I'll never forget Hazel. She lived at Rosewood when my uncle was there, and was still there when my dad, mom and mother-in-law, one at a time, became residents. Hazel would often sleep during the day, but at night she would walk. And walk. And walk. Hazel literally must have walked thousands of miles thorough the years, and a lot of those miles were put on at night.
She'd walk up and down the halls, then stop and sigh, "I'm soooo tired." The staff, and even family members like me, would say, "Of course you're tired, Hazel. Why don't you sit and rest?"
Hazel would sit for maybe a minute and then say, "But I have to go." And on she'd go, walking until she was ready to drop. She walked during the day in her early years, but that switch to nighttime. I don't know what a person trying to care for Hazel in a family home would do.
Many people with Alzheimer's are nocturnal. Sometimes it's just that they fall asleep during the day, maybe just from being bored, and then they aren't tired. But sometimes, as with Hazel in her later years, something else is driving them.
The New York Times recently ran a story about a night care program at Hebrew Home which Doran Martin mentions in her post on wandering. The idea for night care is a natural outgrowth of the adult day care (I prefer day services, but not everyone identifies with that) movement.
Adult day care took a long time to really get rolling, but now it's proven to be a very good idea, and many caregivers use it so the caregiver can get out to do errands, go to work, or just have time alone. Night care will fill the same role except for many it may be, for some people, more practical.
When an elder has what is called sundowners (they get agitated and active toward the end of the day), a night program to look forward to could be very useful. One theory of sundowners is that people are agitated as they feel they have to "do something" at that time of day, and they don't know what it is. Imagine being able to say when you see this restlessness, "Let's get you ready for the bus, Dad. They are coming to pick you up for your volunteer work."
This would be a great way to channel Dad's agitation into something where he feels needed and useful. Get him ready, the bus picks him up (or you drop him off) at night care, and Dad can wear off his energy by interacting with peers. He can enjoy music and take part in programs that he may sleep through during the day. And you can get some time alone and a good night's sleep.
Then, when Dad's night care is done, you will be fresh yourself to care for him during the day, rather than having to drag yourself out of bed, still exhausted, because he was up and down all night. Will he sleep all day? That will depend on what he did at night care. But many older people, with or without dementia, have a hard time sleeping for long periods and find naps better suit them. So, you may have Dad sleeping some during the day, but he'll likely be awake quite a bit, as well. You'll be able to interact with him, but you'll also have a more relaxed day.
Thankfully, at Rosewood, Hazel was in very good hands. The staff understood her nocturnal habits and let her cruise the hallway all night if she needed to do that. That would have been hard to handle at home.
I'm excited about the idea of night care becoming one more option for caregivers to give quality care to those they love. The programs can't grow too fast, because there's no doubt that the need it there.
Published On: June 24, 2009