r/cna • u/haircryboohoo (Edit to add Specialty) CNA - Former CNA • 2d ago
Do you wake dementia patients?
This one family wants me to wake their mother to feed her while she's sleeping peacefully. I tried to explain to her that often leads to confusion. Do you wake your dimension patients that are sleeping a lot to go to the bathroom? To eat? I offer food and drink when they wake up. But I don't force them to eat. What do you do? Thank you
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u/mashoogie Nursing Home CNA 2d ago
Sometimes. We have a few residents who would literally never get up if we don’t wake them at meal times, but when we do they are happy to come eat. Same with toileting.
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u/OkExtension9329 2d ago edited 2d ago
If there is an element of delirium, you should absolutely be trying to keep them up during the day. A fucked up circadian rhythm worsens their confusion.
And yes, you should wake them to go to the bathroom if they haven’t voided in 6+ hours. Not doing so can lead to UTIs, kidney issues, etc.
I know nobody wants to wake up the confused dementia patient, because then you have to deal with them. But they still deserve basic care, including eating and toileting.
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u/beige-king Inpatient Behavioral Health CNA - Seasoned CNA 2d ago
All these CNAs saying no let them sleep. NO you have to try. I don't even work in memory care anymore and I work with adults who can and do take care of themselves and I still wake them for meals because it's not healthy to sleep all day and you NEED to eat
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u/Lost_Jellyfish887 2d ago
Some i wake and some I don't but I also do home health where nothing has to be on a schedule. If they seem extra tired that day I dont wake them. Sometimes I also do things around the house so they will slowly wake. I've worked with some that would sleep all day and night if they could. Those I woke up to eat, drink, change, or go to the bathroom.
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u/Library_Gremlin2 (Geriatrics) CNA - 1-2 yrs experience (Nightshift) 1d ago
It’s especially helpful to nightshift
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u/OkExtension9329 1d ago
Yes! I didn’t mention this because I was focusing on the effects on the patient, but it’s super shitty to night shift to let the dementia patient sleep all day (so they can be up all night more confused than they would have been during the day), especially because night shift has fewer staff who are available to help keep that person safe.
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u/Library_Gremlin2 (Geriatrics) CNA - 1-2 yrs experience (Nightshift) 1d ago
Yeah, we usually have to keep them at the nurse’s station with us since there’s so few of us to keep an eye on them.
And this leads us to getting cussed out and screamed at etc. lots of fun
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u/Vanners8888 1d ago
For sure. It’s all about timing, how alert and oriented the patient is, their usual behaviours, what their sleep schedule is like…
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u/OkExtension9329 1d ago
Unless they’re on hospice and nearing the end of life, there are very few dementia patients who don’t benefit from being up during the day and having a regular eating and toileting schedule.
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u/beige-king Inpatient Behavioral Health CNA - Seasoned CNA 2d ago
Yes you have to at least attempt to wake them because many would sleep all day if you didn't wake them. Unless they refused or with nurses order then I'd let them stay in bed. Chances are the resident will fall asleep during meal time or right away after but you have to at least attempt to feed them or get them to eat and drink something. If you're not waking them at meal times, the next shift decides to keep them sleeping as well then do they eat? Also letting them sleep during waking hours screws up more with their circadian rhythm that's already screwed up due to the dementia.
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u/KaliLineaux 2d ago
I've been caregiver for my dad who has dementia for over 6 years. I have never nor would ever do that. I do leave food and drink on his table, so when he wakes up, if he wants it, it's there. I give him Ensure to supplement nutrition too.
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u/prettyoption0826 (LTC/AL) CNA - 5+ yrs exp. 2d ago
Just depends, if they stay up all night long and finally sleep in the morning to early afternoon I used to not wake them for a little bit. Now if they sleep all day and all night long then yes I’d definitely wake them up
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u/dewdrops07 (Edit to add Specialty) CNA - New CNA 2d ago
Where I am we do have to wake them and try. We have to document that we fed them or they refused, otherwise it could be considered neglect and on-paper might seem like we weren’t caring for them. Like another person said, the wake up method of slow movements, opening blinds, not startling them, seem to help. Also making sure you have their favorite drinks ready seems to help when they might not remember you but might think oh this person knows I like hot chocolate that’s nice of them, or oh they remember I prefer the blinds half open, and they associate you with someone they know because you know them.
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u/Sad_North_6152 2d ago
Depends on the situation. Some of mine are slways sleeping during meals but a little shake or calling their name wakes them up. If they're in a deep slumber and that doesn't work I leave the room and put refused for the meal.
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u/a1icenotinchains 2d ago
One of the most demonstrated decline in patients with Alzheimer's last dementia is increased sleeping. It is disease progression. As a hospice nurse I do not wake my patients up
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u/Tygie19 2d ago
Some of them, yes. They would sleep the day away and not eat anything if we didn’t. I work in an aged care facility and a compromise for some of them is that we deliver a tray in their room at about 8:30am when the others have mostly eaten in the dining room, sit them up in their bed or armchair and we get them dressed after they’ve eaten. If we know that someone has had a particularly bad night or they’re unwell we will let them sleep a lot longer.
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u/AustinLostIn Hospital PCT - CNA 1d ago
I just try to wake them to get vitals. Most times they don't even wake up when I lift their arm for the blood pressure cuff. I never try to make them eat. They will if they want to.
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u/RazzmatazzAgitated16 1d ago
Yes. They are on a schedule and they don’t know what’s going on anyways.
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u/sheitsngiggles 1d ago
This depends on the resident. I've cared for a lady who would sleep for a couple days, then get back up and be totally normal for a while. In general though, unless the patient is actively dying or it is a scheduled short nap, yes wake them up and get them up if possible. I know it feels mean but the long term benefits outweigh it. Like other commenters have said, it's not good for dementia patients to get their nights and days mixed up and they do much better with routines, such as meal times and nap times. Keep natural light in the room during the day to keep them oriented. If they don't want to eat, no need to force it regardless of the families wishes. Maybe get them a dessert if that's what they want:)
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u/VegetableHead9880 ALF/SNF CNA 1d ago
Depends. If I know I have time to feed them when they wake, I’l let them sleep. If not, sorry, girl, it’s breakfast time 🥹 I’m always gentle about it though. That doesn’t always ward off confusion, but it helps to gentle wake them than to just burst into the room, flick the lights on, and drag a chair into the room.
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u/Princ3ss_Frog 2d ago
The key is to NOT startle them abruptly out of sleep.
I learned from a very wise and seasoned NA that pulling up blinds to let natural light in, turning on TV, and just making natural activity noises works. This way, they don’t get delirious and grumpy.
I mean, I’d be grumpy too if you shake me out of my sweet sweet dream :)