It’s Never “Just Lighting” in the Care of Alzheimer’s Patients

Most people usually take a room's lighting for granted. They switch lights on and off for comfort, like wanting total darkness when they sleep. For some, the concern is purely for design, like dim lights to make the room cozy or yellowish light to give a hotel-like feel to the place.

For patients with Alzheimer's disease, however, caregivers adjust the lighting, not because of the above reasons, but for a more worthwhile purpose—to foster a patient’s wellbeing.

Experts agree that typical dementia-related behavior, such those stated below, worsen when a room is poorly or improperly lit.

ABNORMAL SLEEP PATTERNS

People need adequate lighting, not only to see, but also to establish wake and sleep patterns. When the sun rises, it signals the body to wake and be active during the day. When the sun goes down in the late afternoon, it signals the body to stop working and start relaxing until finally drifting off to sleep at night. Brain changes in Alzheimer's, however, make the patient unable to do this repetitive pattern.

As dementia worsens, a patient's sleep and wakefulness cycles become abnormal. They tend to sleep more during the day but are up and about for most of the night. Caregivers who care for these patients can be burned out from disrupted and inadequate rest, themselves.

DIFFICULT AND AGGRESSIVE BEHAVIOR

Patients with Alzheimer’s also tend to be more upset, forgetful, restless, and worried in the late afternoon and early evening, which coincides with the setting of the sun. This behavior is called “sundowning” and is frequently observed in those with unrestful sleep during the night.

DEPRESSION

Depression is common in dementia patients, especially those in nursing homes. Brain changes as well as being away from family and friends make a patient lose interest in formerly enjoyable activities, which makes them sicker and weaker in the long run.
Here are helpful ways to adjust lighting in an area to improve the wellbeing of a patient with Alzheimer's disease:

1. Use lots of natural light.

Let the sunshine in! In the morning, open curtains and windows. If possible, put them in a room with views of the outside world, something that stimulates memory and thinking. This is a good way to help establish their sleep and waking cycles. They'll be more alert and active during the day and sleep better at night. They are also less likely to get anxious at nightfall.

Also, natural light is the best for older people to see things around them. Here’s a fact: Older people aged 75 years and above need their environment twice as bright as the standard to be able to see their surroundings properly, and lots of natural light will do the trick.

2. When the weather is gloomy, or if access to natural light is limited, caregivers need to be creative.

In the morning, turn on the brightest light that will give an equal amount of brightness across the room. Here's an interesting thing to consider: People with Alzheimer's tend to misinterpret things around them, so unequal lighting that produces shadows is a big no-no! Keep the lights on until just before bedtime to prevent or lessen sundowning behaviors.

At night, turn on yellow lights or LED strips that lead to the restroom. These lights will guide the patient if they need to use the toilet. Strong lights in the hallway can make them think it is daytime and add to their confusion.

3. Remove glare.

Glare is light bouncing off smooth and shiny surfaces, such as metal, floors, and mirrors. It can also result when a light source shines directly in one's eyes, such as a bare bulb, spotlight, or direct sunlight passing through a window. Glare is uncomfortable and distracting, and must be avoided.

So, you see, when caring for an Alzheimer's patient, lighting is a big deal. When someone wonders about all the fuss over keeping a room brightly and uniformly lit, tell them it's about promoting a patient's wellbeing.