Sleeping through meals - advice please

Brogues

Registered User
Apr 13, 2014
150
0
Hi there

It is time to review mum's care plans and look at her end of life care - recently they just tired to withdraw mums Respiridone stating she was sleeping through her meals and starting to loose weight ( she gained 10kg when she was put on it)

The reduction of her meds was a disaster she spend nights screaming and ripping at her pads it was terrible to see her exhausted from no sleep the night before

I will be honest I'm angry at the care home decision as they did not include me I would have cautioned as mums behavior had been so bad i would have said please be very careful

anyway

the reson the nurse said she had changed it was.......................mum was sleeping through meals and was begining to loose weight

sorry but isnt that a progression

my main question is when i said this she accused me of wanting htem to neglect mum

how is letting the disease progress and allowing my mum to peacefully sleep her way out of this suffering not in her best interests?

I'm wanting to ask they leave her to sleep if she doesn't want to eat, the run up to where we find ourselves now has been extremely difficult with her paranoia and obsession with a pretend husband'

Can I ask she be allowed to sleep through meal times?

Isnt inner peace a much better goal that mantaining a dying persons weight?

Any advice greatly appreciated xx
 

Witzend

Registered User
Aug 29, 2007
4,283
0
SW London
Can I ask she be allowed to sleep through meal times?

Isnt inner peace a much better goal that mantaining a dying persons weight?

Any advice greatly appreciated xx

I would want the same as you in such circs. But I think 'duty of care' can sometimes = 'duty to keep alive at all costs no matter how pitiful a state the person is in'. Whether it is at all kind, or in the person's best interests is IMO the question. But there is no doubt that some relatives DO want everything possible done to keep someone going, no matter what, and become angry/upset if anyone suggests otherwise.

I would certainly make my wishes known to the CH, and would also suggest discussing it with her GP - insist if necessary - and ask whether this is truly in your mum's best interests at this stage.
 

Spamar

Registered User
Oct 5, 2013
7,723
0
Suffolk
OH doesn't sleep through meals but he does want to go to bed immediately, or after the main course. He has a fairly small appetite so meals are not huge affairs, but, if he has a day at home he wants to go to bed mid- afternoon. If he's been to daycare, he's usually in bed within an hour of getting home.
I don't think it's tablets, there has been no additions for over a year.
Gp reckons it's age (81), not sure I agree. More like the beginning of the end (which, of course, might last several years). I don't really know.

However, he's at home and can eat when he wishes. If someone is in a care home and is sleepy at mealtimes can he not have treats when he is awake? Or is he like OH and sleeping 17 hrs a day?
 

Brogues

Registered User
Apr 13, 2014
150
0
OH doesn't sleep through meals but he does want to go to bed immediately, or after the main course. He has a fairly small appetite so meals are not huge affairs, but, if he has a day at home he wants to go to bed mid- afternoon. If he's been to daycare, he's usually in bed within an hour of getting home.
I don't think it's tablets, there has been no additions for over a year.
Gp reckons it's age (81), not sure I agree. More like the beginning of the end (which, of course, might last several years). I don't really know.

However, he's at home and can eat when he wishes. If someone is in a care home and is sleepy at mealtimes can he not have treats when he is awake? Or is he like OH and sleeping 17 hrs a day?


To be honest it makes no sense to me yes mum is loosing weight BUT is still OVER weight! I will see what they say to me when i ask
 

Brogues

Registered User
Apr 13, 2014
150
0
Compromise - suggest she has a sandwich/snack when she is awake.

I did say that - in tears when I found pulled apart pad all over her bedroom floor because she had been up screaming all night :(

She isnt under weight - but long term she will be shes dying cant she be allowed to sleep out whats left
 

Spamar

Registered User
Oct 5, 2013
7,723
0
Suffolk
I think it's important that she is losing weight. I mean, I could lose several stone and no one would notice! But I would still be losing weight for some reason. OH is losing weight, he's slightly underweight, but nothing to worry about. At one stage both will become underweight and therein lies the problem.
I think she should be offered food when she is awake.
Why isn't she getting something to help her sleep? Spending all night in such distress seems completely wrong to me.
 

nitram

Registered User
Apr 6, 2011
30,075
0
Bury
"...recently they just tired to withdraw mums Respiridone...
...I will be honest I'm angry at the care home decision as they did not include me I would have cautioned as mums behavior had been so bad i would have said please be very careful..."


