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More and more these days my bedbound MIL is always awake. She stares a lot but never seems to sleep. Her bed is in my living room/kitchen area and if I enter or leave the room, she starts talking a bit - well sundown-like behavior.
She used to take Seroquel for combativeness and it worked for a while but then the results reversed on us. So no drugs now for over a month. She is still able to talk - but fewer words.
I feel bad that she is laying there staring at nothing. I try to interact with her and play music and tv and we have therapists come 3 days/wk with hospice.
But, she NEVER seems to sleep.
Is that okay?
Sometimes she is very restless and nothing seems to satisfy her.

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More than one caregiver has found a warm Epsom salt bath helps. If you can't get her in the tub, mix a tablespoon of Epsom salt in 4 quarts (liters) of hot water until it dissolves. Use a clean dishtowel and apply warm moist compresses to the head, hands and feet, with a gentle massage. Do this just before sleeptime. AND while you are at it, wrap one across the back of your neck and shoulders. Then toast each other with just a shotglass of red wine. It is a vasodilator with lots of antioxidants in it. Good Luck.
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We sleep in the same room with my mom and I think that helps her to feel comfortable and safe. So it is me, my husband, our three dogs and my mom all piled up in the family room. She has her own room (with new mattresses that were supposed to be "just right") and sometimes she go sleep in there on her own but the standard arrangement is all of us together. My husband and I have been crashing on the floor with our sleeping bags while she gets the sofa with one dog at her feet and the other two dogs share the recliners.
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Oh Razzleberry that's doesn't sound like a wise decision.. Speak with her Dr about her anxiety.. I would think your husband will resent your Mom sooner or later..
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Actually we are both totally onboard with it. He says he has never felt better. It helps his back. She does not have anxiety, whatever she had years ago is long gone. We have been doing this for five plus years. Not for everyone but it works for us.
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I want to add, I truly appreciate your concern. It is good to know we are all looking out for each other. I am very grateful for that. :-)
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To each his own! If it works for you :)
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Razzle I think that sounds very sweet. I battle the same thing here. My mom is in hospice but is controlled but she has anxiety out the a**. She started taking zanex, and then that stopped working, as of yesterday we up here dose, much better now. Not sure how long if it will stop again but for now she is at least getting rest. Hospice keeps saying Moraphine and we say NO a phine!!lol We have no pain just anxiety - she has had it her whole life. Anyways good luck.
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Marijuana will help as sleep aid.
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This is becoming a make-or-break with us. Giving mom a little food when she gets up will sometimes keep her from staying up. Putting the tea-making stuff out of sight keeps her from getting involved in that. Sleep medications have the opposite effect on her: She acts like an energizer bunny & won't believe that being up at 2 am is any sort of a problem (it wouldn't be if others didn't have to be up with her.)
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When her doctor started Mom on Seroquel, he cautioned that dosage increases would be necessary over time and that some people take up to 800 mg. a day. At present Mom is on 150 mg morning, 100 mg noon and 200 mg evening. We worked up to that, starting with 50/25/75 last August.

But if that drug doesn't work, ask her doctor to keep trying. Surely hospice can help. Are they convinced she's as comfortable as possible for her last days?

And does anyone respond when she speaks? Perhaps verbal communication is garbled, but the language of the heart remains the same. Sometimes Mom makes no sense at all, but hugs and kisses always work in reply.

