- Introduction
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Caregiving
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- Coping with Memory Loss
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- Creating a Daily Routine
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- Health and Wellbeing of the Caregiver
- Home Safety Adjustments
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Q: alzheimer pt. (grandpa) has trouble sleeping @ nigh. Dr. put him on low dose serquel (15mg) @ night.? Isnt there a better choice? Im a nurse and disagree!
Hi T,
There are some good answers to your questions on the site, already. I support the idea that you may want to try for a second opinion. I do believe we have a right to question medications and their uses. But they aren't all bad, either. For some, Serquel is a good drug, for others it is not. Asking a second physician for options could help ease your mind. Anyway, it's good of you to be alert and to question. The doctor and you both want to find a solution. Good luck,
Carol
Hello. I'm not a physician, and so I would not wish to dispute a physician's advice unless I had a second opinion from another physician.
But your question interested me, because, as a nurse, you are probably aware of "sundown syndrome," and so you probably do understand that there are indeterminable physiological issues taking place with your grandpa that drugs might or might not assist.
My father (who suffered from vascular dementia, not Alzheimer's) developed very severe sundowners, coupled with paranoia, and he became very hard to handle, sometimes violent (unpredicatbly so).
I know nothing of the drug you mention, but if it is something meant to relax the patient, then perhaps it is not a bad thing?
Does your grandpa wander at night? Get agitated? Hallucinate about those around him (or no one around him)?
For a time, with my father, we used palliative things like warm milk, which soothed him. Sometimes we gave him ensure at night and told him it was a milkshake. Milk and a cookie might help him relax?
I think if you doubt the advice of your physician, it might be useful to seek a second opinion from a physician.
Best wishes with your grandpa. You are kind to want to find the best solutions for his issues. What a loving gesture.
CJ
Hi T,
My father-in-law has stage 6/7 Alzheimer's. He has never really had a bad time sleeping. Back home before he moved to this residential home, he slept right away. He knew sleeping was important and he would just close his eyes and sleep. But this does not mean he cannot hear what is going on in the house. He did get up in the middle of the night and the caregiver had to talk to him for a while until he went back to bed. Sometimes he was confused asking where is the baby? (not sure why he asked that.) Sometimes he refused to go to bed because he was very confused and wanted to get some problem solved. If we disturbed him in the evening by accident, he would stay up all night talking about his confusion and no one could reason with him and he gradually got tired and went to bed. In general he can sleep well if no one bothers him.
So maybe you need to find out what is bothering grandpa unless he is the person who cannot sleep sound. Some people do have trouble sleeping.
It depends on his problem. If there is some issue going on, you may want to solve the problem and distract him so he can go to bed. e.g., if he asks for cash all night... Giving him paper money or some small cash helps. (There was a time we put some cash in his pocket of his pants and he put his pants under the pillow!)
If he really cannot sleep, then this low dose of serquel may help. However, if he does not have psychiatric behaviors, he should not use this kind of pills. maybe you can try to do what I mentioned, or try to give him milk as CJ suggested. My FIL only takes drugs for depression, and he takes nothing for sleeping.
Hope this helps,
Nina
If you have concerns about medications and treatments, it is recommended that you bring these concerns up with the prescribing physician. In the case of prescribing atypical anti-psychotics, such as Seroquel, a discussion about the risks and benefits is definitely warranted. In the meantime, you may also wish to consider employing behavioral interventions. It might be helpful to assess your grandfather's daily and nightly routine. Consider adjusting his bedtime, perhaps allowing him to go to bed later which might help him to sleep in later. It is also advisable to have a wind-down routine for bedtime (such as a glass of warm milk, listening to soothing music, etc) and to limit stimulating activities and beverages (such as coffee or sodas) in the hours prior. Additionally, limit naps during the day so that when it is bedtime, he is more tired. Lastly, evaluate his daily activities, keeping in mind that staying active and engaged during the day will help promote proper sleep/wake cycles while also providing him with an improved quality of life.
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