Daylight Saving Time Can Trigger Sundowning Behaviors
It's almost that time again. On Sunday, November 6, Daylight Saving Time ends and we turn our clocks back. This can have a dramatic effect on those who are living with dementia and their loved ones.
I already suffer from sundowning and Daylight Saving Time always makes it worse. Everyone has an internal clock, and light plays a huge role in our sleep/wake cycles. Changes in natural light are part of why sundowning occurs in the first place, but messing with the timing and amounts of daylight we receive only complicates things further.
I have long ago lost the concept of time, but when it's only 5:00 PM and it's already getting dark, I'm aware that this isn't "normal." Change itself is one of the biggest things that affects me and other dementia patients. Even subtle changes can be stressful for us.
According to the Mayo Clinic, sundown syndrome is described as "…a state of confusion at the end of the day and [that can last] into the night. Sundowning can cause a variety of behaviors, such as confusion, anxiety, aggression or ignoring directions. It can also lead to pacing or wandering. Sundowning isn't a disease, but a group of symptoms that occur at a specific time of the day that may affect people with dementia, such as Alzheimer's disease. The exact cause of this behavior is unknown."
They had this mostly right, but the very first sentence is wrong in my opinion. Sundowning can actually affect people living with dementia during anytime of the day. It does not always have to be at dusk or in the evening.
Just dealing with the fact that the days are shorter can be a struggle for dementia patients. I have said many times that your loved one has a routine. Every patient has one. Try setting the table differently or changing the linens on their bed. You'll see that even the smallest adjustments can be very disorienting for them.
Now, because of the time change, most of us will be eating supper when the sun has gone down or is at least in the process. You will hear many experts recommend turning the lights up before the sun begins to set. They will say, "Change the time you begin dinner, that way you can be through with it before sunset and nightfall." But again, you are dealing with people who have a set routine.
None of these suggestions have ever worked for me, but I am just one patient. Each one is entirely unique. For me, it can happen mid-morning on an average Tuesday. It certainly doesn't have to be at sunset, and it doesn't happen solely around Daylight Saving Time. I just have to deal with this.
Unless a patient is in the very early or late stages, you can bet they will have increased confusion and agitation starting on Sunday. For the patient, it feels like everything changes, not just the time. They will know by their internal clocks that something isn't quite right. As with all things dementia-related, you are dealing with something there simply isn't a "fix" for. However, it is still important to do what you can to help with this.
Some will say, "Just explain to your loved one what is happening; that it is time to turn the clocks back." Anyone who thinks this will help has missed the boat. Remember, the first thing to go with dementia is one's short term memory. People around me often forget this. My short term memory is all but gone and has been for some time. So, telling me the clocks were turned back and why is waste of time. Pardon the pun, but it's true. Your loved one may still have the ability to understand the concept of the time change, but the problem is, as always, that they won't remember this from one minute, one hour, or one day to the next.
Instead, make a point of keeping your home well-lit and the atmosphere upbeat. Natural light is important, but dusk and twilight can cause distorting shadows and colors that are overwhelming to a patient. In the late afternoon or early evening, make a point of drawing the curtains, closing the blinds and switching on plenty of warm, artificial lights. Playing their favorite music can also help keep them calm and content.
Since people naturally tire as the day wears on, keep in mind that this applies to dementia patients tenfold. Plan evening activities that are low key and not too complex to avoid increased disorientation and frustration. These emotions can escalate into troublesome behaviors that are more difficult to handle, like delusions, hallucinations and paranoia.
You may be one of the lucky ones who can rearrange the timing of their routine without much of an issue, but it isn't likely. The time change is coming. The one and only way to avoid it is to move to a state that doesn't recognize it, like Arizona or Hawaii. For most people, this isn't a practical option and will cause more problems with the routine your loved one has. Just be prepared and try to make this time and the transition as calm and uneventful as you can.
~A den Tex