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She is at home with us and nightime becomes more demanding because of falls. She uses the toilet maybe 4 times at night even though we give her water mainly during the morning until mid-day.

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How "creative" can a caregiver be in the middle of the night when trying to get some well needed sleep? While the elder is up all night urinating, wandering around, or suffering from insomnia or a reversed circadian rhythm due to dementia? This is one of THE biggest issues caregivers face with in home care. Mobility issues are another form of difficulty bc falls and wheelchairs create more headaches and heartaches inside homes that are not handicap accessible as facilities are.

My mother had to move into Memory Care Assisted Living when her dementia, mobility issues and incontinence reached the point where regular AL could no longer manage her needs effectively. I certainly couldn't at home......her wheelchair wouldn't even fit inside one of my bathrooms. MC did a fine job caring for and managing all of her myriad needs and I slept at night and kept my marriage intact at the same time.

You can dress mom in an overnight Depends with an extra pad and not get her up to use the toilet at all......but once at 4 or 5 am for a brief change. That's what is normally done in managed care so the elder can sleep well, and so can you.

If theres an issue with using a brief, you may want to hire a nighttime caregiver at home or look into placement when exhaustion takes over. I wish you the best of luck with all of this. I know how hard it can be to deal with, and you have my sympathy.
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AliOJ58 Jun 2023
Can’t do it alone! Need 24/7/365 and ideally 2 people so one can sleep
and live in between. One friend let’s three people juggle the scheudule between them for a while -
livein is essential here as well as family!
my sisters in law managed FIL as a tag team for several years -
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I've got my 96 year old mother living with me for the past 6 years.

A bed alarm has been a lifesaver for me. When my mother raises her shoulders off the bed, it wakes me up so I can get to her.

I carry that annoying monitor around with me everywhere - while cutting grass, while sleeping, wherever I go when she is in the bed.

https://www.amazon.com/Smart-Caregiver-Wireless-Alarm-System/dp/B07RCYD69T/ref=sr_1_1_sspa?keywords=smart+caregiver+wireless+bed+alarm&qid=1688036139&sr=8-1-spons&ufe=app_do%3Aamzn1.fos.f5122f16-c3e8-4386-bf32-63e904010ad0&sp_csd=d2lkZ2V0TmFtZT1zcF9hdGY&psc=1

I also put a rectangular pillow - about 36" x 6" - along the side of the bed that makes it a bit more difficult for her to crawl over, thus slowing her down and giving me time to get to her. I will sometimes back a chair up to the side of the bed to slow her down as well.

In addition to that, I put her walker out of reach.

Of course, I have to wake up suddenly or drop what I'm going and gallop up to the bedroom but it at least gives me some freedom.

I also use this baby monitor but it's not as vital as the bed alarm.

https://www.amazon.com/gp/product/B08CZLWGNC/ref=ppx_yo_dt_b_search_asin_title?ie=UTF8&psc=1

Aaand... I have this camera in her bedroom. It enables me to go a little bit farther away than the other two monitors, so I can walk up and down my street in the evenings for my "decompression walk" when she has gone to sleep and still keep watch on her. (Maybe that's living dangerously, but it's more dangerous for me to neglect my health.)

https://www.amazon.com/gp/product/B0B28H2DFZ/ref=ppx_yo_dt_b_search_asin_title?ie=UTF8&psc=1

During the day, she is out of bed from 11:30 am until 5:30 on average. I put her in the kitchen in a comfy chair and she eats and drinks and sits there and yells my name incessantly. She doesn't always like it and wants to go lie down but it's the best solution to tiring her out when she is so sedentary.

The last thing I do before bedtime is give her one CBD gummy to calm her. She is not on any pharmaceuticals and I'm holding off on those until things get unmanageable. She is under Hospice care and they are constantly pushing Ativan. If I give her Ativan, it would be for me and not her which I'm not okay with as of now.

I don't know how creative those things are, but they have made caring for my mother at least somewhat bearable.
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RedVanAnnie Jun 2023
You have some helpful strategies in place. It's still a lot of work and constant vigilance on your part, but congratulations on figuring out some useful ways of coping.
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I don't know how creative it is, but as soon as Mom's hospital team told me she would need 24-hour care, a NH was the only answer.
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What you are describing is a person who needs 24/7 care in a facility where there's always someone on duty to help her.

A serious concern is that she may not be getting enough water to stay properly hydrated. I know what you're going through, and I understand why you're mainly giving her water in morning and until midday. It's not working, though - she still has to get up at night. And if she becomes dehydrated with your method, you've got an even worse problem. Dehydration is very serious in elders.

It can cause dizziness (another fall?). Muscle cramps (another fall?), headache, low blood pressure (another fall?), heart and kidney issues, clots, UTIs, delirium, the list goes on and on - even including death.

