Did we learn to live life at a slower pace during our time of quarantine?
Ever since re-entry, I hear over and over about how fast time is going. Of course, we all know that time is the same, yesterday, today, and tomorrow, but our perception of it has changed. Instead of the old daily calendar sheets flying off the wall Hollywood-style, now those calendars are weeks and months.
The delightful Fall weather has fooled us into thinking that it's still August. This weekend, we turn the clocks back one hour as darkness descends closer to 5 pm. For most of us, it's a minor adjustment -- we unpack our cozy sweaters, spend less time outdoors after work, and settle into our winter selves. The binge T.V. begins again...
Let there be LIGHT
Adjusting to the increased darkness can be a much greater challenge for our vulnerable elders and others, especially those who suffer from cognitive decline, dementia, and mental health concerns. Often, sundowning (disorientation, confusion, agitation, and depressive symptoms) is associated with this time of day. Daily, our world delivers tremendous input into our central nervous systems. Yet, we don't consider how the natural world affects us.
We all know about "Seasonal Affective Disorder" (S.A.D.) and probably appreciate that it is, in fact, a "real" thing that affects people. Try the following exercise to help you understand the impact of environmental change on those for whom self-regulation is difficult: imagine yourself in your lowest mood, feeling very anxious and afraid, and when you go outside for a breath of fresh air, it's stormy and 4 degrees. Compared with a day like we've had recently (crisp, clear, sunny, and 70 degrees), you will "feel" it. We can't change the amount of daylight or weather that mother nature gives us, but we can be creative and clever about how we respond.
I have visited many homes in my 30 years as a home care nurse, and most have poor lighting throughout with old, dim fixtures and low-wattage bulbs. If that is the situation for your elder loved one, brighten it up! Add some new lights, brighten the output, and put their lights on timers. If we bridge the gap between daylight and dusk (and do it early, say 3 pm), there is evidence to support an easier transition and fewer symptoms of sundowning. The addition of light is a valuable tool.
Pulling the wool over your eyes
Often, folks who have done well over the summer are revealed to be struggling when seasons change. For example, they may not adjust their clothing for the season without help. They may even leave windows open or have the heat very high (or not on at all).
Making the seasonal shift might not happen automatically, even if it has every other year. Keeping eyes wide open and assessing for these types of behaviors can be alarming for sure. But, on the other hand, knowing what might have been a vague suspicion for a while yields valuable information about what might be helpful and necessary.
Daily phone calls for the first few weeks after the time change are helpful to reorient and reassure. Gentle reminders about dinner time, taking medications, locking doors, and turning on outside lights go a long way. During those calls, get a sense of your loved one's mental clarity and purpose. Many vulnerable elders can really "turn it on," meaning they can present their very best selves on-demand… you've all seen it at their doctor's appointments. "I'm fine, Doctor, no complaints at all," dressed to the 9's and charming. When we suspect some compromised thinking, it reveals itself with consistent checking in and assessment.
Things that go BEEP in the night…
It's time to change over the batteries in your smoke and carbon monoxide detectors. While you are at it, go crazy and check the fire extinguisher you have in the cellar stairway, kitchen, or other location. Is it covered with dust? Replace it. If it's more than a couple of years old, replace it.
What your vulnerable elder loved one needs for a Holiday gift, more than a box of chocolates or another scarf, is many good flashlights sprinkled around the house. Buckets of ice melt ready to go at the doorways, shovels and brooms at the ready, and the winter clothes checked for fit and size and made readily available. Check their boots too. Are they so old that the soles are slippery? Never a better gift.
Running hot and cold
Want to go the extra mile? A programable thermostat can save the day. A "win-win" is getting Mom/Dad/Auntie/Uncle out of the habit of touching it… and if they are comfortable, there's no reason to even think about it, let alone turn it up to 90 degrees.
Watch out for the old "trusty" space heaters. Many new tower models automatically shut off if tipped over, do not overheat, and are not the fire risk of the old models. Most elders run "chilly."
And lastly, check their slippers to make sure they have anti-slip soles. Many hips have been broken because socks were slippery on wood floors…despite the familiar promise of "don't worry, I won't fall!"
Sorry to add to your "to-do" list…but an ounce of prevention beats a pound of cure.
(Joanne MacInnis is RN CDP, President - CEO of Aberdeen Home Care, Inc.)