Good luck and God bless.
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I tried seroquel for the combative dementia and at the 200 level, she was clocked during the day but was up all night and then calling out.l The last two years of my MIL's life, no one got any sleep. Before she was so unruly, leaving a slice of bread on a plate would help when she wanted to eat but eventually, all those things only caused her to try to sleep all day and be up all night. Try to avoid her taking naps during the day, something that will almost be impossible. This is why many people give up and place their parents in nursing care because this kind of level can only be sustained by killing yourself. Good luck. Seroquel does wind up reversing itself and that makes it hell if you have someone with combative dementia because then they really do focus on one person (in this case it was me) and any chance they get will try to hit or kick you because they think you are keeping them in your home instead of theirs, or worse, they think their son is their husband and you are coming between them. It was literally not possible to be in the same room with her without being attacked. When my husband went to the store for groceries or to his doctors' appointments, she would demand to know where he was ever 3 or 4 minutes and when confronting me, she would be maneuvering into position to hit or kick me. You CANNOT hit back under ANY circumstances. There are laws on the books to protect the elderly but there are no laws on the books to protect the caregiver. On advice of my therapist, she told me to take photos of the damage inflicted on me--the knocked out teeth, the split lips, the baseball sized bruises, and to give these to her doctor. Don't think it can't happen to me. My MIL was 96 when she got really violent and she lives ANOTHER TWO YEARS before she just recently died. My husband was an only child and from another culture so putting her in a home was never an option. Her doctor said he had nearly been strangled by a 76 year old man who had combative dementia and while he sympathized with us and gave us the prescription for seroquel, nothing BUT DEATH really helped. I am SO GLAD she is gone!!!
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Try some Melatonin. It is not a "drug" and may help. The staring is typical behavior for a person with dementia. There is nothing to do about it, and just let her do what she does. You'll spend all your time being exhausted. She has a terminal illness and if hospice is coming, the end might not be long. Let her cope with whatever she is thinking on her own, and just be there to listen. My best to her and you.
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My MIL had problems sleeping too. With all her other meds we did not want her taking more prescriptions with more side effects so we give her 30 mg of melatonin a day. She gets 10 mg in the evening and the other 20 at bedtime. This has worked very well for her. Her doctor is aware of this and approves it.
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Marialake, there is a lot of good information in this article from experts. I hope it helps.
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My 93 yr. old aunt died a couple of years ago from ALZ. She got to where she wouldn't go to bed at night. She just wanted to wander or sit up in her recliner all night. That was the point at which I convinced my uncle she needed the nursing home. The nurses at the home said that not sleeping was part of the final stages of ALZ. She only lived a couple of months at the home.
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If your mom will not sleep, this may not help --- but a nurse practitioner who specializes in seeing people with dementia said that a person with Alz. should have two naps every day - one after breakfast and one in the late afternoon. This, ironically, helps the person sleep better at night.
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My 93-year old mom used to get up several times/night with urgency incontinence, and had undiagnosed (but easy to hear) sleep apnea. When she was in rehab for a broken wrist and hip, the nursing staff put her on ambien at night--without my knowledge. Now, I have mom using melatonin, and the hospital bed allows us to raise her head for sleeping. Incontinence continues but doesn't interrupt her sleep several times a night.

I also am a strong believer in homeopathic and TCM (Traditional Chinese Medicine) remedies--being used for 2000 years, and the opposite, the most recent neurological research. I don't know if it's been discussed before, but I use, and it's pretty successful for mom, subliminal cd's that help move the brainwave patterns into delta waves--deep sleep. Quite a few on the internet, or even in e.g., Barnes & Noble in alternative music sections. Hope these can help.
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I would speak to her physician first. But have you tried any of the nighty night or sleepy time teas? Make sure she isn't during the day on any thing with caffeine including even chocolate. If you wanted to try something natural Melatonin works for some if you don't want to go medicinal. I pretty much had them take my mom off everything except risperdal for agitation and to sleep trazadone low dose. Once their internal clock kicks in we made that a prn (as needed) Also, is she sleeping during the day a lot? That can be interfering with her sleeping through the night. She may need more stimulation if that is the case. Good Luck and Godspeed!
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Dear pst, Since she is bed-bound now, she probably isn't sleepy because she doesn't get to "use up" her energy. or rather, get tired. That can make a person feel listless. I don't know what to tell you to do about that. There has got to be something, though. How can we allow our bed-bound loved ones a way to release stress & anxiety that build up over the day when they are not able to physically be active? My all-time-narcoleptic Dad has become an insomniac now. Never was before. I try to discourage him from naps during the day & it helps a lot. He is still ambulatory, though. He will be perfectly fine on 2 1/2 hours sleep--bouncing off the walls all night! But, I cannot. I have to be awake when he is, since he gets into EVERYTHING while awake! Good luck & keep up the good work. You are doing an awesome job! blou
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Marialake: Wow I feel for you but I feel for her as well. I just do not know how any human being can go on and on without sleep. My mother who has moderate dementia went ballistic on us with no sleep, screaming, yelling, flipping on lights, trying to feed the sleeping dog, you name it it was horrible for her but we were ALL GOING CRAZY trying to put up with the behavior. She had gall stones and had to have surgery. After, they put her on Remeron and Celexa and it worked great for two months until headaches began and we tried to stop them to no avail so she was removed from the meds. Now the Gerontologist is using Ativan 12 pill at lunch and dinner. It is barely maintaining her. What she takes I have taken in the past and it knocked me on my butt and I would sleep for 8 hours straight...NOT MY MOM! She takes it and may get tired but she will be up til 9-10-11pm before she finally gives up and goes to sleep. We are all on edge as we realize this medication is not going to be the "right" medication for her either. Everything that normally works for people, does NOT WORK FOR HER.

