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Disorientation

Changing behaviour

"My sister visits once a week (on Tuesdays) but I lose track of time. Last week, I complained that she never comes round. She reminded me that she had been to see me the day before." (Petra)

"My father complains that I leave him on his own for hours which is just not true. One day, as a bit of a joke, I gave him a kitchen timer, set it for one hour and said I’d be back in an hour. I came back about 50 minutes later and he commented that I was early. Well at least it worked!" (Jack)

People can generally judge the passing of time fairly accurately. For example, they know roughly what time it is, how long they have been in a certain place, how long somebody will take to do something etc. This ability is linked to some extent to remembering what has just been done and correctly interpreting signs in the immediate environment. They also tend to have a kind of internal clock which guides them to eat, sleep and wake according to their own regular schedule.

Dementia often affects this internal clock and the ability to judge the passing of time accurately. This can lead to restlessness and anxiety. For example, it may not be important to know the exact time. However, if a person usually does something at a particular time, it can be distressing not to know when that time is. The person may be afraid of missing out on something important e.g. a shopping trip or a favourite television series. This is possibly one reason for repeatedly asking what time it is or when a particular event is going to take place. Some people who have had a lifetime habit of doing something important at a particular time (perhaps linked to their work) feel restless at that time of the day. It can help relieve the restlessness if the person does something else at that specific time each day.

For the person with dementia

  • Develop and stick to routines in order to keep track of events.
  • Keep a schedule of your daily routine.
  • Make a note of appointments.
  • Mark important events on a calendar and cross them off when they are over.
  • Keep track of time by marking off days on a calendar.
  • Ask someone to make sure that you don’t miss anything of importance to you.
  • Check the time by looking at your watch or clock from time to time. Clocks with faces and numbers might be easier to understand than roman numerals or fancy designs. Some people with dementia find the 24 hour clock confusing.
  • Look for other clues as to what time of the day it is e.g. darkness in the evening, certain people being at home, the mail arriving etc.

For the carer

  • Help create routines e.g. for meals, baths, doctors’ appointments, shopping etc.
  • Help the person with dementia to keep track of appointments and events.
  • Make regular reference to dates and times when talking e.g. “it’s a nice day for December” or “oh, it’s Wednesday, your sister should be here soon.”
  • Don’t immediately contradict what the person with dementia says even if they mix up dates. It might be possible in the course of the conversation to help them to position themselves more accurately in time.
  • With repeated questions, try to find out what is worrying the person with dementia. Try to provide reassurance in addition to answering the question.
  • If the question is about time, repeating the time does not help as the person with dementia may forget the answer. It doesn’t help either to say “in one hour” as one minute may seem like one hour to someone who has lost the notion of time.
  • Worrying about the person with dementia getting up in the middle of the night may disturb your sleep. If so, get a pressure pad for the bed which will alert you only if the person with dementia gets out of bed. Alternatively, you could use an alarm which goes off when someone leaves the bedroom.

 

 
 

Last Updated: vendredi 11 septembre 2009

 

 
 

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