Winter brings caregivers new difficulties


DAYTON—Winter’s earlier, darker nights wreak havoc on internal clocks and routines for almost everyone, but one group that already struggles with nightfall may face additional difficulty as clocks are set back for the winter.

Individuals living with Alzheimer’s disease and dementia often are affected by “sundowning,” which typically is seen during dark or evening hours and can disrupt the body’s sleep-wake cycle. Sundowning is marked by increased confusion, anxiety, agitation, pacing and disorientation late in the day as the sun starts to set. Having the sun set at a different time, accompanied by shorter days and darker evenings, can cause additional stress for someone living with dementia.

“Keeping the days structured is one way that caregivers can help their loved ones through this transition,” said Annemarie Barnett, executive director of the Alzheimer’s Association Miami Valley and Greater Cincinnati Chapters.

“Alzheimer’s and other dementia can make people feel incredibly out of control, so they rely on their caregivers for cues,” Barnett said. “A structured routine and predictable environment can make things easier for them, particularly as the days get shorter and darker.”

Because the likelihood of difficulty during dark hours increases in the winter, these tips can help caregivers with this transition and the longer winter nights: Shift daily activities to account for the earlier darkness, such as shifting the person’s scheduled routine to an hour earlier; schedule activities such as doctor appointments, trips and bathing in the morning or early afternoon hours when the person living with dementia is more alert and talk to the physician about the best times of the day for taking medication; engage your loved one in activities near dusk to distract from the change in light. As much as possible, encourage a regular routine of waking up, meals and going to bed; when possible and appropriate, take walks together or spend time outside in the sunlight; make notes about what happens before sundowning events and try to identify triggers.

Do not physically restrain the person; it can make agitation worse and reduce stimulation during the evening hours, from TV, doing chores, loud music and other distractions, as they may add to the person’s confusion.

Keep the home well-lit in the evening, as adequate lighting can reduce confusion. Turn on indoor lights earlier or install timers; open curtains during daylight hours; and consider installing motion detector lights to help illuminate walkways around the home, as darkness may fall before arriving home from an outing.

Try to identify activities that are soothing to the person, such as listening to calming music, looking at photographs or watching a favorite movie. If behavioral interventions and environmental changes do not work, discuss the situation with your loved one’s doctor.

“It’s definitely harder in the winter,” Barnett said. “But with some shifts in strategy, the effects of the time change can be mitigated somewhat. Caregivers can always contact us for help creating some strategies to use.”

Caregivers can share what has worked for them and get ideas from others through ALZConnected, the Alzheimer’s Association’s online support community for caregivers. Visit www.alzconnected.org to find support.

In 2021, there were 421,000 caregivers caring for 220,000 Ohioans age 65 and older living with Alzheimer’s disease, according to the Alzheimer’s Association “2022 Alzheimer’s Disease Facts and Figures.” The number of people living with Alzheimer’s is expected to increase to 250,000 by 2025.

Those concerned about themselves or a loved one can contact the Alzheimer’s Association Miami Valley Chapter office at 937-291-3332 to schedule a care consultation and be connected to local resources that can help. The Alzheimer’s Association’s Helpline can be reached 24/7 at 800-272-3900. For more safety resources, visit www.alz.org/safety.