Her Clock Has Turned Around, and the House Is Keeping Her Hours

Sometimes the first sign is not at the door. It is the kitchen light on at three in the morning, a chair turned toward the window, and a woman dressed for a day that has not started yet. Her clock has turned around, and the house is now keeping her hours. This happens often enough after a dementia diagnosis that it helps to know what it looks like before you have to solve it in the dark.

Local option: New Plan Care gives families in the St. Louis area in-home help so a parent can stay home: companionship, help with bathing and dressing, meals, and overnight care. Call (314) 405-0887.

What the reversal looks like

A reversal is a pattern, not a single bad night. She sleeps late into the morning and wakes as the light is going. She naps long in the afternoon and is restless after supper. When the house is quiet, she is up and moving from room to room, and when you finally fall asleep, she wants to go out or start the day. Compare this with her own normal. A few broken nights after a change in routine is one thing. Two weeks in which her day has moved to the other end of the clock is another.

Keep a short log

For about two weeks, write down the hour she goes to bed, the hour she first gets up, any long nap, and what the evening looked like. A page on the refrigerator works. Note the small things too: a meal skipped, a visitor, a television left on, a change in her room. The log is not for proving anything. It gives her doctor a clear picture, and it shows you where the pattern starts.

Bring the pattern to her doctor

Take the log to her next visit and say what changed and when you first noticed it. Ask whether anything in her body or her surroundings could be behind the shift, such as pain, a bladder problem, a room that is too hot or too cold, or a change in one of her medicines. Ask what you should watch for and what would make it urgent. Keep an up-to-date list of everything she takes so questions can be answered quickly. Any change to her medicine is the doctor's decision and the pharmacist's to check, not something to adjust at home.

Make the night easier while you work it out

Use a low, steady light in the hallway and along the route to the bathroom, not a bright overhead switch that tells her it is morning. Keep the chairs and the path clear. Check the outside doors before the house settles, so that a walk to the kitchen cannot become a walk out the back. Plan a quiet activity for the hours she is up, something that asks very little of her and lets you sit beside her. She does not need correcting for being awake. The goal is a calm room, not a fixed clock.

Plan for your own sleep

If you are the one awake with her, the reversal will wear you down faster than she notices. Split the night with another adult where you can, and decide ahead of time who takes which hours. The Lifelines: Dementia Help in St. Louis page covers local dementia help, and it is worth reading before the schedule starts to slip.