Safe sleep aid for alzhiemer/dementia residents

Specialties Geriatric

Published

Could you all give me some examples of Sleep aids you use at your facility to help your resident's rest/sleep when all other interventions do not work.

ex. We have a Portuguese speaking dementia resident who sundowns and starts to wander in out of other residents rooms "looking for her husband" when there is no Portuguese speaking CNA on, she is very difficult to redirect. We have tried many non-pharmacologic interventions that are not working. she wanders around sometimes till 12am-1am, waking up the other residents and getting them upset.

The House MD at our place seems to have a liken to Trazodone. This is what he ordered for her. (which isn't working)

Isn't Trazodone an antidepressant? maybe drowsiness a side effect but not what it should be used for.

I would love some input from experienced Nurses who work with Dementia patients. What are some successful interventions you have used.

And Is there a safe sleeping aid for elderly as a last resort?

Thank you,

Bea

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At the Geri-psych unit I used to work on (mostly Alzheimer's dementia patients) the only sleep aid we used was trazodone. 50-100mg at HS, may repeat x1 before 0300.

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What dose of Trazodone? It works good for many of my people but many people need a higher dose, like 100 mg. I think it is labeled for "depression with insomnia." Also I see Ativan used (0.5 mg) and Benadryl.

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I agree with the last post. Trazadone is what I used as well. However depending on the fragility of the pt...I could only administer 25mg for one pt in particular...50-100mg is the usual.

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Why is using Trazadone as a sleeping pill a bad thing? Medications have multiple uses.

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Specializes in Gerontology, Med surg, Home Health.

Benadryl is on the Beer's list and shouldn't be used in the elderly. Melatonin is a joke. Trazodone works well for most people. Try to establish a nighttime routine. We had one guy who would be up all night. The doc gave him Zyprexa. We finally called his wife and she said for the 55 years they'd been married, he'd be up all night. When he got dementia that didn't change. She would just leave snacks around the house for him. So we took him off the Zyprexa, put snacks around the unit and let him walk around all he wanted. He'd sleep during the day and be up all night. No behaviors at all.

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Thanks for the answers so far, I am surprised to learn that Trazodone is used more than I thought.

The issue isn't just the wandering, in fact I don't mind the fact that she is up and walkig around, cause he is safe and not a fall risk, However, she gets awfully loud at this time (11pm-12am) she is wandering in and out of rooms waking sleeping residents up lookin for Mario, and she is upset that she cannot find him. I want to find a way to redirect and put her at ease.

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Benadryl is on the Beer's list and shouldn't be used in the elderly. Melatonin is a joke. Trazodone works well for most people. Try to establish a nighttime routine. We had one guy who would be up all night. The doc gave him Zyprexa. We finally called his wife and she said for the 55 years they'd been married he'd be up all night. When he got dementia that didn't change. She would just leave snacks around the house for him. So we took him off the Zyprexa, put snacks around the unit and let him walk around all he wanted. He'd sleep during the day and be up all night. No behaviors at all.[/quote']

Did not know it was on the BEERs list - thanks CCM!

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Ask your Portuguese staff for advice. What are they saying to her? How are they soothing her? Can you learn some basics in Portuguese? Make a book with some translated words and phrases. Put basic pictures in like a communication board.

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My problem with your request is that you are looking for a chemical restraint. Think long and hard before doing that - or at east, don't post about it on a message board.

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"My problem with your request is that you are looking for a chemical restraint. Think long and hard before doing that - or at east, don't post about it on a message board"

@SuesquatchRN

In My original post, I asked about Sleep Aids because the woman was already put on one at this point and I was questioning WHY Trazodone was used. I was questioning OUR MD's choice and wanted to know what other's peoples experience/opinion on this medication was.

I am a fairly new nurse and still learning. I have only been in this facility and often ask how other facility deal with situations.

I am NOT for sleep aids for the elderly, without trying all other interventions. Which is why I also asked "What are other sucessfull interventions you have used."

I went into LTC because I don't think there are enough good Nurses that care about the elderly and thier care. But I LOVE it, and am proud to be a part of what ever time they have left and I believe they deserve the best of care til the very end.

If anyone else has any advice that would help, I appreciate it.

Bea

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Way to go beatrice1- I too was SHOCKED at the post "think long and hard before doing that- or at least, don't post about it on message board" are you kidding me??? This IS the place to ask for advice anonymously! It is a typical "nurses eat their young" attitude

While I understand the issues with chemical restraints, sometimes I have to weigh the options and having about 30 patients to look after is no easy task when you are short staffed, not to mention the patient walking into other residents rooms, after all the other residents deserve their privacy too. It's their home too!

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