Why Do People with Dementia Struggle to Tell the Time?
Being unable to make sense of time is something that can happen quite early in a person's dementia journey, which is why the tests that a GP uses for memory assessment usually include drawing a clock face, with hands set at a specific time.
The part of the brain that controls time perception is the hippocampus, situated in the medial temporal lobe, and damage to this region can result in a lot of the symptoms we might notice early in a person's dementia journey as well as affecting their internal body clock. This helps to explain why, according to the NHS website, symptoms such as "being confused about time and place...may appear some time before a diagnosis of dementia."
What Issues Can Be Caused by This?
Not being able to effectively keep track of the time can be very distressing for a person who was previously very independent and used to living their life by a routine based around their clock or watch. To be made aware that they're missing meals, struggling to keep appointments or not correctly administering their medication can be confusing and cause high levels of anxiety, as they see their world is changing beyond their control.
Sundowning syndrome is so-called because the symptoms associated with it most often happen from the time the sun goes down. It can lead to a person becoming agitated and anxious, convinced they're in the wrong place and that there's somewhere else they have to be. According to Dementia UK, "There are lots of reasons why sundowning occurs. As the day goes on, the person with dementia becomes more tired, and this can lead to their symptoms worsening.
Hunger, thirst and physical pain can also play a part." To help someone make sense of the time of day and try to help their malfunctioning internal body clock, curtains can be closed before darkness arrives to ease the transition into night-time, as well as preventing naps during the day so that the person naturally feels more tired as the evening wears on.
Clocks that give picture clues as to what time of day it is can sometimes help too, especially when seasonal changes make it difficult for someone to understand why it's dark or light. The Alzheimer's Society online shop sells digital and manual clocks, some with a changing face from day to night to help someone make sense of whether it's a.m. or p.m.
How Can You Make it Easier?
We're fortunate that, as a greater understanding of dementia has been developed over recent years, technology has been invented that can help to reduce a person's anxiety about what time of day or day of the week it is. Clocks and watches now exist that can help someone living with dementia to understand better what time of day it is, as well as other assistive technology that can be beneficial to everyday life, but before buying, it's important to think about whether it's the right solution for the person you're getting it for. Will they embrace the technology? Or could it lead to even more confusion? Sometimes, all it takes is a little distraction to make the person forget that they were anxious about the time, so asking them if they'd like a cup of tea or a favourite biscuit for instance, may be the key to managing time issues, rather than worrying about which timepiece to buy.
What Types of Dementia Clocks Make it Easy to Tell the Time?
There are many different types of clocks available for someone living with dementia, such as the talking variety, those with large-print digital faces for people whose sight is failing, clocks that can display the day, and ones that have soft lights that get brighter for morning and dimmer when it's time to sleep. The experience with diseases such as Alzheimer's that cause cognitive impairment under the 'umbrella term' of dementia is different for everybody, meaning there is no 'one size fits all' way to help those who are struggling with making sense of the time. However, with a combination of technology, thinking 'outside of the box', and distraction techniques it can be prevented from causing too much distress.
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