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Identifying Suitable Activities for an Elder with Alzheimer's

by Carole Larkin, Alzheimer's & Dementia Expert
September 22, 2011

Question: My husband who has Alzheimer’s, insists on going to bed all day. No matter what activities I provide he refuses. What should I do?

Answer:

Is your husband sleeping all day because he is up all night? If so, he is exhibiting what is called day/ night transference. That behavior is not terribly unusual for people who have a form of dementia. Simply, because time has no real meaning to them, day and night get all jumbled up. To reverse this time reversal without sleeping medications takes time and patience but can be done. Essentially you will slowly be changing the person’s internal circadian clock back to the same as everyone else’s. You do that by keeping him up an hour longer during the day. For example, if he normally goes to bed at 8:00 am, start by keeping him up until 9:00 am. When that becomes part of his pattern, then keep him up until 10:00 am and so forth. If you are really ambitious, try keeping him up two hours more at a time. That way you get his clock changed faster. It sounds exhausting I know; but aren’t you already exhausted from the way it is now?

If it’s not day/night transference then you’ll need to be a detective to figure out what really is behind all this sleeping. Could it be the combination or side effects of a medication or combination of medications he is currently on? Many medications can cause drowsiness. Ask his doctor or your pharmacist. Perhaps the medication can be switched to another that does not cause drowsiness or lessens the effects of drowsiness. Maybe he could get by on a lower dose. Maybe he could take it in a different manner, like taking one half of it in the morning and one half of it at night. Maybe he is depressed. It is not unusual for people with a dementia to also have depression. If it is depression, there are medicines that do work on that disease. Have you had his thyroid checked? If he has a dysfunctioning thyroid, (hypothyroidism) many times people become sluggish, tired and even weak. These are all things you should discuss with his doctor.

Finally, maybe you are not offering the right kind of activities that appeal to him, in particular. To motivate him to participate he needs to feel that he was the one who came up with the idea to do the activity. If he was a golfer, instead of parking him in front of the TV to watch the golf channel, try saying to him, would you help me with my swing or my putting stroke? Then take him to a driving range or to a park or public course with a putting green and let him “teach “you to drive or put. Perhaps his interest is in classic cars, there are classic car shows occasionally. Maybe a friend has a classic car. You could take him to visit it and tell you about it, often. It may be new to him every time. At a minimum you could buy a book about classic cars, or get one from a local library and go through some pages of it with him. The object is for you to participate in these activities with him, not leave him by himself to look at the book alone. He’ll surely doze off without the stimulation of you being there and talking about things with him. If his ability to speak is impaired, you still need to be with him, so he can listen to you speak. Even listening uses brain cells. My point is, be creative, in looking to appeal to his current or past interests. He has lost the ability to be motivated to find something he likes to do. You’ll need to put in front of him those things and be with him while doing those things. Optimal would be if you can do two activities in the morning and two activities during the afternoon and perhaps one after supper;. More reasonable is one activity in each part of the day. If that means your kids come over to do the laundry for you, or your friends, close neighbors or church members cook a meal for you both once or twice a week so you have the time available to do things with him, then ask them. They really WANT to help. They just don’t know how. Ask for specific tasks to be done so you can spend time with him. You know, time with him is the only thing that you’ll never be able to make up.

I  like the following for activity ideas:

The Best Friends Book(s) of Alzheimer’s Activities by Bell, Troxel, Cox and Hamon

The Alzheimer’s Activities Guide from Forest Pharmaceuticals (email or call the company)

The Alzheimer’s Activities Book by B.J. FitzRay from the Alzheimer’s Store http://alzstore.com/Alzheimers/alzheimers-activities-book.htm

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Carole Larkin MA, CMC, CAEd, QDCS, EICS is a geriatric care manager who specializes in helping families with Alzheimer’s and related dementias issues. She also trains caregivers in home care companies, assisted livings, memory care communities, and nursing homes in dementia specific techniques for best care of dementia sufferers. Her company, ThirdAge Services LLC, is located in Dallas, TX.

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