Sleep disturbance 2
Just recently I came across a gentleman who in living with dementia and supported by his wife at home has been struggling with his sleep. Waking in the early hours 0330, 0400 in the summer is not too bad accompanied by the dawn chorus, but if it happens most days? And then in Winter: that is another matter.
Also fairly recently there are increasing instances of this man not being sure that the lady- who is in their / his house and is taking him shopping - is his wife. She looks like my wife...? She knows what to buy and then she pays for the shopping.
Who are you?
|Have the doctor consider|
prescribing a sleeping tablet
"Oh OK! Hello Sandra."
|Arrange a medical review|
This gent is up early anyway as there is a newspaper to collect which involves a walk. The problem is he leaves too early and is then outside waiting. His wife was struggling with all this so we discussed the need for a care review by the community mental health team. A sleep diary was provided to obtain some data upon which to base decisions. While I was in the garden with Mr. my student (thanks Katie) suggested to Mrs Y that this 'imposter' be passed as a friend. This has since proved very effective at reducing anxiety, social tension and distress.
Whilst we constantly strive for truth, honesty and respecting autonomy and dignity, sometimes sadly, 'truth' is compromised. It becomes less clear when it is being cognitively undermined.
We also want to maximise independence and support what are the usual daily activities of living: collecting the newspaper included. Risks were becoming evident however. So, Mrs Y came up with a strategic decision which has seen this gentleman adjust very quickly. Sleeping in until 8 o'clock is quite a surprise for the rest of the family to hear. And for us too. It is as if the (subscription) token for the newspaper was not only sitting waiting in a pocket or wallet. It also had slot in memory, where it had to be kept on constant refresh, whirring away; of such importance that it was proving quite disruptive introducing new risks, disturbing sleep. There are still many other activities and walks to be enjoyed. Nice call Mrs Y:
|Cancel the newspaper|