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Recent diagnosis. Doesn't seem like end of life is near. We walk 1.2 miles each morning. His appetite is excellent. He has ST, OT and PT 3 times a week. Other than these activities, he just wants to go to bed and sleep.

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Particularly in the latter stages, people with dementia may spend a lot of time sleeping. Caregivers, friends, and family members may occasionally worry about this. It's crucial to understand why someone with dementia could sleep more than a typical person their age does. Since my father had the same situation and is presently staying at https://silvergaterr.com/, I have been reading and investigating the topic. Sleepiness may be exacerbated by several drugs. Some antipsychotics, antidepressants, antihistamines, and obviously sleeping drugs are among them.
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Charmander: As your husband is walking 1.2 miles every day of the week and having ST, OT and PT 3 times a week, Richard is no doubt exhausted. Add in the fact that he suffered a stroke makes him probably all the more tiring.
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It may be stating the obvious, but I'll add that some meds have residual effects. My wife, who has Alzheimer's, is very sensitive to meds, often requiring only a half dose of selected meds. I notice that even meds that supposedly "wear off" after, say, four hours will still affect her alertness or her tendency to sleep many hours after that time - sometimes all day.
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An aside question: how does one determine that the dementia is a mix of Alzheimer's and vascular? Are scans or spinal taps necessary? (My wife was diagnosed with Alzheimer's, but only based on a neurologist's opinion, so I've wondered.)
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KathleenQ Oct 2022
Yes, scans are necessary to be precise but I don’t see how knowing will help. Vascular dementia is often caused by what they call “mini strokes” which people don’t notice when having them. They used to call it “hardening of the arteries”. It is not as progressive as Alzheimer’s but you really should go to a neurologist.
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For someone with your husband's diagnosis, the activities and therapies you describe take a lot of energy and, can be very fatiguing. Even eating takes energy for everyone, we just do not realize it while we are " healthy".

Also, his diagnosis brings with it , as you know, many changes in his neurological functions and this includes fatigue and tiredness and sleeping. He will not have the same energy and drive and expectations of the day, that the other "healthier" members of the family have.

There are many other reasons why he may want to sleep more ; one may also include grief and distress recognizing as much as he is able the decline in his health.

Speak more with his physician about your observations for more specific input from the physician who will be able to best speak to your husband's condition and, the expectations one may have making this journey with him or anyone with his dementia illness.

Practice good self care for yourself and other family members.
You are important too. Maintaining your " normal" activities and lifestyle to the best ability that you can and, getting support for yourself ( perhaps via Dementia support groups, your clergy or other counseling) may also help you cope with the many changes your husband's illness brings.

Peace,
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I too will recommend MC or daycare becausof the social enrichment keeps them awake
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Important activities during COVID-19? I suppose it works vs isolation. Social distancing as in-person is not easy for these folks. That's because we social beings rely so much on each other.
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I always suggest that people go on YouTube and check out some videos of Teepa Snow (the older ones have more information) she is a wealth of information on the practical skills in dealing with dementia patients and what you can expect as the various types of dementia progress.
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My mother did the same thing when she was still at home. She'd sleep 8 or 9 hours at night, get up, have breakfast, take a "nap" until lunch time, then "take a little nap" until the news came on at 5 pm. She and Dad would watch reruns of TV shows she knew by heart until 9 pm, then go to bed and it'd start all over again the next day.

Once I moved her to memory care after Dad died, that all stopped. They'd get her up at 7:30 a.m., bring her out to breakfast, then rotate her through all the activities they had all day. No activity lasted more than 30-45 minutes and she didn't actively participate in everything, but there were things to do, people to watch and listen to, and an area outside to sit and watch the birds.

She never took naps again, unless she dozed off for 15 minutes in her wheelchair. She took hours-long naps her entire life, but once she was engaged and not bored, she just didn't do it anymore. No anti-depression drugs were needed, because it wasn't depression.

I don't know what goes on in the mind of a dementia patient when they're left to their own devices, but I think it's just easier to sleep. It's virtually impossible for one person to keep a dementia patient engaged all the time, so I suggest getting him to a senior center that might have activities for him to do or hiring someone to come in and play mind stimulating games with him for a few hours a day. You can't do it all, plus deal with the house and meals and such.
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Because he’s TIRED
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This gentleman is taking a daily walk of more than a mile. He is eating well. He is engaging with speech therapists, occupational therapists and physical therapists in weekly sessions (which believe you me can be very hard work for someone who's had a stroke). What indication is there that he is depressed? What he is is knackered, because his brain is demanding the sleep to repair itself.

[I agree that depression is a common consequence of stroke, and is common in vascular dementia, but there's nothing mentioned that suggests it's present at the moment. If it emerges, the OP will notice a falling off in appetite, motivation, engagement and mood.]
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Grandma1954 Oct 2022
You are right that the healing process is tiring, exhausting particularly for someone with dementia as the work is extra difficult.
thank you for pointing this out.
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I agree that it is very possibly depression and this should be addressed with his doctor.
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When did he have the stroke?

With a routine like that, I'm not surprised he needs to sleep. Exercise and activity are great but over exertion is not. Let him rest whenever he wants to.
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There can be an aspect of Depression that can be involved. consult his doctor about this if it is a new occurrence.
Sleeping a lot is a sign of decline and the number of hours sleeping will increase as he declines.
My Husband went from sleeping 12 hours around the time of his diagnosis (Alzheimer's and I suspect Vascular) to sleeping 20 to 23 hours the last 6 months of his life.
Get him involved in Adult Day care if there is one in your area.
There are "Dementia friendly" programs like Memory Café and some Senior Centers have programs for people with dementia and their caregivers.
Keeping him active and on a routine will do wonders. A routine helps prevent some of the agitation and anxiety that some experience.
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