How can I get Dad moving in the morning?

A fellow caregiver asked...

Hello, I'm a care-giver for both parents. My mom is 79, dad is 84 with Alzheimer's they still live together at home. I live right next door to give them the help they need. Dad is in the moderate stage. It is very hard to get him out of bed in the a.m. for about a yr. I asked the doctor if there is something of his current medication that we can ease off of to help him, dad is on 20mg Paroxetine (Dr.had us cut in half){that helped for about 1 day}, 10mg Aricept, 25mg Levothyroxine 1 1/2 tablet(changed from p.m. to a.m.)10-80mg Vytorin(cut in half),10mg Namenda 2X daily. He is taking Warfarin among other meds. To be honest, I moved all the clocks 20 mins ahead of time, which helped a bit especially with a.m. clinic appointments. I have a gentle routine of opening the shades in the bedroom, turning on the corner lamp. He says, "Good morning", then I ask him to try to wake up then I walk out. With the living room nearby, I then turn the TV on, very loud (he wears aides in both ears) just to get him thinking he's missing out of something, and hopefully is curious enough to wake up and check it out. I give him 10 more mins to wake himself up, then I go in the bedroom again to see if he has gotten up. Usually not. Then I try to keep him in a conversation while folding up the top throw blanket, and getting out his under garments. He likes to joke about getting up, then says, "I'm retired and can sleep in as long as I want to". But it is already 8:30 a.m. and needs to take his medication with breakfast and have meds spaced several hours apart. That isn't even matter to him. Most times after he gets up, and finishes his breakfast it is almost 10:15.

For about a month, I was treating his athelets feet with a cream every other day, and that has helped to wake him up. But...his feet are better now and I will not be doing that any longer. He has been taking half of his Paroxetine for a week, and we already can see a change in his behavior. He argues allot more, and is more stubborn. Any suggestions of what we can do to help us get him out of bed in the a.m.? Thank you! ~J

Expert Answer

Joanne Koenig Coste is a nationally recognized expert on Alzheimer's care and an outspoken advocate for patient and family care. She is the author of Learning to Speak Alzheimer's. Also, she currently is in private practice as an Alzheimer's family therapist. Ms. Koenig Coste also serves as President of Alzheimer Consulting Associates, implementing state-of-the-art Alzheimer care throughout the United States.

You certainly sound like a dedicated carepartner for your Dad with Alzheimer's disease (AD); not always an easy task! Your Mom and Dad are fortunate to have you living close enough to assist with his daily routine. I'm sure it is frustrating at those times when Dad is not that interested in your schedule. As healthcare professionals, we have come a long way in recognizing the need to adjust our caregiving schedule to reflect the needs of the AD residents in Skilled Nursing Care or Assisted Living facilities. That means often changing the staff routine to the preferred and familiar routine of the resident. It is actually much easier to make these adjustments in a home setting. If you think of just getting Dad up in the morning as a goal rather than the time-of-day being the objective, life will most likely be easier - for both of you. WHEN he gets out of bed is not half as important as is having a positive experience. You can make this happen by letting Dad sleep until 10a.m. if that's what works best for him. Continue to do all the other wonderful things you already do and by all means, keep on massaging his feet; you might find a cream with peppermint offers a bit of sensory stimulation and subtlely urges him to 'get moving'! Finding the right time-of-day to offer medications and finding the right combination of meds is a daunting task but keep with it and do ask your pharmacist for assistance in defining both. Remember to take care of YOU!