We have just moved my mother-in-law into our home. My husband works and I will be her primary caregiver. I will be working with a team of doctors and would like to use home health care. She is 87 and has congestive heart failure, stage 4 renal disease, and type 2 diabetes. The past several years she has stayed up until 2-3 am reading and sleeping in her chair. Then she goes to bed and sleeps until noon. The doctor has stressed to her that a schedule is imperative because of taking her medicines on a regular time frame to avoid dialysis. How should we change her schedule and how much should she be sleeping? She wants to sleep all the time. I am having to constantly wake her up to give her medicines to her. I know that she is 87 years old but I am trying to give her the proper care. She was living by herself in an assisted living facility that prepared her meals and home health was coming on a weekly basis to fill her medicine box. I am now preparing her meals and dispensing her medicines. Any help would be appreciated. This has been a real challenge!!
I have a sleep disorder and so I have done a fair amount of reading and regularly see specialists. As far as I can tell, there is nothing inherently healthier about going to bed at 9 pm compared to going to bed at 2 am. We all need a certain amount of uninterrupted sleep per 24 hour period. But there is no "magic" period when that has to occur.
I don't think you have to change her schedule for her health, but it is perfectly OK to change it to suit your needs.
Bear in mind that diuretics like Lasix can make her GFR results look abnormal. Buy a stethoscope and listen to her lungs. On a good day you just hear air whooshing in and out. If fluids build up the lungs will be muffled or crackly and she may cough a lot. Summer heat and humidity are tough on CHF patients.
Listen to her heart, get to know the normal sound so you can tell if it is too slow or too fast or if it is faint. Watch, listen, learn.
As for urine output, it's much easier to weigh her every AM & PM. A gain of more than 2 pounds should be treated as needing a diuretic. Ankles sometimes swell, sometimes not. The weight is the key. Make sure she drinks PLENTY of water - at least 8 glasses per day. That's water, not cola, not tea, not juice, not coffee.
How's her appetite?
Otherwise I agree with everyone, especially about the happy sleeping compromises.