by Shelley | Jan 28, 2026 | Dear Donna
Dear Donna:
As the primary caregiver for my grandpa, every day seems to present something new. He was diagnosed with Alzheimer’s disease about 18 months ago.
Lately, he’s been getting agitated in the evenings. He paces and makes laps around the house. Several times I’ve caught him trying to open exterior doors and windows in what seems like an attempt to leave the house.
My husband and I moved in with my grandpa about six months ago to take care of him. I work remotely so I can be with him around the clock. But this behavior really has me worried. Our neighbor said her mom exhibited similar symptoms and the neurologist they saw called it sundowning.
Can you help me to better understand this behavior and what I can do to keep him safe?
Sincerely,
Morgan in Sutton’s Bay, MI
Navigating Sundowner’s Syndrome
Dear Morgan:
I’m glad you wrote to ask about this! It can be one of the most challenging behaviors associated with Alzheimer’s disease.
Sundowner’s syndrome, often called “sundowning,” occurs in older adults living with Alzheimer’s disease or other forms of dementia. It refers to a pattern of increased confusion, agitation, anxiety, or restlessness that typically occurs in the late afternoon, evening, or nighttime hours. While sundowning can be distressing for both seniors and caregivers, understanding the condition and learning effective management strategies can help reduce its impact.
What Causes Sundowning?
The exact cause of sundowner’s syndrome is not fully understood, but several factors are believed to contribute:
- Changes in the body’s internal clock
- Fatigue from the day’s activities
- Reduced daylight and increased shadows
- More household noise in the evening
As you’ve witnessed, the most common signs of sundowning include increased confusion, pacing, restlessness, irritability, mood swings, paranoia, or verbal outbursts. Wandering from home or attempting to do so are also more likely.
Some people may become more withdrawn, while others may experience hallucinations or difficulty sleeping. These behaviors are not intentional and can be frightening for the person experiencing them.
Reducing the Symptoms of Sundowner’s Syndrome
Managing sundowner’s syndrome begins with creating a calm, predictable routine. Consistency helps provide a sense of security and reduces anxiety. Maintaining regular times for waking, meals, activities, and bedtime can help stabilize the body’s internal rhythm. Limiting daytime naps—especially late in the afternoon—may also improve nighttime sleep.
Other steps you can take to try to minimize the impact of the symptoms include:
- Managing lighting: Light plays an important role in managing sundowning. Increasing exposure to natural daylight in the morning and early afternoon can help regulate sleep-wake cycles. In the evening, keeping rooms well-lit can reduce shadows that may cause confusion or fear. Pulling blinds and curtains closed can also help. As bedtime approaches, gradually dimming lights can signal that it is time to wind down.
- Avoiding overstimulation: Reducing stimulation in the late afternoon and evening can also help. Loud noises, crowded spaces, or too much activity may increase agitation. Calm activities such as listening to soothing music, reading, or having gentle conversation can create a more relaxing environment. Avoiding caffeine, alcohol, and heavy meals later in the day may also reduce restlessness.
- Controlling physical needs: Meeting basic physical needs is essential. Ensuring the individual is well-hydrated, has eaten balanced meals, and is comfortable can prevent discomfort that may contribute to agitation. Pain, urinary urgency, or constipation should be addressed promptly, as these can intensify sundowning behaviors.
When agitation does occur, responding with patience and reassurance is key. Speaking calmly, offering simple explanations, and avoiding confrontation can help de-escalate the situation. Redirecting attention to a familiar or comforting activity may also be effective. Arguing or correcting the person can increase distress and should be avoided.
Support for Family Caregivers
For family members, managing sundowner’s syndrome can be emotionally and physically exhausting. It may be beneficial to schedule an appointment with your grandfather’s physician. They may have solutions to help.
You may also want to consider utilizing respite care services in a specialized dementia care community. Your grandfather will be in good hands while you take a break to rest or enjoy time with your husband.
I hope this information is helpful, Morgan!
Kind regards,
Donna
by Shelley | Jan 28, 2026 | Caregiving, Dear Donna
Dear Donna:
My father passed away recently and my mom is living alone for the first time in her life. While she’s obviously grieving, she is also very lonely on her own. My husband and I have been thinking of getting her a dog this spring. It seems like a good time to bring a new friend into her home. Until my dad got sick, my parents always had a dog. They lost theirs just before my dad’s diagnosis.
While mom is planning on staying in her home for another year or so, we are trying to think ahead. Our hope is that she will be ready to transition to an independent living community before next winter. Do you think the benefits of having a pet as a senior are worth the extra work? Do most senior living communities allow pets? We want to clarify that before we approach my mom with this idea.
