One of the most disconcerting losses when dementia strikes is becoming unable to track time, understand the calendar, or keep appointments.
Can you remember an occasion when you were struggling to understand something and suddenly comprehension dawned? That welcome rush of understanding—of mastery of an idea or the way to do something—is one we all enjoyed daily as we progressed through childhood. Yet by adulthood, we have become so used to understanding what we see, read, and hear that we forget how frustrating and scary it is to be unable to. If you’ve ever traveled in a country where you don’t speak the language, you’ve had a reminder of how it feels to not be able to make sense out of what you see or hear.
Dementia can feel like being in a foreign land
Our loved ones and clients experiencing dementia are traveling in a land that’s becoming increasingly foreign to them. And, hard as it is to not understand written or spoken information, they are also becoming unable to imagine how quickly the clock hand moves from 12:00 to 12:05, or how much longer it takes for it to go from 12:05 to 3:00. Worse, they are becoming unable to hold two facts in their minds at once, unable to see cause and effect, unable to make plans, unable to initiate an activity on their own.
Without these skills, how can we expect them to calmly accept an assertion that they could go for lunch and be back in time for a three o’clock hair appointment, or go to a doctor’s appointment in the morning and be home again by noon?
The inability to read a calendar or clock is distressing
The inability to keep appointments and read clocks and calendars becomes distressing for both parties. How can we help our loved ones stay on top of things and in-the-know, and feel more comfortable as they lose cognitive functions? Here are a few tips from what we do with our clients here at DAWN.
Dementia tips for calendars and schedules:
Expect experiential learning only
Dementia takes away or rational thought processes but leaves our intuitive ones, so people become unable to learn by memorization but continue to learn from experience. So, if you allow deadlines and appointments to become a source of conflict, you’ll have increasing trouble over time issues. Instead, keep in mind that when someone has dementia, it is always possible that you’ll make it to an appointment on time, but never probable. Focus your attention on one preparatory task at a time, but primarily on your loved one. This approach gives you the best chance of making deadlines. More importantly, though, your loved one will learn that it’s always fun to do things with you, rather than learning that when the clock is involved there’ll be trouble.
Keep it simple
Here are some tips for how to make a calendar easier to understand for someone experiencing dementia:
- Find a large calendar that shows no more than one month when laid open on the counter.
- Each morning, cross out yesterday so that the first square not crossed out is always “today.”
- Watch to see whether your loved one can interpret “3 pm,” “3:00” or “3 o’clock” and use that format only.
- Always put the time first and follow it with a succinct description of the activity.
- Use whiteout; don’t cross things out.
- Keep notepaper and a pen nearby so they can attempt to write their own notes, because copying something out gives a feeling of mastery and security.
Schedule one activity per day
When people are in the early stages of dementia, they are able to manage more than one activity in a day without becoming stressed. As they progress, it’s best to cut activities back to one each morning and afternoon, then to one per day, and eventually to provide sensory and social stimulation with brief interactions rather than activities.
Helping our loved ones and clients feel safe even though they cannot read the clock or make sense of the passage of time is an important way we can support them.
If you would like to learn more about the DAWN Method of dementia care, sign up for our newsletter and get our free video series, “Preparing for Dementia.”
Other resources: Dementia With Dignity (book) and DAWN HomeCare: Dementia Training for Families and their Caregivers (6-person group membership for online video course).
FAQs about dementia and calendars
Try to get a large paper calendar that only shows one month at a time. Keep it somewhere on a counter or table top. Each morning, cross out the day before on the calendar so that the next day is always “today.” For more dementia calendar tips, read the rest of this article, Dementia and the Calendar.
There is no easy answer to this, but try a few of the following strategies. Only schedule one activity in a day. When getting your loved one ready to go, ask them to complete only one task at a time since people with dementia are losing the ability to remember processes. (So, ask them to put on a sock. Then, when they’re done, ask them to put on a shoe.) And, above all, keep smiling while you ask. Keeping everyone in a positive mood is the most important tool of the DAWN Method of dementia care.
People experiencing dementia are in the “3-second now.” They are losing a sense of the past and the future, but are very much in the present. If they are enjoying their cup of coffee, they may not want to get up and get ready for a doctor’s appointment. Because of this, it’s important for caregivers to change their expectations of what can be accomplished each day. Also, remember not to frown if you’re running late. Your companion with dementia will take that personally.