Unless the prescription(s) said PRN - ("pro re nata" - as required) - the care home should have contacted a doctor, preferably the prescriber, before they altered any dosage.
 

Dudley

Registered User
Nov 24, 2014
4
0
Hiya,, tell the care home staff Ur is in her best intreats to be given the medication, as it keeps her calm etc,, n they have a duty of care for Ur mum and care is 24 hours a day 7 days a week, they should change your mums eating times as to when she is a wake,, even if it's in the earlier hours of the morning ,, x


Sent from my iPhone using Talking Point
 

BR_ANA

Registered User
Jun 27, 2012
1,080
0
Brazil
My mom has phases of sleeping while eating. I just asked to nurse to put chocolate on her mouth ( she really enjoy and wake up), and asked for hyper caloric food.
 

Brogues

Registered User
Apr 13, 2014
150
0
"...recently they just tired to withdraw mums Respiridone...
...I will be honest I'm angry at the care home decision as they did not include me I would have cautioned as mums behavior had been so bad i would have said please be very careful..."


Unless the prescription(s) said PRN - ("pro re nata" - as required) - the care home should have contacted a doctor, preferably the prescriber, before they altered any dosage.

Apparently they did the NEW tot he home nurse said she didn't understand why mum was on it - IF she had spoken to us or read her notes she might have had more insight thankfully I find out it was reduced for a short time as the mental health team were not convinced - but still no one involved us in this decision making process again
 

Neph

Registered User
Jan 27, 2014
179
0
Mum is losing weight, she was doing so even on suppliments and I took the decision to talk to the GP and they have taken her off them. I have also asked them not to wake her for her meals as she is eating very little anyway and is slowly slipping away. I found out that they thought she was deteriorating last year which is why they put her on the suppliments, as far as I am concerned this is just prolonging my mums existence. I know there is a duty of care but surely if she is asleep she isn't hungry.

It's so hard to watch them shrink before your eyes but it's not as if they are going to get better.

I feel for you it's such a hard thing to deal with, I hope you can sort it out with the home and come to some agreement.

hugs x
 

Brogues

Registered User
Apr 13, 2014
150
0
Mum is losing weight, she was doing so even on suppliments and I took the decision to talk to the GP and they have taken her off them. I have also asked them not to wake her for her meals as she is eating very little anyway and is slowly slipping away. I found out that they thought she was deteriorating last year which is why they put her on the suppliments, as far as I am concerned this is just prolonging my mums existence. I know there is a duty of care but surely if she is asleep she isn't hungry.

It's so hard to watch them shrink before your eyes but it's not as if they are going to get better.

I feel for you it's such a hard thing to deal with, I hope you can sort it out with the home and come to some agreement.

hugs x

Thanks xx Am going in for another chat to see where we can go with this
 

MirandaT

Registered User
Jul 19, 2010
94
0
Spain
It sounds like the Care Home is being really rigid about mealtimes! Many people in the later stages of dementia just have to sleep a lot of the time but still want to eat and drink. They need to have food available when they want it and the Care Home should sort that out! My mum's Care home had regular mealtimes tho breakfast was anytime from 7am to 11am, and apart from tea and biscuits morning and afternoon, there would be little dishes of cheese, raisins and fruit on the tables, plus hot chocolate and sandwiches in the evening. Is there someone there you can have a reasonable discussion with? It's not that you don't want your mum to eat! Eventually she may not want to eat at all, but that's usually very late on in the illness. Good luck, your mum is lucky to have you looking out for her.
 

oldman1952

Registered User
Apr 4, 2014
45
0
Sleeping through meal's / Stopping risperidal? without slow detox dangerous!!!!!