Any advice would be appreciated.
Sincerely,
Chris in Williamsburg, MI
Can Pets Help Seniors Improve Emotional Well-Being?
Dear Chris:
First, my condolences on the loss of your father. I’m sure it’s been a tough time for you, too. Watching a parent grieve is also difficult. But it sounds like your idea could be worth considering.
Pets play a powerful role in enhancing emotional well-being, especially for seniors. As people age, life changes such as retirement, reduced mobility, or the loss of loved ones can lead to feelings of loneliness or isolation. Pets offer friendship, comfort, and a sense of purpose that can greatly improve a senior’s emotional health.
- Companionship: One of the most significant benefits of having a pet is companionship. Pets provide a constant, nonjudgmental presence, which can be especially comforting for seniors who live alone. The simple routine of greeting a pet in the morning or having one nearby throughout the day can reduce feelings of loneliness and create a sense of connection. For many seniors, pets become trusted friends to talk to.
- Lower stress: Pets also help reduce stress and anxiety. Studies have shown that interacting with animals can lower cortisol levels and increase the release of feel-good hormones like serotonin and oxytocin. Petting a dog or cat, listening to a bird sing, or watching fish swim can have a calming effect on the mind and body. This can be particularly beneficial for seniors dealing with anxiety, depression, or cognitive changes.
- Responsibility and purpose: Having a pet encourages routine and responsibility, which can be emotionally grounding. Daily activities such as feeding, grooming, or walking a pet provide structure and purpose. This sense of responsibility can help seniors feel needed and valued, reinforcing self-esteem and motivation. Even small tasks related to pet care can bring a sense of accomplishment and meaning to each day.
- Socializing: Pets also promote social interaction. Walking a dog through your community or local park often leads to casual conversations with neighbors and other pet owners. These interactions can help seniors build connections and feel more engaged with their community. In senior living settings, pets often become a shared source of joy, sparking conversations and strengthening relationships among residents.
- Devotion: Additionally, pets offer unconditional love. They do not judge, criticize, or hold grudges. This consistent affection can be deeply reassuring, particularly during times of emotional difficulty. For seniors coping with grief or major life transitions, a pet’s loyalty and presence can provide comfort and stability.
Finally, in response to your question about senior living communities and dogs, I would say most allow pets. But with a qualifier or two. Communities often have a weight/size limit and some may have breed restrictions. Most also require the senior to manage the pet’s care or be able to pay for someone who can.
If you haven’t already, it might be helpful to read this article, “Best Pets for Older Adults in Michigan,” on our blog. It might offer some additional insight on what types of animals to consider.
Kind regards,
Donna
by Shelley | Dec 29, 2025 | Dear Donna
Dear Donna:
My 84-year-old father is a veteran. His health has been slowly declining over the last few years. I don’t live close enough to him to provide the amount of care I think he needs.
Dad’s neighbor, who is also a veteran, told me there are benefits available to help pay for his care. He wasn’t sure how much my dad could qualify for or how it worked, though. Can you offer any advice or point me in the right direction?
Sincerely,
Julie in Midland, MI
Senior Care Covered by VA Benefits
Dear Julie:
I’m so glad that your father’s neighbor shared this information with you! There are benefits available for veterans who qualify, but they often go overlooked because older adults aren’t aware of them. So, here’s a quick overview.
The U.S. Department of Veterans Affairs offers several programs that help pay for senior care, ranging from medical services to personal assistance for daily living. What a veteran qualifies for depends on service history, medical needs, income, and disability rating. The most notable one is the Veterans Aid and Attendance benefit. This benefit provides monthly payments added to the amount of monthly VA pension qualified veterans and survivors already receive.
How Does a Veteran Qualify for the VA Aid and Attendance Benefit?
To receive this enhanced benefit, a veteran must already be eligible for a basic VA pension. Once that hurdle is overcome, a veteran or their surviving spouse must:
- Require help with two activities of daily living (ADLs), which can include tasks such as dressing, bathing, or toileting
- Be bedridden due to an illness or injury
- Live in a nursing care center because of a physical or cognitive disability
- Have vision loss that measures 5/200 or less in both eyes, even when wearing glasses, or a visual field of 5 degrees or fewer
VA Aid and Attendance Benefit Amounts
The VA Aid and Attendance benefit is evaluated by Congress on a regular basis. They determine what is known as the maximum payment amount rate (MPAR). The benefit payment then depends on a veteran or surviving spouse’s individual circumstances.
