Good Night

As morning problems have to do with getting started, the evening challenge is to wind up the day and get some sleep. Fatigue adds stress in any situation. In an Alzheimer’s household, fatigue can make evenings seem unbearably long.

Dad and I are exhausted, but we can’t rest til Mom is safely in bed.

Mom is tired, but she doesn’t understand how to “fix” that feeling, and is in no mood to cooperate when we try to help her.

Seems we’re all trapped in the dark.

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I concentrate on five strategies to get us all unstuck and tucked in:

1)  Don’t argue with Mom. Agree with her version of reality.

2)  Use actions, not words, to calm her anxieties.

3)  If she refuses to go to bed, be ready to back off and try again.

4)  Old behaviors and routines can help Mom cooperate.

5)  Talk works well as a distraction when I’m maneuvering Mom in a direction she doesn’t want to go.

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 These strategies take time, but they work.

Arguing with Mom—or any Alzheimer’s patient—is worse than pointless. Trying to convince her of what is clear and reasonable to me only increases her frustration and confusion. So when she says she’s afraid a fire might destroy the house during the night, I do not try to convince her that the house is safe. Instead, I agree that a fire in the night would be a problem. Then…

…I take action. Instead of relying on words to convince her the house is safe, I walk through it, every room, “checking it.” Mom sees that I take her fear seriously. Watching me act on her reality helps her accept my words.

If Mom refuses my first suggestion of bedtime, I have two choices. I can use physical strength to make her cooperate, or I can back off and try again later. As I pointed out in the previous post, I always do the latter. For one thing, trying to force Mom to do something would likely get one or both of us hurt. And Mom still wouldn’t be in bed. Waiting a few minutes gives Mom time to forget my earlier request and her earlier refusal. I ask her again, as if for the first time. Sometimes she says yes in relatively short order. But if not, I don’t ask any more. I move on to the next strategy.

Old behaviors and routines can help your loved one cooperate. If you remember a habit your loved one used to engage in, use it to accomplish what needs to be done. For example: my mother used to love to share trivial information with me or my sister that she pointedly refused to tell my father. She enjoyed feeling she knew things he didn’t know. So some evenings when she doesn’t want to go to bed, I coax her into the bathroom on the pretense of telling her something important. I whisper that “Daddy doesn’t need to know this; this is just for you and me.” I’m not sure she understands, but clearly something in her mind reacts to my drama of secrecy, and she accompanies me to the bathroom. Once there, I just talk girl talk – what I should wear to a non-existent party, who’s dating whom in Hollywood – it doesn’t matter as long I keep whispering and giggling. All through the difficult clean-up jobs, the persuasion to change her clothes from the skin out, the washing of hands and face – girl talk.

Talk has another useful purpose. In the evening or at any time of day when you must persuade your loved one to move in a certain direction, non-stop talk can be the distraction you need. In the evening, for example, whether during the trip to the bathroom or from the bathroom to the bed, I could take Mom’s arm and maneuver her with the bulk of my body. If she was inclined to resist, I’d start talking, laughing, asking questions. The non-stop chatter drew her attention away from where we going, and by the time we got there, she had usually forgotten she didn’t want to go.

Finally, the one strategy that applies across the board in caregiving bears repeating here. We must believe. Believe that the day can end sweetly, sleep will come, rest will refresh us all, and – whether through the night or in the light of day – we are never alone. Knowing and believing give us strength, energy, and compassion to pass along to our loved ones. They keep us moving forward.

When we’re tired, Lord, it’s not easy to remember You’re with us. At those times, remind us, please, of evenings in the past when You turned stress to calm and fatigue to peaceful sleep. Those memories give us strength in the present and confidence for the future.

“Come to me, all you who are weary and burdened, and I will give you rest.”

(Matthew 11:28.NIV)