A care facility would know this and recognize signs that you won't. The truth is that you can no longer take care of her at home because you don't have the skills for it. That's not your fault, and I wish you luck. I hope you can find a place where she'll get the care she needs.
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I have been on AC for a bit over four years. I have not seen creative answers to 24/7 caregiving. What I have seen falls more within the realm of survival. I will follow this thread to see who is out there doing 24/7 creatively.
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I wish you luck in how you handle this at home . There is no real creativity to the night time problems you describe , other than a super absorbent overnight adult sized incontinence product , if/when she becomes incontinent .

She will be getting up for now . I also am concerned about dehydration . Does she urinate a lot in a “ go”, or frequent small amounts . Have you had her checked for UTI ? I don’t have an answer other than a night time aide, that may be problematic getting steady help .

The real creativity comes in when you are executing a plan to get her into a care facility . We can help with those questions as well . I hope you have POA is place .
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WhackP Jun 2023
Thank you, when we monitor her water, she still get another 3 cups but yes that isn’t working either. So back to the drawing board…
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I have nothing to offer from a creative basis, I would place her in a home where she could get 24/7 care as her dementia will only get worse and your life will as well the longer you care for her at home.
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How come nobody has suggested a bedside commode?
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WhackP Jun 2023
She does have a bedside commode but her dementia doesn’t help … sometimes she will pee in her bed, or on the way to the commode …
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I’m not sure what you are asking.

This is what elder care is once you move the person into your house. The only thing you can do is hire a night nurse for help.
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Fawnby Jun 2023
Well, there is another option - a facility where the patient has a care team 24/7.

I've done the night nurse route. It's difficult because there's always some issue going on and it disturbs everyone else in the house.

We had wonderful in-home help, but I'd never do it again. One night I woke up to kitchen smells I can't describe. The caregiver was from a different culture, and she was cooking her dinner at 3 a.m. It might have been fried iguana. I didn't complain because she was a fine caregiver, but I could smell it in my upstairs room for days.
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it takes a village. And a long term care plan.
we are trying to abide by moms desire to age in place in her home. mom is 90+ agile and strong with early - moderate ALZ and otherwise healthy. She worked until 2 years ago in a “part time hobby job” (med tech) after retiring from county service.
She has LTC insurance for in home care which we started using in March ‘23 We are working toward 24/7 coverage - paid family member cares for her m-f 9a-7p and a hired caregiver stays from Friday night to Monday am. she has small children mom loves when they visit. The younger one will spend the weekend. (mom loves having young people around and coloring with them.)
M-F evenings a family member is available as needed. she gets up 1-2 times at night and is able to get to and from BR. We will soon need ON person M-F
We have ties to area universities and have identified potential student to live in rent free as a backup for safety monitoring. (Mom has had students from the college she worked at live in for companionship after Dad died).
we have a contract with a staffing agency identified through this website that can place folks as needed for backup or permanent.
Mom has had a home security system since dad passed that we enhanced with door bell and in home cameras that alerts us on our phones to motion and cameras detect sound. Throughout the house - door open / door closed alerts, door bell camera, kitchen, bedroom, den cameras - more cameras can be added for $150-200 each. We can speak to the cameras from our phones. (Ie when she leaves phone off the hook). She usually remembers to put in her hearing aids - and charge them! (new ones don’t need batteries -rah). Meals and pills are administered by caregivers - but mom take them from a small glass next to her plate at breakfast and dinner.
we are 3 adult children (bro, me and hubby in our 60s) living nearby - mom is 90+.
Hubby and I took 5 day vacation a 5 hour drive away with bro covering.

Mom lives in a close knit community with a dear friend on the same ten home deadend street receiving in home care 24/7. She cultivated close relationships with neighbors and others that are like family over the years. Her “sister”visits weekly, former neighbors take her out 2x monthly. one neighbor takes out her trash another is in law enforcement and keeps watch…. His wife and children visit mom. Tonite she’s going to dinner with dear friend and her aid will make sure she gets home.

we see her often (not as often as she’d like but I’m still working as a consultant) and my brother works most days out of an office in her basement.
our lawyer has options for continuity through trust.
this takes foresight, long term planning and a village of care. You can’t be the backup and the plan - and I recommend a backup to your backup plan.

We also have lots of experience - when we were first married, I worked in senior center, hubby and I lived in the second floor of 2 family and helped my grandmother care for gramps.
He also had a pt nurse. When he passed we continued to live above gram her into her mid-90s -(we paid the oil bill) she had Medicare home Care M-F days. (No longer exists as a benefit) We used a baby monitor at night.
After 12 years, we were able to afford a down payment and moved to our own place. Gram moved in with mom. Mom and dad had already taken care of MIL when I was a teen - hiring livein caregiver. Her children are like family to us.
mom always had live-in caregiver and other supports for both her mom and MIL and for Dad ( that was a much longer and painful journey).
Mom got the LTC insurance and set up financial accounts so she could have needed care in her own home and not move in with us.
Get help. There’s hope and your need a plan. Then taking this one day at a time. It’s all you get anyway.
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WhackP Jun 2023
I must say “i am impressed by the village” for sure … it sure could be helpful here for us :(
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