Mr. B. is an 83-year-old male who was diagnosed with mild-to-moderate Alzheimer’s disease five years ago. He is cared for in his home by his wife of 45 years. Over the past few months, he has become increasingly more dependent in his activities of daily living and requires a significant amount of assistance with dressing, toileting, and personal hygiene. Most recently, he has begun to wake up multiple times during the night, even opening the front door and wandering into his neighbor’s yard on one occasion.
Patients with neurocognitive deficits often have atypical sleep-wake cycles. Although changes in the structure and organization of the sleep cycle are a normal part of the aging process, these alterations appear to be more pronounced in patients affected by Alzheimer’s disease. Associated with neurocognitive declines, degeneration of neural pathways that regulate the sleep-wake cycle may contribute to these sleep alterations.
Commonly, these patients may take frequent daytime naps and experience a nighttime sleep pattern characterized by frequent awakenings. As a result of the altered sleep cycle, patients with Alzheimer’s disease may feel rested during the nighttime hours and are inclined to get up and wander.
This behavior can have a significant impact on caregivers and can be a major risk factor for early institutionalization. The ongoing nighttime surveillance of a loved one with Alzheimer’s disease places a very important responsibility on the caregiver. Consequently, the caregiver’s round-the-clock responsibilities can be particularly onerous. If the caregiver is an older spouse, the ensuing lack of nighttime sleep makes providing daytime care even more challenging.
That’s where RiverSpring Health’s RiverSpring at Night program comes in. Our facility recognized this concern and developed a unique overnight care program geared toward addressing these challenges that caregivers must face. The response from patients and families has been overwhelmingly positive. For patients, the overnight program has offered them a sense of community. For caregivers, this program has been a life saver — enabling them to get much needed rest so that they can function and provide their best care during the day.
RiverSpring at Night functions like a medical model day care program during the night and is the only overnight respite care program in the country. The program features social and recreational activities and serves as an essential service for those suffering from sleep disturbances as a result of various forms of neurocognitive impairment. Night sessions provide assistance with activities of daily living, such as bathing, grooming, and eating. In addition, patients receive nutritional services, medication dispensing, podiatry, dental, and social services.
The overwhelming success and popularity of the RiverSpring at Night program is based upon its nonpharmacologic approach to dementia care — addressing and catering to the patient’s behavior by creating a program around the patient, rather than medicating the patient.
For more information about RiverSpring Health’s RiverSpring at Night program at The Hebrew Home at Riverdale, go here.
Zachary Palace, MD, is the medical director of the Hebrew Home at Riverdale by Riverspring Health in The Bronx, N.Y. He is board certified in geriatric medicine and internal medicine.
This article originally appeared on Neurology Advisor