Minimizing Sleep Disruptions
People with Alzheimer’s Disease often have trouble sleeping through the night. There are some things we as caregivers can do to encourage uninterrupted rest.

Bedtime routine
Much like getting your loved one ready for the day, it’s important to develop a bedtime routine. If they fall asleep after an episode of confusion or agitation, their chance of waking before morning is likely to increase. Routines are essential to minimizing stress, agitation, confusion and disorientation. A standard bedtime routine may include the basics such as a nutritious meal, medication maintenance, a change of clothes and a trip to the restroom. You may also want to include one of the following types of activities to personalize their routine:
• Watch an episode of their favorite TV show
• Read a book
• Tend to the needs of pets or small children they care about
• Enjoy a cup of caffeine-free tea or coffee
• Start/complete a crossword puzzle

When considering what to include, reflect on their lifelong traditions. They will likely enjoy adopting the same types of activities. Try to begin their routine about the same time every night.

A lack of activity during the day, could cause restlessness in the evening. It is important to incorporate exercise and activity throughout the day, being careful not to wear them out too early. Consider a daily exercise routine, outings or hobbies like gardening. Discourage naps, or limit them if you can.

Reassurance
Individuals with Alzheimer’s and dementia need constant reassurance throughout the day and nighttime is no exception. While some will insist on an independent trip to their bedroom, others may desire company. To respect their privacy and independence offer your assistance.

Before you turn the lights out, assure them that you are available if they need anything and that you will see them in the morning to minimize concerns that they will be left alone.

Cultivate a safe and comfortable environment
To create a comfortable environment, remember the five senses. Ensure they don’t go to bed hungry, for instance, by offering a light snack before bedtime.

Is it too loud in the next room? Its it too quiet? Consider turning down your television set and hush small children at play. Or if they prefer noise, offer soothing music to help them relax.

Are the blankets on the bed too heavy? Is it warm enough? Are their pajamas too confining? Observe your loved one’s reactions to their environment and try correcting the things that pose frustrations.
Make sure hallways and rooms are equipped with night lights to help navigate through the darkness. Complete darkness could increase the chances of falls or injuries, but it may also spark fear and confusion if they can’t see their surroundings.

Investing in a monitor will allow you to observe your loved one’s activities in the middle of the night. These devices can help to minimize the number of times you intervene and increase their chances of getting back to sleep. If you need to intervene, gently remind them that it’s not time to get up and help them back to bed. Again, confirm that they’re comfortable and reassure them that you will be there when they wake in the morning.

Medication & Doctor’s Visits
Though you may want to delay medication as long as possible, sometimes there are underlying issues that need temporary attention. An early visit to the doctor could reveal unforeseen issues that your loved one may not be able to communicate.

Disruptions in sleep patterns can be a result of a urinary tract infection, for instance. Medical attention could minimize, if not eliminate multiple sleep disruptions. A lack of sleep could also indicate necessary changes to current medications he/she may be taking. Involve the professionals in these decisions to encourage uninterrupted sleep.

Remember, there is no guarantee to get them to sleep through the night. But you will rest better, knowing you’ve done what you can by keeping these suggestions in mind. And once you find something that works, be flexible, knowing their preferences can change as the disease progresses.

Contributed by Leah Bigham

Many people affected by Alzheimer’s Disease have a tendency to wander. Though it is common behavior, it can cause high levels of stress and fear for caregivers. Wandering isn’t always harmful, but it can be if your loved one is prone to leave. Here are some tips to help ease your fears and minimize the dangers of wandering.

Safety First
The most important thing is your loved one’s safety. While it may sound obvious, caregivers should never leave someone affected by the disease alone. You may think that your loved one is independent enough to care for themselves for a few minutes while you make a “quick trip” to the store. Despite their capabilities, though, your absence could spark an episode of agitation.

Confusion, frustration and boredom are known to prompt wandering behaviors. In your absence, your loved one could become confused and may even fear for your safety. They could get frustrated for being left alone, or simply get bored.

It is not burdensome to depend on your closest friends and family for help when you need to leave. If you don’t have friends or family available for this type of help, familiarize yourself with the community day programs and services that are available to help.

Remove trip hazards and install night lights so as to avoid any falls in the night. Keep dangerous items out of the reach of your loved one and consider childproofing doors and cabinets in your home.

Redirection
Wandering can often be a sign of an unmet basic need such as hunger, body temperature or the need to use the restroom. Keeping your loved one occupied and content is one of the best ways to keep them from wandering. If you observe excessive fidgeting or agitation, consider what basic need must be met.

If, on the other hand, they become bored, confused, or frustrated, you will have to be more creative in finding something to appease them. Knowing what keeps your loved one content can reduce their instinct to elope. Knowing their dislikes will be imperative for avoiding escalation.
Capitalize on their likes by offering to do things they enjoy, such as turning on a sports program or their favorite music. The activity may distract your loved one from whatever agitated them in the first place.

If they have a common escape route, try strategically placing points of interest that can be used as deterrents along the way. Old pictures, for instance, may serve as a distraction. Pointing out these points of interest may engage your loved one in such a way that they forget why they were trying to leave in the first place. Food, books, and other attachment items may also prove to be simple but effective strategies.

If your loved one does elope, it may be your first instinct to tell them they need to return home. Under stress, your tone may even be on the demanding side. They are likely to resist any such requests. You can honor their independence by simply diverting their attention to conversation. “What a great idea to go on a walk today, mom! The weather is perfect, isn’t it?” Simply walk and engage in conversation. As you talk, gently and casually redirect the “walk” back to the house. Consider taking an abnormal route back inside, such as through the back door.

Making your home as wander-friendly as possible could prevent your loved one from ever leaving. Its not necessary to discourage their need to wander, but rather to maintain their safety as they do.
Contributed by Leah Bigham.