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All night long

The families and friends of people suffering from dementia will be all too familiar with the nocturnal tendencies that can accompany the onset of the disease. For many carers, this can add further strain to an already strenuous time as they attempt to supervise their loved ones throughout the night.

New York based aged care home, Elderserve At Night has developed a model to alleviate some of this stress, for both the carers and patients, with a revolutionary new model for dementia care.

Up all night

Dementia  Australia describes the disease as, “a collection of symptoms that are caused by disorders affecting the brain. It is not one specific disease.”

While dementia is most commonly associated with memory loss, sleep disturbance or “sundowning” is common  amongst  patients.  Along with trouble  sleeping, according to Dementia Australia people with dementia can become  upset, suspicious and disoriented at night. Other cognitive symptoms such as hallucinations can become heightened at night. While it is difficult to know the exact cause of sundowning, it seems  likely that it is connected to the brain damage caused by the dementia.

“Their day is our night and vice versa, and they are confused about it, Deborah Messina, who runs the overnight program at Elderserve at Night, told The Atlantic. “It is usually at dusk where an agitation comes, a confusion comes,”

 New care model

David Pomeranz,  who founded Elderserve at Night, told The Atlantic that he was inspired to create the program after he saw the difficulties faced by patients and families who were trying to manage sundowning in his capacity as executive director at aged care facility, The Hebrew Home.

“People were sleeping in front of doorways because they were concerned that mom or dad would wander out of the house,” he said.

While there are many day programs available for dementia patients, there are far fewer night programs, meaning that relatively high functioning patients are often placed into nursing homes prematurely.

The model embraces the idea that people with dementia are more active at night. Instead of attempting to convince distressed patients to go to sleep, they offer a range of activities, all supervised by professionals.

 According to The Atlantic, some patients take part in arts and crafts, cooking, yoga, or Zumba, and even live performances, while those whose dementia is more advanced spend the night in a more tranquil environment.  Therapists help them do basic puzzles and work with blocks, helping to ease their agitation and keeping their hands moving.

At 7am patients are showered, given breakfast and driven back to their homes.

Does it work?

While there is little scientific research in this area, there is certainly strong anecdotal evidence to support the Elderserve model.

After Paul Navarro’s mother had been enrolled in Elderserve for a year he told The New York Times, “It’s like her mind cleared up. She’s happier. She’s truly, truly happier.”

Josephina Deletejo, whose mother is also in the program told The Atlantic, “She was very weak when she started there. We had to carry her up and down [the stairs]. But now she walks up and down. She walks to Broadway. She would not react to any of the conversation. Now she does. She’s a totally new person. I would say she’s 200 percent better.”

While there are no similar programs in Australia, the success of Elderserve could provide a model for aged care facilities around the world.