Daylight savings and dementia: I am, by no means, a doctor. However, as a relative of someone suffering with Alzheimers, the following information resonated with me. Anyone familiar with the disease will know that routine is vital for those with dementia. With the imminent hour “gain” this week, we take a look at how you can support a loved one and help minimise the disruption and confusion it may cause. 

Dementia Statistics

As of today, “research shows more than 944,000 people in the UK have dementia, with numbers rising because people are living longer.

It is estimated that by 2030 there will be more than one million people with the condition in the UK.” reports the BBC.

Daylight Savings

“Fall back and spring forward”. Our friends across the pond coined this phrase, which serves as a helpful reminder when trying to determine whether to set your clock an hour earlier or later (although any digital clock connected to the internet should adjust itself automatically). Let’s face it, it would be hard to create a mnemonic that utilises the word “Autumn” effectively. 

For some interesting information about the origin of the phrase, check out: Phrases.com

How Could DST Impact Us?

To most, the change is minor and, if you’re a glass half full kind of person, means an extra hour in bed! It does, however, mean that it will get dark “earlier”, which could impact on those with SAD (seasonal affective disorder). It may also result in a slight change to people’s Circadian rhythms (our internal clocks). 

There are several ways that the time change can alter you (medically speaking) during the transition from DST to Standard Time. “In addition to sleep loss, people are at greater risk of mood disturbance, suicide, and being involved in traffic accidents during both bi-annual transition periods.”- Sleep Foundation.org.

However, in more extreme and long-term cases, people can be affected severely. Sleep Foundation states that, “While many people adapt to time changes, some studies have suggested the human body never fully acclimates to DST. Rather, their circadian misalignment may become a chronic or permanent condition. This can lead to more serious health problems, especially for those who experience “social jet lag” because their demands at work or school take precedence over a full night’s sleep. Social jet lag has been linked to a higher risk of obesity, depression, and cardiovascular disease. The effects of DST subside gradually after a few weeks.”

DST and Dementia

According to a recent article published by the BBC, “A charity supporting those with dementia says the upcoming clock change could be unsettling for them.”

This statement may seem obvious, especially considering how the adjustment can heavily impact on those who don’t struggle with a reduced level of cognitive function. 

Dementia sufferers may experience varying degrees of disorientation from Sunday. Their sleep patterns could be hindered and “It could also take longer to regulate their circadian biological clock, compared to those without the condition.”

A lack of sunlight exposure in general can also aggravate sleep patterns, as sunshine plays a role in “regulating hormones and sleep patterns by affecting the melatonin circadian rhythm”. – TheWomens.org

Disrupted sleep patterns and an overall lack of sleep can exacerbate the symptoms of dementia due to the vital role it plays “in cognitive function and memory consolidation.” says Alzheimers-Illinois.

Research shows that, with reduced sleep, Alzheimer’s and dementia sufferers may find “it even more difficult (…) to perform daily activities and maintain independence”.

Sundowning

Dementia UK explains this phenomenon on their website as: “…a term used for changes in behaviour that occur in the evening, around dusk. Some people who have dementia experience a growing sense of agitation or anxiety at this time. 

Sundowning often makes the person with dementia feel very strongly that they are in the wrong place. They might say they need to go home, even if they are at home, or that they need to pick the children up from school, even if they’re now adults. Other symptoms might include shouting or arguing, pacing, or becoming confused about who people are or what’s going on around them.”

As we get deeper into Autumn/Winter, sundowning may become more prevalent in people with dementia, because their usual time cues and routines are affected. 

“Just dealing with the fact that the days are shorter during winter can be a struggle for dementia patients.” 

Sundowning is normally associated with the middle stage of dementia and can lead to a series of adverse side effects, including hallucinations, wandering and violent behaviours.

Other factors can contribute to sundowning, such as:

• tiredness, hunger, pain or other unmet physical needs
• not enough exposure to sunlight during the day
• overstimulation during the day, such as from a noisy or busy environment
• disturbance to the person’s ‘body clock’ caused by damage to the brain
• disturbed levels of hormones that vary over the course of the day
• sensory impairment, such as hearing or sight loss
• tiredness in other people causing the person with dementia to become upset
• mood disorders, such as anxiety or depression
• fewer carers around to look after the person (in a care home)
• side effects of prescribed drugs.

-Alzheimer’s Society. 

How to Support Sufferers After DST

The hour shift in time can be overwhelming for some, and, where possible, it is good practice to make gradual adjustments in order to ease the shock. 

“Adjusting the sleep schedule gradually, providing exposure to natural light, and creating a comfortable sleep environment can help individuals with Alzheimer’s and Dementia adjust to DST and improve their sleep quality.” advises Alzheimer’s Illinois.

Dementia UK also have lots of helpful tips for carers and families to aid individuals with dementia:

-Use distraction techniques: go into a different room, make the person a drink, have a snack, turn some music on, or go out for a walk 
-Ask them what the matter is. Listen carefully to their response and if possible, see if you can deal with the reason for their distress 
-Talk in a slow, soothing way 
-Speak in short sentences and give simple instructions to try to avoid confusion 
-Hold the person’s hand or sit close to them and stroke their arm 

Other recommendations include: 

-Keep a predictable routine for bedtime, waking, meals and activities.
-Plan for activities and exposure to light during the day to encourage nighttime sleepiness.
-Limit daytime napping.
-Limit caffeine and sugar to morning hours.
-Turn on a night light to reduce agitation that occurs when surroundings are dark or unfamiliar.
-In the evening, try to reduce background noise and stimulating activities, including TV viewing, which can sometimes be upsetting.
-In a strange or unfamiliar setting, bring familiar items — such as photographs — to create a more relaxed, familiar setting.
-Play familiar, gentle music in the evening or relaxing sounds of nature, such as the sound of waves.

–Mayoclinic.org

Take Home

Overall, the main thing to bear in mind in times of stress is to emit a calming and soothing presence and reassure the person that they are safe. Dementia can be a very scary thing for both the victim and the relative/carer. If you love or care for someone with the illness and need some support yourself, visit: Alzheimer’s.org

You can also access courses designed to help you understand the disease better and learn the best ways for dealing with difficult situations that may arise: Dementia UK

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