Most families care for their loved ones with dementia or Alzheimers at home as long as they possibly can. The two most common reasons people call me to help find memory care for a spouse or parent is because their loved one begins to wander (wandering at night is particularly problematic) or they become too taxing physically to care for (putting the caregiving spouse or child at risk of a fall or injury). Last year, I worked with a wife in her early eighties who had taken such good care of her husband for four years at home, but said she had not slept through the night in over two years.
Placing someone in a memory care community comes with its own problems—the most pressing one being the expense. In this region, private pay memory care costs from $4,500 up to over $9,000/month, depending on the care needs; in other words, that’s from $54,000/year on the low end up to over $108,000 on the high end. And if the average length of time a person with Alzheimers lives after diagnosis is eight to ten years, that’s an unfathomable cost.
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How does a spouse or child extend the amount of time they can safely care for a loved one at home who wanders at night?
Not long ago, my parents introduced me to Jim Walters, a maverick in the sense that, though he is 73 years old, he continues finding tools to manage his wife’s care needs as they arise. While he has sent me numerous tools for different phases of his wife’s illness, in this article we’ll concentrate on those that can help with one of the most challenging behaviors: night-time wakefulness and wandering.
- To prevent wandering out of the house while a caregiver sleeps, he has installed special combination locks for all the doors that lead outside. (I have seen other families use door alarms, as well as sliding bolts placed very high or low on the door such that the spouse or parent with dementia cannot undo it).
- Jim has installed a bed pad and remote chime. I have seen this model (Smart Caregiver Cordless bed monitoring system, on Amazon for $119) used successfully in several local family care homes. What is important is to make sure whatever you choose doesn’t ring in the person’s bedroom, as they go to sleep after sitting up without intervention– unless a chime in the room wakes them fully up.
- Jim uses a video camera in his wife’s bedroom in order to see why the remote chime has gone off and whether she resettles herself or whether she needs help. (PowCube 2.4 inch Wireless Video Baby Monitor Night Vision, $70 on Amazon)
- Jim and families in a support group at Dementia Alliance both recommend a weighted blanket to reduce agitation in bed. (There are a number of options on Amazon ranging in price from $79 to $159).
- Several nurses who work in secure memory care units also suggest a white noise machine, as well as aromatherapy with a calming oil like lavender.
- The nurses recommend limiting water during the two hours before bed, as well as intentionally have your loved one use the toilet right before bed.
- High quality night-time diapers can also help a loved one sleep through the night. One brand several families at Dementia Alliance recommend is Tena.
- Some physicians recommend Midnite Sleep Aid, which is over-the-counter. Belsomra is one of the only prescription sleep aides that is not associated with falls. In either case, if middle-of-the-night wakings are common, speak with your loved one’s doctor.
- Finally, to help avoid a fall, families might install motion detector lights near the bed.
If you know of other tested tools, please email me and I will add them to this post.