Communion Of Dreams

Fearing to sleep.
September 20, 2007, 9:57 am
Filed under: Alzheimer's, Health, Hospice, Sleep

The last couple of days with my MIL have been relatively calm. Given her behaviour on Monday, my wife and I have settled on a TIA as being the likely culprit, though of course that’s a non-medical opinion.

One odd thing we’ve noticed, though, is that particularly in the mornings after breakfast, while my MIL displays a marked tiredness, she’s been reluctant to take a nap. This is new – for the last couple of months a nap in the morning has been fairly routine for her. When we ask her after getting her dressed whether she would like to have a nap, it’s almost like she is fearful of the notion. She says that she’s worried about when she’ll get up, and how to call for help, et cetera. But there seems to be more to it than that.

In talking about it this morning following another such episode (my MIL did finally opt to have a nap), my wife suggested that perhaps she (my MIL) is actually concerned that she’ll go to sleep and not wake up, but that the idea of that hasn’t been formulated solidly in her mind. I have to wonder whether this is an unconscious awareness of her approaching death.

And here we run into one of the biggest problems in helping someone with dementia at the end of life – the difficulty in helping them understand what is happening, of allaying her fears. With someone still in full possession of their mental faculties, you can discuss what is happening either directly or indirectly, suss out their concerns, help them come to terms with it. My MIL doesn’t have the ability to process such things any longer, and to try and penetrate her mental fog with a clear message of an impending death would just be cruel; it would pointlessly and needlessly frighten her, without giving any sort of comfort or peace of understanding. All we can do is provide her such love, safety, and reassurance as we can, as we all stumble along this unknown and unknowable path.

Jim Downey

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[…] unknown wrote an interesting post today!.Here’s a quick excerptIn talking about it this morning following another such episode (my MIL did finally opt to have a nap), my wife suggested that perhaps she (my MIL) is actually concerned that she’ll go to sleep and not wake up, but that the idea of that … […]

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I think that yes, on some level YMIL is afraid of going to sleep and not waking. Especially if she thinks she needs to be there for her parents to meet her, and doesn’t realize that they are “on the other side” (or however one thinks of it) and won’t be coming to get her (most likely) while she is awake. Maybe you can try telling her that if anybody comes to see her while she is sleeping, you will try to wake her.

I don’t think you need to talk with her about death. But if the fear is about being awake when she needs to be, or when she thinks she needs to get on the train or off the train or whatever will happen, maybe the answer is simpler. Just as you reassure her that you will care for YMIL until her parents (or whomever) come to get her, so too you can try reassuring her that you will waken her from the nap if someone wants to see her.

Tough being on a trip like this, with no roadsigns, no map, and heavy ground fog. My thoughts are with y’all.

The dementia may be making it hard for her to understand the concept of slipping from sleep into death, and therefore she cannot articulate it except as a fear of going to sleep. I know that when I am tired I have trouble sometimes in forming a thought or following it to the end, and I would guess that’s what YMIL is experiencing on a more profound level.

Comment by ML

I don’t have any real advice. I have volunteered for Hospice for 4 patients now. All were long-running, considering. I have no medical background; I’ve just been around the block a few times.

You’re doing the right things for your MIL. It’s all you can do, to make sure she’s safe, loved, and reassured. And even when it seems like those things aren’t enough for her, just know that it makes a difference.

Comment by Jayleigh

ML and Jayleigh, thanks for your words and thoughts. Caring for my MIL has been a remarkable experience, for all that it is exhausting.

Jim D.

Comment by Communion of Dreams

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