The arrival of daylight saving time is a minor inconvenience for most people - we groan about losing an hour of sleep, but quickly adjust to the new schedule. However, for those caring for a loved one with dementia, the biannual time change can be extremely disruptive and detrimental.
The concept of springing forward or falling back an hour seems simple enough, but it can wreak havoc on the circadian rhythms and natural body clock of someone with cognitive impairments. Disrupting these ingrained daily patterns often leads to confusion, agitation, and a range of challenging behavioral issues for dementia patients and their caregivers.
In this blog post, we'll explore why daylight saving time impacts dementia patients so profoundly, the signs to watch for, and strategies to help your loved one transition as smoothly as possible. For many families, enlisting the support of an experienced, trained caregiver is invaluable during this time.
The Vicious Cycle of Circadian Disruption
The core problem with daylight saving time for dementia patients stems from the way it throws off their circadian rhythms - the natural 24-hour cycle that governs our sleep-wake patterns, hormones, body temperature, and other biological processes. This inner clock is regulated by light exposure and runs on a consistent loop, releasing different hormones and neurochemicals at specific times of day to control functions like sleep, appetite, and alertness.
When you shift the clocks by an hour twice a year, you are essentially causing "jet lag" and desynchronizing the circadian rhythms from the external cues of light and dark. While most people can adjust to this change in a few days, the brain impairments caused by dementia make it extremely difficult for the body's natural rhythms to realign. And the longer this disconnect persists, the worse the side effects become as critical biological functions are thrown off kilter.
Impact on "Sundowning" Syndrome
One of the primary dementia-related conditions exacerbated by daylight saving time is sundowning syndrome, in which patients experience increased confusion, anxiety, agitation, restlessness, and even hallucinations in the late afternoon and evening hours. While scientists are still investigating the precise neurological causes, most experts believe it is related to fatigue, low lighting, disrupted circadian rhythms, and a depletion of certain neurochemicals in the brain.
It's estimated that around 20% of dementia patients suffer from sundowning syndrome on a regular basis. Anecdotal evidence from caregivers indicates that the disorientation intensifies markedly after the biannual time changes. The overstimulation and exhaustion caused by the time shift appear to exacerbate the very factors that trigger sundowning behaviors.
Signs of Sundowning After the Time Change
If your loved one experiences sundowning, you may notice some of the following signs and symptoms in the days and weeks after daylight saving time begins or ends:
- Increased pacing, restlessness, and wandering
- Feelings of overwhelming anxiety, fear, or panic
- Heightened irritability, anger, and aggression
- Extreme confusion and disorientation
- Demanding behavior and refusal to cooperate
- Paranoia and delusional thinking
- Visual or auditory hallucinations
- Erratic mood swings and emotional outbursts
While sundowning syndrome itself is challenging, the time change can make these neurological symptoms even more pronounced and disabling. As a caregiver, it's vital to recognize the signs and have strategies ready to help minimize your loved one's distress.
Tips for Easing the Transition
Although there's no way to prevent the effects of circadian rhythm disruption entirely, there are steps you can take to facilitate a smoother adjustment and reduce sundowning triggers:
1. Maintain Routines & Schedules
Sticking to daily routines and schedules is one of the best ways to manage sundowning in general, and it becomes even more crucial after the time change. Do your best to keep meal times, medications, activities, and bedtimes as consistent as possible, even though the clocks have shifted. Maintaining these familiar patterns provides important environmental cues to help re-establish the body's natural rhythms.
2. Control Light Exposure
Since light is the primary regulator of circadian rhythms, managing your loved one's light exposure is key. Open blinds and curtains promptly each morning to expose them to bright natural light. Then minimize bright lights in the evening and ensure the bedroom is cool and dark at bedtime. This will promote the natural release of melatonin to regulate healthy sleep-wake cycles.
3. Encourage Physical Activity
Daytime exercise and activity serve a dual purpose: boosting exposure to sunlight while also promoting better sleep quality at night through physical exertion. Go for short walks outdoors, do gentle indoor exercises, or engage in favorite hobbies or activities earlier in the day when possible.
4. Limit Daytime Napping
While a short afternoon rest period can be beneficial, too much sleep during the day makes it harder to sleep well at night. Discourage excessive or prolonged napping by keeping your loved one engaged and stimulated throughout the day.
5. Avoid Stimulants Later in the Day
Caffeine, sugary foods and drinks, nicotine, and alcohol can increase restlessness, agitation, and insomnia - all of which exacerbate sundowning behaviors. It's best to eliminate these stimulants several hours before your loved one's regular bedtime.
6. Create a Calming Evening Routine
Sticking to a predictable series of low-key activities each evening can provide comfort and reassurance. For example, you might offer a light snack, take a brief walk, give medication, bathe or shower, and then settle in a quiet space with familiar objects, soothing music, and dim lighting to help cue the body for restful sleep.
7. Enlist Support from a Professional Caregiver
With their specialized training and experience, in-home caregivers can be an invaluable asset, especially during transitional periods like daylight saving time when dementia symptoms tend to worsen.
Student caregivers from CareYaya undergo a comprehensive onboarding and are in pursuit of a medical degree, so they can help clients with Alzheimer's and dementia maintain healthy sleep patterns, nutrition, hydration, and activity levels. They assist with evening routines, redirection, and soothing techniques to minimize sundowning behaviors and prevent wandering or unsafe situations.
Perhaps most importantly, a dedicated caregiver helps relieve the stress, burnout, and compassion fatigue often experienced by family members. With the support of a professional, you and other loved ones can find greater work-life balance and peace of mind knowing your family member is receiving consistent, high-quality care during this challenging time.
The Importance of Community and Support
While the biannual time change is disruptive for everyone, the compounding effects on seniors with dementia can be severe and destabilizing. By being proactive about routines, creating a calming environment, and seeking professional support, you can help your loved one navigate this transition as smoothly as possible.
Remember, you don't have to go through this alone. Hiring a quality and affordable caregiver can help families like yours affected by Alzheimer's, dementia, and sundowning syndrome. We're here to provide guidance, respite care, and compassionate in-home assistance to improve the quality of life for both your loved one and your entire family.