Now that I can see my mom in MC, I’m realizing that after the super early meal at 4pm, everyone goes to their apartment to be all alone ALL night. During the day, there’s clearly more staff and activities. I try to spend time with my mom at least 3 evenings during the week. It just makes me sad thinking this whole time she has just sat all alone in her apartment during lockdown. Is this normal for MC facilities to have less staff during evenings? Do other MC facilities have evening activities or just as many staff as they do during the day? I understand most are tired due to the day’s activities. However, many are sundowning after supper and are in their rooms all alone with their crazy thoughts.

Most facilities do reduce staff in the evening hours, but that shouldn't mean residents must retire for the night at a particular time. Does the staff escort the residents to their room or do they freely wind up there after supper? I doubt if the latter is true. The staff may have to help some one to their room in the evening, but then they should be there to get some sleep, to be helped into bed, if necessary, and to be tucked in, not to be placed in a chair or on the edge of the bed to finish out the evening.

Dementia does take a toll on a person's energy and some might be ready to sleep after supper, but they'll probably be up at 1 AM. Just like you and me, the wake sleep cycle for MC residents is different for each. In fact, when the disease progresses, the circadian clock no longer functions as it once did. The person can't differentiate day from night. At times, my wife was awake for 24 straight hours. She might wake up at 2 AM, get dressed and want to get the day started. Facilities that dictate times to sleep and times to awaken aren't doing the residents any favors. Some residents may voluntarily go to their rooms and hit the sack. Others may be awake long after dinner and just wander around or sit on a couch in the common area, or even fall asleep there. I don't know of a facility that offers activities in the evening, but that's no excuse to put everyone to bed early. What many care facilities lack is person centered care. Knowing each resident and catering to each's lifestyle as much as possible.
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Reply to sjplegacy

This is sort of a side issue, but I see in many of the comments that staff in MC tend to wake up residents early, like 6 AM. Why? That would work fine for me because I am always up early anyway, but it would drive my husband crazy. Each of us have internal clocks that work differently. I am an early person but my husband and my 2 children (by a different husband) have always tended to be night owls and sleep late. Given that there is basically nothing they must do, why not let the night owls sleep in until 10 or so? I would think that it would ease the mornings considerably if the staff had a quarter or so of the residents to awaken at each of the 4 morning hours rather than rushing through getting them all up at once. My experience with late risers is that they have little interest in breakfast, anyway. They prefer coffee or juice and little else, maybe dry toast. After all, when you get up at 10, lunch isn't far off. Call it brunch for the late risers. Surely such regimentation and lack of appreciation for individuality is not great for those whose lives are already confused and confusing.
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Reply to LittleOrchid
usjet333 May 2, 2021
That may have something to do with "sundowning." Sundowners Syndrome is something that adversely affects many seniors with dementia. When the sun goes down, they get anxious and many of the adverse behaviors with dementia get amplified.

So, maybe these facilities are trying to maximize sunlight for the residents, so that they're tired and want to go to sleep before the sun goes down.
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I can't speak to memory care but at our nursing home the majority of activities were scheduled in the afternoon, with memory care there is the added complication of sundowning so evening activities are going to be more complicated. I also think many facilities like to administer evening meds at meal time because compliance is better and it's easier to get to everyone when they are corralled in the dining room, and sometimes those meds are sedative. Don't forget they are likely getting people up and about by 6:00 a.m. (or earlier) to get them washed, toileted and dressed for breakfast.
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Reply to cwillie

As a former LTC Activity Director, I can tell you most programs are held late morning and mid afternoon. That is when you have highest rate of participation. Have held entertainment , games and motion picture shows in after dinner hours, but majority of residents do not attend. Think most residents ready to end their day after supper time. We do try to provide for evening activities. However, think of what most elders actually do in the evenings, even those at home. Also think two activity programs daily would be more than this population does when at home! We cannot be constantly busy! It is also good to have alone time and rest periods.
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Reply to drooney

Some facilities may show a movie or have occasional evening activities. I think most of the time the residents may want to be in their own spaces after dinner. Is there a common area where she can sit with others, including staff, if she wants to be with people?
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Reply to NancyIS

I suppose it depends on the facility but I know of a memory care facility that even allows overnight guests.

I know of an assisted living facility that has a guest room for out of town visitors.

Some have a relaxed ‘open door’ policy but ask that visitors are courteous of other residents, while some have
visiting hours end at 8:00.

There isn’t one set of rules. It varies.
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Reply to NeedHelpWithMom
Invisible May 2, 2021
We were allowed to visit my father in memory care any time, day or night (pre-Covid) and were allowed to sleep over in his room if we wanted to without any special arrangements. There was also a guest room for rent in the assisted living wing.
Seniors get up very early in those facilities, so they need to go to bed earlier.
Also, most elderly people have "wound down" by supper time and don't have the energy to attend activities in the evening.

If a person is sundowning, their confusion would make it appropriate for them to attend a group activity, such as Bingo, because they could not follow the instructions or behave socially. It would not make them "less confused," since the confusion is biologically based.

All facilities, including hospitals, have a lot less going on during the evenings, compared to days.
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Reply to dragonflower

You're lucky if a facility is staffed with enough help during the day..

Horribly sad for all the Seniors to have no contact with lived ones for over a year because they totally didn't get much human contact except for necessities.

I personally think it was wrong and made it worse on them that they will never get over.

People aren't made to be alone.

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Reply to bevthegreat

Imho, while most elders eat a much earlier dinner than normal, the staff is no doubt waking patients up as early as 6 AM to start the day.
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Reply to Llamalover47

All facilities have less staff in the evenings since daytimes are pretty full of therapy, activities, housekeeping... However, there should be enough staff to meet needs of the residents. Evening activities may depend on the amount of residents, the type of problems residents have (dementia clients need more structured routine while residents with mobility issues need more adaptive activities), and the resources available. Before COVID, most facilities had at least 1-2 group activities for residents in the evenings. With COVID, large group activities are frowned on. Almost every facility has somebody responsible for resident activities. Talk to this person about options for your mom. The facility should be willing to help you out.
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Reply to Taarna

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