Stays Up Into Wee Hours of the Morning

hoppetablet

Good Evening. My mom, who has dementia, stays awake until the wee hours of the morning (often not going to bed until 2:30a.m. or after). My dad is her primary caregiver. They live independently in their own home. What advice can I share with my dad to help my mom go to bed earlier? (My dad will not go to bed until she does, not wanting her to be awake alone. What advice can I give to him so that he too will go to bed earlier?).

harshedbuzz

Hi and welcome.

I am sorry for your reason to be here, but glad you found this place.

I read both your posts (mean-mom night-owl-mom) and will combine my answers here as I feel they are interconnected. But first, the questions you didn't ask.

Does your dad have the legal paperwork in place for you to take over. Are there POAs and Medical Directives for both with you as dad's primary agent (because mom can't speak for him any longer) and you as secondary to take over should dad die first or become incapacitated?

Recognizing that a full 1/3 of caregivers pass before their PWD, do you have a plan for mom's care that you can execute on-the-fly if needed? Given dad's age, this is especially critical for your situation. If you would be moving mom into your home, are their changes you'd need to make in terms of access now? If you'd opt for memory care, it's best to start touring now so you have a clear idea of prices, availability and top choices.

To the advice for your dad. Is he open to your suggestions? IME, the messenger matters. People of his generation aren't always willing to take caregiving advice from an adult child. My mom blew off my suggestions on the regular, so I brought her to a local IRL support group where they offered her the exact same advice which she took to heart. The other piece is that sometimes when family offer advice from a distance, it can feel like armchair quarterbacking. If you're not hands on in this situation, dad may bristle at your advice and opinions.

I feel like medication would be helpful for you mom's very common delusions about dad's infidelity and her generally depressed/agitated state. Medication could also help with the sleep issue and get her on a more reasonable schedule. A geriatric psychiatrist is the specialist for psychoactive medications and I would attempt to bring her in to see one. Otherwise, her neurologist or geriatric specialist may be willing to prescribe. In addition to meds, we found Validation strategies useful for smoothing over dad's accusation and generally negative thoughts. Redirection was useful when he'd progressed a bit further and was less able to recall grudges.

For the sleep, is she napping at all during the day? Dad used to dose all day and then keep mom up all night. We added Seroquel to help with this. Another option would be a day program; if your mom went to a 9-3 day program, it would engage her and keep her from napping and it would give your dad some much needed respite from caregiving. The activity would likely tire her out and help her sleep more normally. If this isn't possible or doesn't work, the next option is for your dad to get some help in overnights so he can sleep. When my friend's mom went through this stage, she and her son who had a gap before starting grad school split the nights. She retired early while son kept an eye/ear out for mom with a smartphone app and motion detectors (5000 sqft house with mom's quarters on the main floor and theirs upstairs) before handing the phone off to his mom around 3am. Other folks I know have brought in aides for a night shift to allow the spouse to sleep.

I hope this helps.

HB

hoppetablet

Thank you so much for your response. You shared insightful thoughts that I will be sharing with my siblings. There are a few things we do need to make sure we have in order. We continue to have open communication with our dad, but you are so accurate in your statement regarding people from his generation not always willing to take caregiving advice.

Thanks again for sharing with me.

M1

I very much second the suggestion to consider Seroquel to help her sleep and tamp the delusions. Sleep fragmentation can very much be part of the disease. A low dose of Seroquel helped my partner with this enormously and she has stayed on it.