The end of daylight saving time — happening this weekend — causes groans for those who hate going back on regular time, and cheers from sleep experts who say regular time is better for us. For people with Alzheimer's or dementia, the time change can be particularly rough.
"When we have dementia, anytime there's any kind of change to our routine — we could be doing the same things that we always do, but we're used to doing those things when it's dark, or we're used to doing those things when it's light — that can cause a lot of confusion about ... just everything," says Dayna Ritchey, program director for the Greater Cincinnati and Miami Valley chapters of the Alzheimer's Association.
Daylight saving time in the United States dates to 1918, and was clarified by the 1966 Uniform Time Act. The idea is that daylight saving time saves energy. However, NPR and the American Academy of Sleep Medicine (AASM) point out there's no clear evidence this is actually the case.
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It can, however, cause problems with our natural circadian rhythms. Ritchey says there's no point in fighting those rhythms if you don't have to.
"Let them try to stick with that regular schedule. If their body has a natural wake-up time, don't necessarily change that just because the clock changes, especially if there's not a good reason for that," Ritchey advises. "If we're not waking up to go to a very early doctor's appointment or to church or things like that, if we can, allow our loved one just to sleep until they want to naturally wake up."
If a person tends to sundown, it could become worse around the time change as well.
"Sundowning," while not a disease, is increased confusion that occurs from dusk through night. Behaviors can include difficulty sleeping, anxiety, agitation, hallucinations, pacing and disorientation. An exact cause is unknown, but it could be an indication of Alzheimer's or dementia progression or brain changes.
Additionally, a person who hasn't previously exhibited sundowning tendencies may begin to do so as the days are darker for longer periods of time, says Ritchey.
Time change tips
The Alzheimer's Association offers the following tips to help people adjust to the time change:
Tips to manage sleep issues and sundowning
- Schedule activities such as doctor appointments, trips and bathing in the morning or early afternoon hours when the person living with dementia is more alert.
- Encourage a regular routine of waking up, eating meals and going to bed.
- When possible, spend time outside in the sunlight during the day.
- Note what happens before sundowning events and try to identify triggers to avoid.
- Reduce stimulation during the evening hours. Limit TV, chores or loud music.
- Keep the home well-lit in the evening to help reduce confusion.
- Try to identify soothing activities such as listening to calming music, looking at photographs or watching a favorite movie.
If the person is awake and upset, try these strategies:
- Approach them in a calm manner.
- Ask if there is something they need.
- Gently remind them of the time.
- Offer reassurance that everything is fine.
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Four tips for families and caregivers
- Determine the cause – Find out why they might wander. Are they seeking lost loved ones? Trying to go to work? Are they scared or over-stimulated?
- Safeguard the home - Eliminate clutter and prevent tripping hazards. Additionally, consider the location of objects such as car keys, jackets, and purses, as they might motivate the person to leave suddenly. Install electronic chimes or doorbells on doors to alert an open door.
- Know the patterns - Encourage healthy sleep habits to minimize the likelihood of a loved one leaving in the middle of the night. In the event of wandering, maintain a record of patterns, including frequency, duration, and time of day
- Develop a safety plan - Maintain a list of potential places someone might go, including their previous home, place of employment, and favorite spots around town. Keep a recent close-up photo and relevant medical information readily accessible to first responders. Create a contact list of individuals to reach out to if the person goes missing. Inform neighbors about the situation and request that they contact you if they observe the person out alone.
