Daylight Saving Time Can Trigger Sundowning Behaviors

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It’s almost that time again. On Sunday, November 5, 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 lost the concept of time long ago, but when it’s only 5:00 p.m. and it’s already getting dark, I’m aware that this isn’t “normal.” Change 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 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 any time of 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 every dementia patient has a routine. If you try to set the table differently or change 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 of setting. 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, sundowning 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. My wife and 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.” The intention behind this is good, but remember that short-term memory is the first thing to go with dementia. People around me often forget this. My short-term memory is entirely gone and has been for some time. So, telling me that 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 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, draw the curtains, close the blinds and switch 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 wandering, delusions, hallucinations and paranoia.

You may be one of the lucky caregivers who can rearrange the timing of their loved one’s routine without much of an issue, but it isn’t likely. The time change is coming. Just be prepared and try to make the transition as calm and uneventful as you can.

Rick Phelps became an advocate for dementia awareness after being diagnosed with Early Onset Alzheimer’s Disease in June of 2010, at the age of 57. He was forced into early retirement and created Memory People, an online dementia and memory impairment group which supports over 7,000 individuals, all touched in some way by dementia.

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2 Comments

It took me a while to learn this, but with my mom, I found the less I tried to explain things, the better it was for both of us. For example, when I would visit, something like turning the clocks back - I would change her clocks without her knowing I did because trying to tell her about it only made her more agitated. I also would try to visit her in her world, and not try to make her live in the present. I don't know if this helps anyone, but even one person, it would be great. I went through so much with my mom and did so for many years, but even if one person is helped with one problem, then I would be glad.
I appreciate your suggestions. Remembering to tune in to where my mother is at when I arrive is critical, and sometimes I misread her. We have a long history of tension & conflict where feelings are concerned, & it makes far more sense for me to use her language if I want an honest & courteous answer. But yes, my mother is often quite withdrawn from the world beyond her; it overwhelms her, and I know it is painful for her to realize she just can't understand what she used to. Finding the patience is tough, because no one would ever accuse her of gently correcting her adult children. To the contrary, so I find myself needing to remind her to please be nice, that I am trying... I have done pretty well, I think, stopping myself from speaking at all when I become angry- unless I think it could be helpful to the situation. I'm learning to change the subject or suddenly need to attend to something right away ("be right back!"). I think one of the losses I am experiencing is the struggle to be right, and to experience the victory of her acknowledging it. It rarely happened anyway, but at least I was sparring with an equal. Now it's all different. I accept that I have impulses to express my frustration & anger in selfish ways, and that I get thru many moments reminding myself I can remove myself if I need to for very short breaks (when alone with her). We have had the luxury of having Home Health Aides much of the time, so I can actually leave to blow off steam or cry or just sit in my car for a few moments before I hit the road. Anyway, thanks, CentralMassach1- your post got me to write in for the 1st time, something I have been wanting to do.