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Good Morning, My mother has dementia and is in a nursing facility. When she is not feeling well she gets agitated. She has had two separate instances of pressure sores. The first one healed and the second is healing. It caused her some discomfort which I could tell as she was agitated and would shift around in her wheelchair. The nurse manager at the facility suggested her going to bed right after lunch to help her heal. My mother does have an air mattress. I do agree with having her have a different position to heal. The nurse also thought it was a good idea for her to nap. I did say once she is healed I would like her up in the afternoon. My mother is not tired after lunch and does enjoy being around people, though she sometimes falls right to sleep when they put her to bed. I am struggling with the issue of whether it is a good idea to have her nap after lunch. I want her to enjoy her life as much as possible and not take away her enjoyment by being awake in the afternoon. She has lunch at noon and is a very slow eater. Sometimes takes her a couple of hours. But by 1:00 they put her to bed and doesn't get her up until 4:00 to be ready for dinner at 5:00. I plan to check with the nurse on her pressure sore to see if it is healed. If so, I am thinking of requesting having her stay up after lunch. If they are concerned with her getting another sore, I was thinking of having them put her in a recliner in the community area instead of in bed for three hours. I am wondering if I am being unreasonable in wanting her up in the afternoon after her sore is healed. The afternoons are when she is visited by family/friends and I would like her to take part in that and also be around people. Any ideas would be appreciated. thanks, Aprildp

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Nurses do not relax in nursing homes. At least, I've never seen one do that.
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As a former CNA, there was never time to relax or even sit down unless I went to the bathroom. Always something to be done to keep ahead of schedule. One facility we weren’t allowed to sit down unless we were feeding Residents.
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They have my mom in bed in the afternoon too, and since that is when most of the entertainment is scheduled it means she seldom takes part. In our case I've discovered that mom has reached the point where she dozes in her wheelchair even when I keep her up, so I've let it be. Do you think changing her nap times would be beneficial, maybe a morning nap and earlier bed time?
And investigate getting a different cushion for her wheelchair, my mom hasn't had any recurrence of pressure sores since we upgraded to a ROHO.
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April, I think it is quite common for anyone older to fall asleep right after a meal, whether they have dementia or not. If your Mom falls right to sleep in her bed, that means she would probably doze off while sitting in her wheelchair or a geri recliner.

So, unless someone has major plans right after lunch, like going to work, an appointment, or housework that needs to be done, I will get tired right after eating because the body is digesting food. I find myself dozing off after lunch at home or in front of my computer. Just signs of getting older. Plus certain meds don't help, either.
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Some health experts think afternoon naps would be a good thing in the workplace! There are lots of opinions about the value and risks of napping. If your mother would otherwise be alert and interested in the entertainment and activities after lunch, then keeping her up might be worthwhile. But if she nods off or gets crabby and restless by dinnertime, napping might be a better option. When her sore is healed, perhaps you could try keeping her up and see how it goes. When she has visitors in the afternoon you could ask them how she seemed. Can you do a lot of visiting in that time slot and see for yourself?

I understand what you mean about missing out on the life she has left. But the disease is what it is, and we can't always overcome the limitations it imposes.
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April,
I'm a nurse and have worked with imobile patients but have never worked in NH's or MC's.

What I've found is that most people have energy for a few hours after they get up. Then, in the early afternoon (after lunch) it's normal to have an "afternoon slump". (energy stores depleting + digestion). That's why they sell energy drinks, highly caffeinated food and drink and energy bars. We're all trying to get our second wind.

I think a small nap (1-1 1/2 hrs.) is a great refresher but 3 hours is too long. That much sleep compromises the sleep at night.

I would look (on Amazon or a medical supply store) for the multitude of products to prevent or assist healing bedsores. (MemoryFoam cushions, gel cushions, sheepskin throws, air cushions, etc.)
Get her up in a recliner and put the cushion in her chair. She can turn on one buttock for 1/2 hr then the other "cheek" for another 1/2 hr.
Also the doctor should be ordering some skin products and dressings for healing.

Preventing bedsores from forming in the first place is best. Rotate the person left side, back, right side, back, and repeat--every 2 hours. Use lotion for massaging the bony areas, use products as mentioned above on all sleeping and sitting surfaces. Keep bottom area clean and dry. If incontinent, use skin barrier cream (Desitin, A &D ointment, etc.). If she can walk, encourage it for increased blood flow.

If her health permits (by that I mean she doesn't have any diseases that would discourage it) she should try to increase her protein and calorie consumption to aid in healing her sores.
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Chiming in about the ROHO cushion for wheelchairs. Late 2016 my dad developed a pressure sore we couldn't seem to get the better of, and then his OT person recommended we request an upgrade to the ROHO. It started to heal right away. He hasn't had a problem on his backside since.
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I insist mom go down for a nap after lunch although without our private caregivers to assist this might not happen

Although she misses the afternoon snack and live music I hate seeing folks slumped over in their wheelchairs after lunch plus for those that are immobile the only way to change their diaper is to transfer to bed

I got mom a reclining wheelchair but it hurts her back to recline - she doesn't have a roho cushion but an expensive one while in the chair

While she was in a nursing home for a month  - everyone was put back to bed by 3 pm and ate dinner in bed

At least at memory care, she is up again for a couple of hours in the evening
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I'm pretty sure my mom gets a nap daily after lunch but is almost always up in a nice TV room near the nursing station with the other residents in wheelchairs (some of whom are still able to communicate well with each other) when I come in daily around 4:30 to eat dinner with her. I'm glad they don't leave her alone in her room all afternoon. Many of them are snoozing in their chairs when I come in. Mom is pretty much out of it regarding her surroundings but does still respond to people talking to her and listens to what's going on around her.
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My mother isn't in a NH, and I know she says she is supremely proud of being "up" all day. Well, truth is, after "brunch" (she eats her morning meal at about 10...the dinner at 4--she spends most of her day in her recliner with the TV on. She sleeps much of the day, and if that's how she wants to spend her time, fine.

Heck, I'm only 61 and I nap almost every day. Just an hour or so "power nap" but I can't get through a day w/o that decompression time. I would be very resentful if somebody was trying to hustle me off to watch a show or "socialize" during my one hour alone!
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