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Circadian 'clock' is off - possibly due to advanced glaucoma

Fri, 06 Apr 2018 19:01:36 GMT

My client has lost vision in 1 eye and is almost legally blind in the other due to advanced glaucoma. He currently resides in skilled nursing facility and can still ambulate without any assistive devices. Historically he was a 'night owl' but I do not know if this was due to his advancing glaucoma or not. He wanders around the facility at night, occasionally disturbing other patients. Moderate to advanced Alzheimer's type dementia makes matters worse. Nursing staff is too busy with acute care patients to be consistent with keeping my client awake during the day. Current medications are: Dorzolamide-Timolol eye drops, Senokot, Milk of Magnesia, Refesh Tears eye drops, Latanoprost eye drops, Vit D3, Vit B-12 & Extra Strength Acetaminophen for pain relief (client has osteoarthritis. *Are these behaviors consistent with NON-24? I have seen advertizements for tasimelteon RX to help with sleep disorders. *Please offer suggestions to help my client get his nights and days back in sync. * Would light therapy be beneficial? He is a MediCal patient .

Mon, 29 Oct 2018 17:00:20 GMT

Apologies, for my computer glitch. Circadian rhythm

Mon, 29 Oct 2018 17:04:32 GMT

The Circaidian rhythm is important, what is more important is what medications is he on and when are they given? If he has behavior meds that are sedating (see the medications page, www.elderconsult.com/medication) they need to be stopped during the day and only given later. He should not be allowed to sleep for several hours a day, but to get up by ~ 10a, then 1 hour nap in the aft and keep up till 10p, or so. Also he needs sunlight and activity, to start.