How to Manage Dementia During Time Changes

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When daylight saving time ends and the clocks go backward, it can be tough to adjust to a new schedule. But for those with dementia, the change in time can be especially impactful. A change in time may increase late-day agitation, sleep problems and confusion.

Why does the switch from daylight savings to standard time affect people with dementia? And how can you help your loved one adjust to the time change? Read on for a few tips on how to navigate the time change and dementia.

Why Does Time Change Affect Those Living With Dementia?

Alzheimer’s disease and dementia affect the body’s natural sleep cycles. Even without the clocks falling back at play, Alzheimer’s can confuse the body’s sleep and wake cycles. Scientists aren’t yet entirely sure why, but dementia often causes sleep disturbances, like difficulty sleeping at night and irregular napping during the day.

Add the switch from daylight savings time to the mix, and these symptoms of dementia can potentially become even more severe. That’s because daylight affects the body’s circadian rhythms, and changes in the body’s circadian rhythms have also been linked to dementia symptoms and risk factors.

Circadian rhythms are the body’s natural processes that follow a 24-hour cycle and include physical, mental and behavioral changes, such as hormone levels, eating habits and sleep patterns. The body’s circadian rhythms primarily respond to light and darkness, so a shift in time can affect more than just your alarm settings.

Luckily, there are a few ways you can try to help yourself or your loved one adjust to the time change and avoid late-day confusion.

Create a Routine Based on Personal History

Have you ever planned to sleep in on a long weekend, only to wake up at 6 a.m. ready for the workday? When we’re used to a routine, our bodies tend to stick to it — especially if we’ve been keeping the same routine for decades.

“It’s important to look at someone’s personal history when you’re thinking about their daytime schedule,” says Sara Terry, Brookdale Senior Vice President of Resident and Family Engagement and Experience. After maintaining certain routines, such as sleep schedules, time spent outdoors, specific mealtimes or exercises, your body’s internal clock may resort to those historic habits when faced with change, according to Terry.

Terry says that it’s often vital for caregivers to learn their loved one’s personal history and habits, and instead of working to change them, adapt to them. For example, if your loved one has a history of waking up at 4 a.m. to start their day, you likely should not try to change this. Instead, it may be better to adapt to it with soft lighting in the mornings to mimic a sunrise, an earlier breakfast time, a midmorning nap, and early afternoons spent outdoors.

The key, Terry says, is understanding, accommodating, and supporting these engrained routines and focusing their historical relationship to sleep.

Schedule Daytime Activity to Avoid Evening Agitation

While late-day confusion or “sundowning” may be triggered when clocks are moved back or forward, these effects can generally be mitigated with the right daytime routine.

“Late-day agitation and restlessness don’t have to be a given for those living with dementia,” says Teresa Gilbert, Brookdale Senior Director of Dementia Care Field Services. “If someone is having difficulty with this, it may be due to fatigue, or the way their daytime routine is organized. When people have experienced proper stimulation, proper engagement, proper support and proper rest throughout the day, you may not have as much late-day agitation.”

Organizing your day to incorporate time outdoors, exercise, purposeful engagement and rest periods may help prevent sundowning. In the evening, it can also be helpful to provide gentle programs after dinner time, says Gilbert. After-dinner activities can not only provide your loved one with stimulation, but also help prevent them from sleeping and waking too early.

Set and Stick to a Sleep Schedule

Once you’ve found a schedule that works for your loved one, it’s important to stick to it as much as possible. Committing to a healthy sleep schedule may help to regulate circadian rhythms and adjust to the time change. To start, waking up, going to bed and even eating meals at the same time each day may also help maintain a sleep routine. Similarly, keeping naps short and in the early afternoon may make it easier to fall asleep at night.

If you’re having trouble keeping to a schedule for you and/or your loved one, try posting sticky note reminders by light switches, encouraging you to dim them two hours before bedtime. Some electronic devices allow you to set an automatic reminder. Setting one to remind you to place your phone or tablet on “do not disturb” at a certain time of night could help with winding down.

Gradually Adjust Bedtime and Dinner

“The switch from daylight savings can be difficult for everyone, even those without dementia,” says Terry. “You can expect a few nights of struggle, but if possible, start going to bed an hour earlier or later depending on which way the clock is changing.”

Beginning a slow adjustment to a new sleep schedule could make the time change easier to navigate. You can try to make adjustments in 15 or 30 minute increments over a series of days, focusing first on the wake-up time. By sticking to a fixed, new, wake-up time, it will generally be easier to get used to falling asleep at the new bedtime, too.

While changing the alarm clock settings, follow those adjustments with new mealtimes. Eating too close to bedtime could make it more difficult to fall asleep, because your body will be expending more energy towards digestion.

It could be helpful to stop eating three to four hours before bedtime, so try shifting dinner to an earlier time about one week before the clocks fall back. Like the new sleep schedule, make the adjustment in 15-minute increments, until reaching one hour.

Once you’ve adapted to a new routine, it’s important to keep it consistent.

Get Sunlight at the Right Times

Tailoring sun exposure to fit an older adult’s schedule can help provide both mental and physical health benefits associated with sun exposure, such as mood improvement, lowered blood pressure, and increased bone strength, all while also helping them adapt to the time change. Bright light in the mornings could help people to feel more awake and alert, while dimming the lights around two hours before bedtime can help them get to sleep on time and sleep better throughout the night.

Feeling the sun throughout the day can also have a mood-boosting effect, which may potentially help ease anxiety or depression brought on by the time change. If you live in an area where sunlight is scarce in the winter, an artificial sunlight lamp (SAD lamp) may help combat sadness due to the changing of the seasons. Some lamps even help to regulate sleep routines with automatic timers and dimming settings.

“Artificial lighting can be really helpful, especially for people who live in parts of the country where the sun goes down very early,” says Gilbert.

While sunlight can be beneficial during the daylight hours, getting too much light before bedtime can sometimes disrupt sleep. If your loved one is struggling to sleep through the night, black-out curtains can help to block out most outside light, which could be a nighttime nuisance.

Find Ways to Exercise

Physical exercise helps encourage blood flow to the brain, offering many benefits, including some which may help those with dementia. Not only does exercise help maintain muscle mass and prevent mobility problems, but it can also promote consistent day and night routines.

If you want to help your loved one incorporate more exercise into their day, consider their mobility needs and ability level. Gentle ways to get a daily dose of activity could be gardening, walking or yoga. Other possibilities include light aerobic, flexibility and balance exercises. Try to limit exercise the closer it gets to bedtime, preferably avoiding rigorous activity at least one hour prior to going to bed, as this could affect sleep quality.

Care for Yourself

If you’re a caregiver or a family member of someone who’s struggling with memory loss, it can be challenging for you when the clocks fall back as well. It’s important to remember to also prioritize your own health. This could look like taking daily breaks, eating nutritious foods, keeping up with your friends or exercising. Be sure to make time for your own hobbies, and don’t be afraid to ask for help.

More Resources for Memory Loss

If your loved one is living with dementia, check out these resources for learning to understand dementia and easing the lifestyle transitions that soon follow.

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