I feel so frustrated in my circumstance, just as I know you feel with your mother in law.

What has hospice care said or her doctor about giving her anything to sleep, I cannot imagine laying there awake all the time and not being able to communicate is the way it should be.

Maria I do not know your MIL full condition but if she were my mother I think I would ask for Morphine for her.. When my father was dying and went into the hospital for the last time, he asked his doctor for "a shot to put him to sleep" he was put on Morphine and passed away several days later as he slept.

You may not agree with this and that is okay, we each have to live with our choices.

God Bless you all on this journey!
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I have sound "sleepy time" tea to work well. Also, I don't give mom anything to drink after around 7pm. This cuts down on her trying to get up in the middle of the night to go to the bathroom and accidents in bed Also, they say lavender is calming. You can get it in a lotion or a spray. I have a friend that sprays her pillow before she sleeps.
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I'm leaning towards Holy Cow's answer. If your MIL is in Hospice, a small amount of morphine to begin with, could do the trick. No worries of becoming addicted at this stage..... Perhaps the morphine could be increased incrementally as it is needed? If the Hospice nurses recommended it, it could relax her, because high anxiety is such an uncomfortable feeling...(I was told by a friend who experiences it and says it can make a person feel like something terrible is going to happen and they can't control it.) You say she stares into space all day long. Maybe she is thinking about things, and playing videos of her past life in her head. It's hard to know what is going on in their minds when they stare into space like that. You say she sometimes seems to be restless. Can she be put into a wheel chair and taken for walks or a change of scenery? Would mobiles of birds or butterflies, etc. hanging from the ceiling that she could watch be something she could get enjoyment out of? Does she sleep at night, when you're sleeping? If she does, then maybe that is all the sleep her body requires right now as she is not getting much exercise or stimulation. I wish you the very best in this process. I can empathize very much!!
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My husband takes something called mirzantipine. Originally given(about 4yrs ago when he was first diagnosed) for "restlessness" that came with sundowners but when that got a little better the Dr kept him on it with serequel for sleep. I use the sleepytime tea for myself and it works well. Also melatonin can be helpful. The shotglass of wine? Great idea but no more than that as it could have the opposite effect.
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Speak with her neurologist, we found that Hydroxyzine worked well for my father-in-law. It has several uses among them are as a sleep aid and for anxiety. They are supposedly non-habit forming and really worked for us. I know how exhausting this can be. For awhile my husband and I had to tag team being awake as it took some time to get everything sorted out. We adopted the parents of a newborn adage of sleep when the baby does, and took catnaps when he did.

Take good care.
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tinawee: Sleepy Time tea really works? Do they all work or is one better than the other?
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6 ounces of organic cherry juice at bedtime will also help. Loaded with melatonin and easy to drink.
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I found that just good old benadryl helps. I learned that while Mom was in Palliative care. Soft music and the lights turned down low and the warm Epsom salt sponge down with a clean gown.
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The trouble for us dealing with AD is that we don't really know what is happening inside the person's brain. I asked mom's doctor about something to help her sleep he gave us a script but said it would make her loopier than she already is. Our solution, cause my mom wonders is to get a gate and put it in the doorway when she decides to go to bed at night, at least this way we know she is reasonably safe. It sounds to me, that your MIL is bed bound and I don't know what to tell you for her sleeplessness, but then again what if anything does she do during the day? Does she nap? Best of luck with it and keep us posted, please.
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For cinderbarb, I put a motion detecter in mom's room on a dresser facing the doorway and the reciever in my room. It is wonderful! If she gets up and crosses the threshhold I am there. I tried baby monitor but found I never had a good night sleep because I could here her turning in bed. I know for now I am very lucky, mom has a routine and sleeps often through the night.
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