience weakness that leads to sepsis and kidney infections before you know it. It's always something to think about when any behavior changes quickly.

If that's not it, look into trying sublingual melatonin. Melatonin taken as an oral swallowed pill is much less effective.

If that doesn't work, talk to the doctor about something to help him sleep through the night. I'd be asking about Trazodone. I've found it to be the best way to regulate the Circadian rhythm with the fewest side effects.
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My 96 yr old Dad with dementia does the same.

It helps a little to give him a small snack like a muffin and a glass of milk late when he wakes up.

Also, started giving him 3 mg of melatonin at night.

My Dad doesn't really like being by himself, it's like a child being scared of being left alone and he doesn't eat a lot but seems to want something to eat every 2-3 hrs.

He has now chosen to sleep in his Recliner verses his bed, seems to relax him better.

Prayers
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Couple of other things to consider:

Make sure he stays awake the majority of the day. If his sleep needs occur during the day, he will be up at night.

Take him outside into the sunshine daily and make sure he has plenty of light during the day. His circadian rhythm will be better adjusted when he gets plenty of light to recalibrate his wake-sleep cycles.

Limit naps to 20 minutes.

Have his prostrate checked. Enlargement causes the feeling of always needing to pee. This could cause him to wake frequently.

Talk to his doctor about medications to help with sleeping.

Please make sure that all caregivers in the family are getting enough sleep (7-9 hours) themselves. Being on constant "call" will eventually mess with your health.
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Jkl2018 Dec 2020
How do you keep someone awake during the day when all they want to do is nap? Now that it is too cold for my mom to be outside walking or rocking in the rocking chair on the front porch, she gets tired of just sitting watching tv, so she wants to sleep. She tries to get in her bed at late afternoon but I get her to come back in the living room, to which she dozes on the couch. It hasn't affected her nighttime sleep yet, but I'm afraid it will. There is no activities that I can get her to do. She doesn't read much anymore, no little jobs she wants or can do, no puzzles, nothing but watch a little tv and doze. I'm worried she is going to get her days and nights mixed up this winter.
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I had the same issue with my mom. She was getting up every couple of hours to use the bathroom, then every hour, then every 20 minutes. Part of the problem seemed to be that she was irritating her private parts with constant wiping. She also had all her over-the-counter medicines - antibiotic ointment for the irritated area, lotion for arthritis pain, eye-drops, ointment for irritated nasal passages and Chapstick for her lips to apply every time she used the bathroom. (It helped to put the over-the-counter medicines out of sight.)
We checked and checked for UTI, tried melatonin, tried adjusting other medicines, etc.
It all ended when she had a mild stroke towards the end of last summer.
Recently, she had some trouble with hallucinations keeping her up at night. Her hospice nurse advised giving her a very small dose of anti-anxiety medicine at bedtime. It does make her sleepier, even during the day, but she is sleeping through the night now.
I have since wondered if the constant trips to the bathroom and the use of all the over-the-counter medicines was due to anxiety. It's worth thinking about if other remedies don't work.
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Maybe what he needs is a little "white" noise in his room. If he is anxious and hears nothing may feel like he is left alone. There are recordings of waves, soft breezes, etc. that might be soothing. Even the noise from an air purifier or humidifier might be soothing. Even a night light. Think what you would do for a baby.
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TouchMatters Dec 2020
We can all use more / some white noise now.
Good idea. Couldn't hurt. Anything to calm a person down.
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I hope it's a UTI. My father went this way also, he was sundowning and it got worse. We had to put him in a care home with wake staff who could assist him at all hours as meds had little affect on his sleep.

This isn't easy and for us it was nearing the end. We lost my dad about 5 months after his sundowning became more than we could handle.

I wish you and your family the best and I'm sorry for this sadness, many of us have been there and understand what you are going through.
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I would check for a UTI. My 98 year old mother gets confused and does not sleep well with a UTI. Good luck.
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We were told the same thing for my 90 year old father. Check for a UTI as that has so many affects I never knew of. Have plenty of fluid during the day (perhaps taking Liquid IV to add to the water). Use Melatonin at nite and limit the caffeine and sugar at night. Keep it light during the day, keep with normal wake up time to have a schedule. Limit naps (sleep hygiene) during the day.
Nothing worked unfortunately for us. He continued to wake up and be tired all day!
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Great suggestions. I wonder if a white noise machine or calming music would be helpful at all?

I really like this meditation music for reducing anxiety/ calm nighttimes/ sleeping-

https://m.youtube.com/watch?v=-vvpsIiUVKY&t=3110s

https://m.youtube.com/watch?v=jK2hS40pr-g
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Mabe you can try some low valum music from dad's time or the tv for the distraction he just may need to keep him calm.... Good luck I know you will figure it out.
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This can be part of sundowning. Their days and nights get turned around. Ask his doctor if he can try melatonin. It really helped my dad have a more peaceful night. Limit the daytime napping.
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TouchMatters Dec 2020
Many people do not realize that our bodies naturally produce melatonin and the production lessens as we age. I agree with you, along with medication assessment. I do recommend Melatonin to my clients.
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Try making him some Chamomile tea. It's very calming and soothing. Try one of the Airwick plugins with Lavender.
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TouchMatters Dec 2020
Plugins are an environmental waste plus lots of chemicals. A person should use an essence oil instead. Although in this situation, chamomile tea, I believe, would be good for a person with mild stress. From my experience working with elders, he needs some prescribed medication (perhaps something like Xanax for anxiety). He needs something to 'knock him out during the night' so everyone else can get enough sleep, 'too.'
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My Papa had Parkinson’s, as well as some dementia. His getting up and down all day and night turned out to be all anxiety related. His doctor put him on a drug called Trazadone, and it made a world of difference. All of the fidgeting stopped and well as the constant bathroom trips. We didn’t notice any side effects either. Maybe speak to his doctor and see what he thinks. Best of luck.
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Imho, you should speak with his neurologist for medication evaluation. Prayers sent.
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I was in the same situation with my dad which is almost 97
, and has alzheimers, 4 month ago the doctor put him in quetiapine 25mg at nigh and is working for know, Thank God.
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Does he like to watch tv or listen to music? Maybe give him a tv to watch or radio.
Alzheimer’s patients are strange, and will develop new and different behaviors over time. In other words as soon as you address an undesirable behavior they may start a new one. Therefore I would be careful using drugs to address any situation.
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A couple of suggestions:

Make sure he doesn't take long naps during the daytime. This will interfere with his nighttime rest.

Make sure to keep him on a consistent schedule - regular bedtime and regular wake time.

Some folks have better luck with non-prescription medications: melatonin, Benadryl, and CBD oil (not a fan of this because of lack of quality control).

Doctor appointment. Physician can prescribe medications to help him stay asleep since falling asleep is not his issue. Doctor can also check to make sure prostate is not causing problems.

Many folks with later stages of dementia do get confused about days and nights. Getting outside daily and bright lights during the day may help. If not, hiring a sitter at night may at least help the rest of the family to get more sleep.
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Is there any way you can have some kind of a lavender sachet somewhere (where he can't get it) in the room, I think that is supposed to be calming.  How about him taking a lose dose of melatonin about 1 hour before bed, it is calming and non habit forming.  how about some soft music without words playing that will be calming.  wishing you luck.
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