09: Sleep: Managing Nighttime Awakenings & Wandering

This program will:

  • Discuss reasons for nighttime awakenings
  • Present strategies for managing nighttime awakenings
  • Provide strategies for preventing and managing wandering
  • Strategies for improving home safety for wandering
  • There are no easy answer when its comes to the care of another
  • Our hope is to offer you useful information and guidelines for careing for someone with dementia
  • These guidelines will need to be adjusted to suit your own individual needs

Sleep issues associated with Alzheimer’s Disease

  • Spend more time awake at night and sleeping during the day
  • Wake up during the night to wander
  • Wake up confused, disoriented, frightened, or feeling alone
  • Delusions and hallucinations disrupt sleep patterns

Why was Robert unable to get to the bathroom?

  • A. He forgot where the bathroom was.
  • B. He got hungry and wanted to go to the store to buy some food.
  • C. He couldn’t remember why he got up.
  • D. He wasn’t sleepy and got bored.
  • E. He was distracted by the shoes.

Choice A: He forgot where the bathroom was, is a good answer.

  • Leave a clear, well-lit path from the bed to the toilet
  • Practice walking the path with the person before going to bed
  • Put up bathroom signs with arrows that point the way

Choice B: He got hungry and wanted to go to the store to buy some food, is a possibility.

  • Try giving the person a light snack sleep-promoting food before bedtime

Choice C: He couldn’t remember why he got up, is a possibility.

  • Reorient the person to the time of day
  • Check for toileting needs, discomfort, and pain
  • Post bathroom signs with arrows that point the way

Choice D: He wasn’t sleepy and got bored, is a possibility.

  • If someone won’t go back to sleep, try redirecting
  • Allow the person to wander in a dedicated, safe area

Choice E:

  • He hurt himself when he bumped into the furniture and got distracted , is a good answer.
  • Create a safe environment by removing clutter
  • Keep hallways and pathways as clear as possible
  • Provide enough light to prevent injuries

Mary’s Approach to Managing Robert’s Wandering

  • Changes in the environment
  • Sets out favorite comfort items
  • Installs nightlights to light the path
  • Moves bed away from windows
  • Removes unnecessary furniture
  • Dedicates the bedroom for sleeping and napping
      • Assess for confusion or discomfort
      • Use a calm tone of voice and body language to orient and reassure
      • Address any need or source of discomfort
      • If the person becomes combative, remain calm
      • Do not argue or try to reason with the person
      • Offer reassurance
      • If the person is frightened, offer to look around
      • Once the person has relaxed, approach the topic of going back to bed
      • Consult a physician if sleep patterns do not improve

Managing nighttime incontinence and toileting

        • Plan scheduled trips to the bathroom during the day
        • Reduce the intake of liquids just before bed
        • Use the bathroom before going to bed
        • Practice walking to the bathroom
        • Well-lit and unobstructed path to the bathroom
        • Nightlight in the bathroom
        • Label the bathroom door
        • Consider a bedside urinal or commode
        • Provide clothing that is easy to take off
        • Never leave someone in wet or soiled
        • clothing or diaper

Increasing Nighttime Home Safety

          • Keep areas free of clutter
          • Provide enough light
          • Make sure the path to the toilet is clear
          • Install hand railings and remove area rugs
          • Dedicate a space safe for wandering
          • Lock away hazardous chemicals
          • Use door locks, latches, bolts, and covers
          • Install window locks
          • Use door alarms, motion sensors, or bells
          • Do not leave shoes, keys, briefcases, or umbrellas by the door
          • Post door signs
          • Try to determine the reason for wandering
          • Make frequent checks for unmet needs before wandering starts
          • Identify sources of stress that may be triggers
          • Change daily routines that may be triggering the wandering
          • Consult a physician about medications
  • Dedicate safe areas free of clutter and other hazards
  • Provide a rummage drawer or chest
  • Comfortable, secure shoes
  • Watch closely and use cues
  • Have security measures in place on all exits
  • Provide medical bracelet or necklace
  • Make sure important information and numbers are always on the person
  • Consider placing a locator on the person
  • GPS (Global Positioning System) locator
  • RFID (Radio Frequency Identification) locator
  • Cellular locator
  • Consider a wanderer alert system
  • Consider enrolling person in the Safe Return® Program

Click here to learn about the Safe Return® program

  • Dementia can cause nighttime awakenings
  • Strategies for managing nighttime awakenings
  • Orient and reassure
  • Do not argue
  • Address any reasons
  • Prevent possible triggers
  • Distract or redirect
  • Consult a physician

Strategies for managing wandering

  • Address possible reasons and sources of stress
  • Change routines that may be triggering wandering
  • Dedicate safe areas for wandering
  • Home safety modifications
  • Remove hazards
  • Doorknob covers, locks, and door alarms
  • Medical bracelet/necklace
  • Wanderer alert system
  • Locator system
  • Alzheimer’s Safe Return ® program

Written by:
Catherine M. Harris, PhD, RNCS.
Mindy J. Kim-Miller, MD, PhD

Edited by:
Sasha Asdourian

www.LightBridgeHealthcare.com

08: Sleep: Promoting Healthy Sleep Patterns

Select the best answers from the list of choices following each question.
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Click here to open Certificate of Completion

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