Hi there, I looked at the original post with amazement. Putting chocolate into a sleeping person's mouth is a No, No in my books. Older people have a higher risk of choking than any of us that has a normal swallowing reflex. I some one has been on an Atypical antipsychotic medication and to stop it without detox are in for a shock when the patient starts to act strangely. What you get as the other poster stated is what we call a rebound psychosis. This happens because the body has become adjusted to that medication and once it has been stopped the problem they had before becomes much, much worse. To end my points, why not allow the person to snack. High energy bars cut up into manageable pieces. Any thing that she likes, when she likes, if she likes. If I was woken up by someone shaking me about I would not be too happy. I eat when I want to eat. There's a saying "Some Nursing Homes are waiting places, like parking spaces. People waiting for what they do not know." Instead of seating the clients in small groups so that they can see someone else they are restricted to being in lines around the walls of a TV room with a programme that they themselves have not had any intention of watching. Occasionally you get a good home that has a good activities co-ordinator working with several clients or on a one to one basis. There is not too many of there around. Yes the organisations that vet these homes rarely do snatch inspections and they tell the home that they are coming so that everything is in place when they do visit. What I would like to see is elderly investigators being admitted to homes and reporting back to the commission what they see as good care and what was bad care. Trust me I've seen it all. I was at an out-patients clinic just the other day. When an elderly resident from a local nursing home also had an appointment. She was frail and very thin, they asked her if she wanted to sit in a normal seat with padding on. She said she did and I looked on in amazement. The care assistant and the care home manager did the unthinkable. They turned the wheel chair into position then they both put their arms under her arms and lifted her onto the seat. That moving and handling procedure for transferring a person changes 15 years ago. The elderly lady could quite easily ended up with 2 dislocated shoulders. Every home in the UK as a whole should have a dementia Champion in situ trained to a national standard, such as the Social Services health care personnel are.
 

Brogues

Registered User
Apr 13, 2014
150
0
Hi there, I looked at the original post with amazement. Putting chocolate into a sleeping person's mouth is a No, No in my books. Older people have a higher risk of choking than any of us that has a normal swallowing reflex. I some one has been on an Atypical antipsychotic medication and to stop it without detox are in for a shock when the patient starts to act strangely. What you get as the other poster stated is what we call a rebound psychosis. This happens because the body has become adjusted to that medication and once it has been stopped the problem they had before becomes much, much worse. To end my points, why not allow the person to snack. High energy bars cut up into manageable pieces. Any thing that she likes, when she likes, if she likes. If I was woken up by someone shaking me about I would not be too happy. I eat when I want to eat. There's a saying "Some Nursing Homes are waiting places, like parking spaces. People waiting for what they do not know." Instead of seating the clients in small groups so that they can see someone else they are restricted to being in lines around the walls of a TV room with a programme that they themselves have not had any intention of watching. Occasionally you get a good home that has a good activities co-ordinator working with several clients or on a one to one basis. There is not too many of there around. Yes the organisations that vet these homes rarely do snatch inspections and they tell the home that they are coming so that everything is in place when they do visit. What I would like to see is elderly investigators being admitted to homes and reporting back to the commission what they see as good care and what was bad care. Trust me I've seen it all. I was at an out-patients clinic just the other day. When an elderly resident from a local nursing home also had an appointment. She was frail and very thin, they asked her if she wanted to sit in a normal seat with padding on. She said she did and I looked on in amazement. The care assistant and the care home manager did the unthinkable. They turned the wheel chair into position then they both put their arms under her arms and lifted her onto the seat. That moving and handling procedure for transferring a person changes 15 years ago. The elderly lady could quite easily ended up with 2 dislocated shoulders. Every home in the UK as a whole should have a dementia Champion in situ trained to a national standard, such as the Social Services health care personnel are.

Actually I suspect there was an alterior motive for the reduction.............but I won't voice it on here yet x