Sleepless Nights - Dementia

[OldMarriedMan]

Dad, 89 years old with cancer got married a few years ago. This is his third wife. She has a progressive case of dementia. They are both on hospice. He initially said that he would take care of her but now he needs help too. She fell out of the bed last night. Thank god my sister-in-law was able to help my step mom back in bed.

She's taking Mirtazapine and Melatonin and we just added .5ml Lorazepam. Does anybody have experience helping dementia patients sleep through the night?

[OldMarriedMan · Accepted solution]

The doctor prescribed Ambien instead of Mirtazapine. They said we should not use the Lorazepam. We'll see how she does on the new medication. Thanks for your assistance. 😊

[JaneCares · Accepted solution]

She should not be on a benzo, aka, Lorazepam, as benzos are a short term solution and addictive. I'd ask her PCP, a geriatric psychiatrist, or even the pharmacist. Perhaps an antidepressant would help with confusion and therefore agitation. Ask the hospice medical director, come to think of it. 

[GailL1]

She is taking a lot of meds that will produce drowsiness -  melatonin is the only one that is specifically directed towards sleep- but it may not be the one for her.  Drowsiness is not a good match for people with dementia - especially the ones that have lots of anxiety too.   Since she is on hospice, she should have a hospice doctor that can evaluate her meds and the health problem they are suppose to help.  

[OldMarriedMan]

Thanks GailL1. I've been in contact with the hospice nurse who is in touch with the doctor. We'll see what they come back with. Just curious, why do you say drowsiness is not a good match for people with dementia? I heard that they could get up in the middle of the night and sleep walk. Are there other cautions?

[GailL1]

@OldMarriedMan 

Being drowsy and thus dizzy - a fall could occur.  

Her anxiety meds + the melatonin could create the drowsiness.  The doc maybe able to prescribe something better - all or some.  

[OldMarriedMan · Accepted solution]

The doctor prescribed Ambien instead of Mirtazapine. They said we should not use the Lorazepam. We'll see how she does on the new medication. Thanks for your assistance. 😊