11/03/2025
For individuals with dementia, time changes like Daylight Saving Time can disrupt their internal body clock and daily routines, often leading to increased confusion, anxiety, and a worsening of "sundowning" symptoms. While most people adjust quickly, a person with a cognitive impairment can find even minor schedule changes deeply unsettling.
How time changes affect dementia patients
Sundowning: This common dementia symptom involves increased confusion, agitation, anxiety, and restlessness that starts in the late afternoon and continues into the evening. The change in daylight hours during the autumn and spring time changes can intensify this effect.
Circadian rhythm disruption: Dementia damages the area of the brain that regulates the body's 24-hour internal clock (the circadian rhythm). The time change further disrupts this cycle, causing issues with sleep-wake patterns, appetite, and mood.
Routine disruption: People with dementia rely on consistent daily routines for a sense of stability and comfort. A sudden shift in mealtimes, medication schedules, or bedtime can be disorienting and cause distress.
Heightened confusion: The longer, darker evenings after the fall time change can cause additional confusion. Shadows and reduced light can be overwhelming or frightening, especially if a person's vision is also impaired.
Strategies for managing the time change
Caregivers can take proactive steps to help ease the transition for someone with dementia.
Before the time change
Make gradual adjustments: In the week or two leading up to the clock change, begin shifting the person's daily schedule by 15-minute increments. This includes wake-up times, meals, and bedtime.
Plan wisely: Schedule appointments and stimulating activities for the morning or early afternoon when the person is typically most alert and has the most energy.
During and after the time change
Maintain routine: Stick to a consistent schedule as much as possible, as predictability is reassuring. For example, serve meals at the new time but keep the sequence of the day's events the same.
Maximize light exposure:
Daytime: Open curtains to maximize natural light and help set the internal body clock. Encourage time outside, like a walk, to boost sunlight exposure and provide gentle exercise.
Evening: As dusk approaches, turn on plenty of warm, indoor lighting to minimize confusing shadows and maintain a bright, calm environment.
Control the environment:
Reduce evening stimulation by limiting TV, loud music, or chores.
Create a calm evening ritual, such as listening to soft music or looking at family photos.
Ensure the bedroom is cool and dark at night.
Monitor diet and rest:
Offer a larger meal at lunchtime and a lighter dinner in the evening, as large meals can disrupt sleep.
Limit daytime naps to promote better sleep at night.
Avoid stimulants like caffeine and sugar in the afternoon and evening.
