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My mom has late stage 6 Alzheimer’s and currently happily resides in her own suite in an AL facility. Since early summer, she’s been waking up with her bed and shirt wet. Initially, we all assumed this was due to her sometimes incontinence. But even after putting her into the heavy duty overnight pull-ups, she continues to awaken wet. Closer observation reveals the wetness is only up her back and carries into her pillow area.


So, now we think the problem is sweating.


And the problem is that she has always preferred her thermostat be set at 78. Day and night. BUT she refuses to allow the a/c to run and has the thermostat set to HEAT! We live in Georgia. It’s HOT here half of the year. If her room manages to cool down to below 78 at any point, that heater is kicking on. And during the day, the temperature in her room skyrockets!


She constantly battles with me over this. And the staff there allows her to adjust her thermostat as she wishes.


I asked the director about placing a box over the thermostat to prevent mom from adjusting it but haven’t gotten an answer.


I think the AL is hesitant to block off her thermostat due to the notion that they (by law) cannot compel her to do anything against her will.


I’m wondering what if anything I can do.


Any ideas other than blocking it off with a box?

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Older people tend to prefer it quite warm. There is likely a waterproof mattress cover on the bed that may be contributing to the sweating. See if you can add another mattress pad over that one, wool being better than cotton for providing a comfortable temp without sweating.
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SatchimosMom Sep 2021
Mom does have a mattress cover, but it’s one with fabric integrated on top. Plus we have a protective pad on top of that which is followed by the bottom sheet.

And it’s always been this way. These sweats at night are a new development.
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Late stage Alzheimer's and living in assisted living??

My mother's memory care had the boxes over every thermostat, so there's no law that says people have to be able to control their thermostat.

However, if your mom is waking up drenched every day, she may just have night sweats. That's less about the room temperature than about her body.

Try not having her eat anything for at least two hours before going to bed. Her metabolism may be trying to process food while she's asleep, and that can contribute to the problem. I know that if I eat within that time frame before going to bed, I'll have terrible night sweats.

Is she on any medication with estrogen in it? Check all of her medications to see if excessive sweating is a side effect.
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SatchimosMom Sep 2021
Yes, she’s in AL. When she moved in (2019) she qualified as memory care but she was so physically fit that they made the decision to put her on the AL side and we agreed to keep her there as long as she was “thriving”.

She did really well. She remained active and engaged. But she fell in May. That’s also about the time they finally opened back up to visitors inside their rooms. Something happened around the time of that fall. She became more frail. She’s stopped leaving her room except for meals. Her room is completely chaotic. She became incontinent.

I recently had cameras installed in her room. It’s been eye opening. And I’ve been speaking to them about moving her over to memory care. They’re resisting the move insisting they don’t want to interrupt her “routine”.

But there is no routine other than she eats three meals a day and reclines on the sofa all day dozing on and off.

She doesn’t eat or drink anything after dinner time (5:30 pm). She is still on estrogen…been on it for decades. I’ll ask her doc about that.
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Until they decide to put a box over the thermostat…
There are PJ’s that are cooling and sheets that are cooling. Typically marketed for people having hot flashes. They are rather expensive and not sure you would want to run the risk of them going to the facility laundry never to be seen again.
Is there a way to change her thermostat to one you can control on your phone or program hers to go to “cooler” temps when she is asleep?
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SatchimosMom Sep 2021
All of those are great ideas. I don’t think they’ll let me install a special thermostat but I can certainly ask.

As for cooling pjs, that’s a brilliant idea. However, mom sleeps in a long sleeved tee and her panties (now pull-ups). She’s done that for decades. She’s also extraordinarily stubborn and I cannot imagine she’ll cooperate with any attempts to get her into anything else.
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What about getting sweat shirts, including heavier ones, for her to wear at night?  They'd keep her back warm.   Flannel shirts with lining might help as well.  So would jackets.

And on that subject, what does she wear at night?   A nightgown?  That might be part of the reason she apparently feels cold.
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SatchimosMom Sep 2021
She wears a long sleeved tee and her pull-up to sleep in. I don’t think I could ever convince her to wear anything else.

