For caregivers of family members suffering from Alzheimer’s or other forms of dementia, nights can be rough.
Dementia often has adverse affects on the sleep/wake cycle, causing many patients to “sundown” — to become agitated or violent in the evenings and to wander around at night.
Not surprisingly, sundowning is one of the top causes of institutionalization of dementia patients, according to Beverly Brinn, director of development and community engagement at the Jewish Association on Aging.
“When [sundowning dementia patients] are living at home with caregivers, the caregivers don’t get a good night’s sleep,” Brinn said. “The impact is great and causes ancillary issues. The caregivers often become ill, and the stress on the health care system is exponential.”
In an effort to provide a respite for caregivers of sundowning dementia patients and to provide healthy nighttime activities for those patients, the JAA will be launching the Nighttime Dementia Program this fall.
“When we were discussing how to allow individuals to remain in their homes as long as possible, the idea of providing services at night came up,” Brinn said.
The JAA decided to build a pilot program to provide nighttime care. A similar program, ElderServe at Night, has been operating out of the Hebrew Home in Riverdale, N.Y., since 1998.
“Our goal is to begin with two clients, but we are trying for three,” said Mary Anne Foley, the JAA’s vice president of home and community based services. “At the end of nine months, we hope to be at six clients.”
Initially, the pilot program will be offered on Sundays, Tuesdays and Thursdays from 9 p.m. until 7 a.m.
“The goal is that individuals can come in any time after 9 and be picked up anytime before 7,” Foley said. “Some may be here all night. Some may be dropped off after midnight, but we’re not offering any type of transportation.”
The nighttime activities will mirror those offered by the JAA during the day and will include music, art, an opportunity to rest in “sleep chairs” and meals.
“We will be caring for those individuals in the same way we do during the day,” Brinn said. “This is what we do. We will be applying what we do to a population we know really needs this help.”
All the patients who will be participating in the pilot program are currently living at home, Brinn said.
“Our goal is to keep people in their homes and to give caregivers a break,” she said. “This can be incredibly meaningful for families. It’s huge.”
Nighttime care for dementia patients may become a significant societal need in the near future, Brinn added.
“Baby boomers are aging,” she said. “And Alzheimer’s statisticians say that a greater percentage of us will have memory issues.”
It is estimated that one out of eight people over the age of 65 will have a memory impairment, Brinn said, and it is projected that 75 percent of those individuals will require nursing home or long-term care.
“The stress on the health care system will be exorbitant,” she said. “We are looking at the big picture.”
The JAA will be working in collaboration with the University of Pittsburgh Alzheimer Disease Research Center, which will study the results of the program once it is up and running.
The ADRC will focus its research on the caregivers of the dementia patients enrolled in the program, measuring conditions such as sleep quality and quality of life, said Jennifer Lingler, a nurse practitioner in the Memory Disorders Clinic, at the ADRC.
“Nighttime behavior disturbances are one of the factors that lead to long-term institutionalism,” Lingler said. “It’s hard on family caregivers. And their stress increases when they place their loved ones in institutions. So it’s taxing in another way. Anything that can be done to delay that would be mentally helpful to family caregivers.”
In addition to giving a break to caregivers, the program should also provide some needed benefits to the patients as well, according to Mildred Morrison, the administrator of the Area Agency on Aging at the Allegheny County Department of Human Services. Morrison provided some guidance to the JAA while it was developing the concept for its nighttime program.
“The intention is that the consumers will be active,” she said. “Then, when they go home to get rest, they will get good sleep. You need good sleep for good health. This could be very beneficial for someone who might otherwise be static or stationery.”
For more information, contact Brinn at BBrinn@jaapgh.org.
Toby Tabachnick can be reached at firstname.lastname@example.org.