My husband typically sleeps half the night on a chair and then comes to bed about 2 am. recently he falls asleep sitting or even standing and falls over. It's not too bad if he falls on to the bed as I can lift his legs on to a stool to keep him comfy. Sometimes he slips on to the floor or even on to his hands and knees. He has arthritic knees and always struggled to get up but now he just can't work out how to do it. One time he was talking to himself in the bathroom mirror, fell asleep, fell over and bruised his back on the toilet pan. I am lucky I have a young man who stays downstairs who will come and help me lift him in the night but I dread he breaks something and has to go to hospital. We live in Fiji, the hospitals are not used to dealing with dementia patients and there are no services. I try very hard to get my husband to bed at a normal time but he absolutely wont. I try to get him to lie down but he is very willful and wont do anything until he's ready. I am not sure if there is anything I can do but would appreciate any suggestions. He takes valium irregularly at night to help him sleep. I don't give it regularly as I've read it's harmful
could be the valium staying in his system and contributing. I would try not giving it to him at all if it is just for sleeping. Have you tried melatonin? Have you spoken to his doctor about it? I was reading common side effects of valium which include: tremors, muscle weakness, loss of coordination, and seizures - all of which could contribute to him falling or even fall asleep while standing.
when he falls, if no one is available and he is not hurt, I would just make him comfortable on the floor - give him a pillow and cover him with a blanket until you can get help with him. Maybe a chair that he can sleep in but can't get out of without help.
I'm a little surprised that he's been prescribed Valium. More typically it would be Ativan, and if that wasn't helping to settle him down, there are other sleeping medications they would try one by one to see which gave the desired effect. (If we're going to start talking about meds, I do have a question: Does Fiji use the British formulary, or are your drug names the same as in the States?)
You may already have things like nightlights, grab bars, and possibly carpets on the floor to make it a little softer if he falls. (I know in the Northern Marianas..where I used to live on Guam...some houses are built of concrete because of the typhoons, and those concrete floors are really hard.) As Charlotte said, maybe a comfortable reclining chair for him to fall asleep in...maybe you would get lucky and he would fall asleep and just stay there all night. Does he try to get himself to the bathroom, or can you put him in some kind of incontinent underwear that he might sleep in all night?
Other than the above thoughts, I agree with Charlotte's advice.
Forgot to ask if he has had a complete neurology consult. Can you have that done on Fiji?
I have just been trying to quickly research health care and Alzheimers on Fiji. There is an Alzheimers Association of Fiji online, but the site doesn't seem to be working. Are you near the bigger hospitals, or are you out on the more distant islands?
And am I correct that you do not have the ties with New Zealand to be able to access any help from there? If you need more help than you can get on Fiji, where do they air-evacuate you to? (For instance, if Guam couldn't handle a case at Guam Memorial, they would send the patient out to Queens Hospital on Hawaii. Do you have any access to a major medical center anywhere else that might be able to provide more help than the Fijian hospitals? Is it Guam, by any chance? (I remember as a nurse down at Guam Memorial Hospital we received a tuna fisherman who was injured off of Fiji.)
I'm wondering about the social culture of Fiji, too. Would it be the norm for you to expect a good deal of help from family, as would be the case on Guam? Do you have a support system for yourself other than the one person downstairs? Would it be possible to find someone to supervise him at night...maybe a paid aide....so you could have the peace of mind that you could get some sleep. How often is he falling? And in Fiji, will his health insurance pay for an aide?
I apologize if I am asking a lot of stupid questions. I don't know much about Fiji, but unfortunately I know more than I want to know about Alzheimers. Sigh. One thing I do know for sure is that if you can plan in advance as much as possible and pull your resources together early, you will be in better shape for taking care of him when he gets worse. And for taking care of yourself, too.
Does he actually have a physician, or is he being followed by a medical officer?
Great suggestions and questions from others. As an RN, my first thought juliedewa was wondering if your husband is having seizures as well. Very common cause of suddenly falling while standing up. Other things can cause this of course but a pattern is happening here which made me think of seizures.