During the day, she wears either a sweater or sweatshirt with some leggings. When she steps out of her room to go to the dining room, she always puts in a windbreaker as she says it’s cold in the dining room.
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The quality of care/level of attention is much greater in Memory Care than it is in regular AL. The CGs at my mother's MC have to check on her once every 2 hours, and make sure her Depends is dry and that she's asked if she needs to use the toilet, etc. The lifestyle in MC is much, much simpler than it is in AL and the activities are geared specifically towards residents who have ALZ/dementia. My mother lived in regular AL for 5 years before moving over to MC in June of 2019; there is no way she'd be able to function properly in AL these days, with advanced dementia and much greater needs as a result.

The thermostat situation is ridiculous. What if your mother wanted her thermostat at 90 degrees suddenly? Would the staff be 'unable to compel' her to do something against her will? Logic like that is ludicrous when dealing with dementia, and measures MUST be taken to protect these elders from harming themselves due to 'obeying' their wishes! MC is around precisely for that reason. The doors are kept locked so the resident cannot 'decide' to go for a walk in the street at midnight, etc. By the same token, if the resident decides to stop eating entirely, the staff will call the POA to have a talk about it and decide what measures to take for the resident's safety. That is the goal, above all else: to keep the resident safe. If 78 degree temps (which require HEAT) in her room are causing her to sweat profusely, that's not keeping her safe.

I would be pushing for a move to MC once you find out what their rules are over there! While they all have rules in place to allow the residents to preserve their rights and their dignity, it only goes SO far when dementia is involved. Their decision making capabilities have gone down the drain, so others are there to see to it that the safe decisions are made FOR them, you know? In the meantime, I'd be speaking to the Executive Director about this situation to see what s/he can do to remedy the problem!

Wishing you the best of luck with a tough situation.
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SatchimosMom Sep 2021
Thank you for your reply.

I went by this afternoon. And I was SHOCKED to find she had moved the lever on her thermostat all the way over to the maximum (90 degrees!!!) with it turned to HEAT!

I immediately changed it while attempting to remain stealthy as if she sees anyone change her thermostat, she’ll change it back as soon as she gets the chance.

I also spoke to staff on duty to ask they check her thermostat regularly.

I’m putting in a phone call first thing in the morning to have an in-person meeting with the director. Besides the thermostat issue, I’ve discovered my mother has not been showering (only once in the month I’ve been observing her), she’s not brushing her teeth, and she’s constantly confused about whether it’s day or night, etc.

It’s clear to me she’s in need of memory care as AL cannot meet her needs. The director this a couple of weeks ago and she was supposed to call me back to set up a meeting. That never happened, so it’s beyond time for me to push the issue.
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Just spoke with the AL facility. They e informed me that they are not allowed to touch the residents’ thermostats. They also informed me that even in the MC portion of the building that those residents also have individual thermostats in their rooms that staff is not allowed to touch.

My mind is blown to hear the MC residents have no oversight for their thermostats.

They’re going to call me back. They have offered to potentially let me replace this old fashioned mechanical thermostat with a digital one. And I’m thinking maybe there’s one out there that’s trickier to adjust. Or maybe there’s one that will auto change from heat to cool that will also allow us to put it into lockdown mode. I don’t know…
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Unless the sweating is causing skin integrity concerns, is there any particular problem with your mother waking up sweaty? [I assume she has help to shower in the mornings, change her bed linen and so on? And plenty of fluids to hand during the night, so she isn't getting dehydrated?]
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SatchimosMom Sep 2021
She awakens somewhere between 2-4 am every day and her sheets are wet. She has to get up and changed and then she gets on her sofa, turns on the tv, and doses off.

No, they weren’t changing her sheets even though she’d tell them she was wet. When we thought this was due to urine, it was outrageous that she was getting ignored and her sheets weren’t being removed. Now that we’ve determined it’s probably just sweat, it’s less of an issue as long as they dry out before the bed is made and they get washed at least weekly. The director has been helpful recently at getting the morning staff to change her sheets more frequently.

Showers? NO. She rarely showers. Only once in six weeks time. They occasionally offer to help her but she refuses. She tells them (and me) that she’s showering. I’d be okay with her just washing herself down with a washcloth, but that’s not happening either. And by state law none of us can force her to do these things. Her hair does get washed weekly in their salon.

Fluids? Again, NO. She refuses all fluids unless she’s eating a meal or taking meds. She does consume multiple glasses of water or tea at mealtime.

I suppose, in the whole scope of things, if having the thermostat set to 90/heat and not running any a/c in the hotter months isn’t dangerous, then I shouldn’t make a fuss. Ok, she wakes up sweaty and wet in the middle of the night. But I can’t help thinking there are elderly who pass away every year from either extreme heat or cold.
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