difficult evenings and not wanting to get out of bed

search4innerpeace

Hello!

New to this site and hoping to learn from others.  My mom has alzheimer's and lives in a nursing facility.  Evenings are difficult due to sundowning and she will have increased anxiety, confusion, and yelling.  Typically starts around 4ish and when staff get her up for supper.  Mom would prefer to sleep and be left alone in her bed all day, but resists primarily around that 4pm time and would yell for them to leave her along and wanting to stay in bed.  Due to her decreased physical capabilities, she is not able to walk and is a 2 person mechanical lift and requires supervision when eating, so eating in her room is not an option and she will not initiate anything on her own.   She does become upset and agitated with getting out of bed and doesn't like the 2 person lift.  I have done research on sundowning and have ideas on strategies and approaches to use to address the resulting behaviors.  However, what I am struggling with is how much to "push" someone to get out of bed when they don't want to.  This could result in her laying in bed more than being up and not having dinner on a regular basis.  Even though she is upset, she almost always eats her dinner.  During the day, this isn't as much of an issue or a struggle.  I  understand that routines are important and should also keep encouraging activities, but to what point if it causes so much upset?  Looking for other ideas to consider as well.  It's a hard balance and thank you!  

towhee

Hi, welcome to the site!

What reason is the nursing home giving you that they cannot provide supervision in her room? Does she need to be fed, or just need to be watched to make sure she doesn't put too much food in her mouth, etc.? Usually at my LOs nursing home you were allowed to choose room or dining room when it came to the point of not being able to feed yourself. If she just needs occasional supervision, you might be able to ask for additional assistance for an hour, so she could eat in her room. Extra expense of course. If she is up and about for most of the day, I would not worry about no socialization at supper. 

search4innerpeace

Hi.  Thanks for the reply.. She is able to eat independently but needs to be line of site while eating.   She usesd to be able to eat in her room prior to that.  I know they are concerned  with if they don't get her up she won't eat dinner.  I will inquire more about assistance in her room.

Cynbar

I actually think the nursing home should be pushed a little harder to provide someone to allow her to eat dinner in her room. I realize so many places are short staffed, but they have an obligation to meet the patient's needs. It sounds like it is a tremendous physical effort to get her out of bed, at a time of day when fatigue is setting in, plus her dementia/sundowning is making it an extra challenge. I don't think it is fair to her to make a choice between comfort and nutrition. If she were more physically able, I would feel differently. Whether she is on hospice or not, it should be mainly about comfort at this stage of her life, especially late in the day.

search4innerpeace

Thank you I appreciate your insight and agree!  I also felt that is was unfair and unfortunately it's more about staff schedules then what's best for the residents.  I'll plan to have more discussions!