Currently, a veteran, couple, or surviving spouse may be entitled to receive one of the following monthly benefits:
- Single veteran: Up to $2,358
- Married veteran: Up to $2,795
- Veteran with spouse who needs care: Up to $1,851
- Surviving spouse: Up to $1,515
- Two married veterans (both eligible): Up to $3,740
The VA does not directly pay communities, but a veteran can use their monthly payment for:
- Assisted living rent
- Personal care fees
- Memory care programs
- Medication management
- Other support services
Here’s a quick look at what types of care your dad might benefit from to help him enjoy the best quality of life.
Senior Care Services to Consider
Many veterans prefer to remain at home as they age, while others feel safer and less isolated in a community setting. The VA provides multiple programs to support either of these.
- Homemaker and home health aide services
These services help with ADLs such as bathing, dressing, toileting, meal preparation, and mobility assistance. An aide may come a few hours a week or work full-time, depending on assessed need.
The VA pays for temporary care to give a family caregiver time off. This can occur at home or in a senior care setting, such as assisted living, memory care, or a skilled nursing center.
These programs provide structured daytime supervision, social activities, rehabilitation therapies, and nursing services. It is ideal for families where the primary caregiver works full-time.
- Assisted living and personal care homes
Depending upon the state in which you will be looking for care for your dad, another solution might be an assisted living community. These are sometimes referred to as personal care homes. Families often consider these to be an ideal solution. They combine the privacy and independence of having a private apartment or suite with the support of on-site caregivers around the clock.
- Specialized dementia care
Designed to support the unique needs of adults with most forms of dementia, including Alzheimer’s, the VA Aid and Attendance benefit can be utilized for this type of senior living. They offer dedicated programs and services to meet the challenges of adults with memory impairments.
- Long-term nursing home care
For veterans with significant medical or custodial needs, the Veterans Administration may cover care in several types of long-term centers either directly or through the use of the Aid and Attendance benefit:
- Community living centers (VA-run nursing homes): These provide 24-hour skilled nursing, rehabilitation, social services, and memory care. Priority is often given to veterans with service-connected disabilities.
- State veterans homes: Partially funded by the VA but operated by states, these facilities offer long-term nursing care, memory care, and sometimes assisted living. Veterans typically pay a reduced cost.
- Community nursing homes (contracted private facilities): The VA contracts with participating nursing homes to pay part or all of the cost for eligible veterans when VA beds are unavailable or unsuitable.
I hope this quick overview is helpful, Julie! I invite you to call a Heritage location near your dad if you need help determining what type of senior care best meets his needs.
Kind regards,
Donna
by Shelley | Dec 29, 2025 | Caregiving
Winter can be a challenging season for caregivers, especially those who live in northern states like Michigan and Indiana. Shorter daylight hours, colder weather, and the post-holiday slump can intensify feelings of exhaustion, isolation, or emotional strain. When your focus is on supporting others, it’s easy to overlook your own needs.
However, practicing healthy self-care isn’t a luxury, it’s essential. It’s as vital to the person you provide care for as it is to you. Here are five practical strategies to help you beat the caregiver blues this winter and restore your sense of balance and well-being.
5 Tips for Caregivers to Protect Mental Health during the Winter
- Practice small, consistent self-care rituals.
Grand self-care plans often fall apart during busy days of caregiving. Instead, focus on small rituals that create steady emotional nourishment. Start with five-minute practices you can realistically maintain: stretch when you wake up, stand by a sunny window to catch morning light, or enjoy a warm drink before tackling the day’s responsibilities. These tiny pauses calm your nervous system and help counter the sluggishness that winter often brings.
If possible, schedule one weekly activity just for yourself. It could be taking a short walk at the park, engaging in a hobby you’ve neglected, or enjoying a relaxing bath. Think of these as non-negotiable appointments. The consistency of small acts like these helps replenish the energy reserves you rely on for caregiving.
- Increase light and movement to boost your mood.
Winter’s lack of sunlight can disrupt sleep patterns and decrease serotonin levels, contributing to mood dips. Combat this by maximizing natural daylight and incorporating movement into your routine.
Open blinds early, take quick outdoor breaks even if it’s chilly, or consider using a light-therapy lamp in the morning. Pairing light exposure with gentle movement, such as a 10-minute session on a walking pad, stretching exercises, or chair yoga, can improve focus, boost mood, and reduce tension.
The key is not intensity but frequency: small bursts of light and movement throughout the day can be remarkably uplifting.
- Don’t hibernate.
Caregiving duties combined with cold weather can make it tempting to hibernate. But reduced social interaction and isolation can amplify stress and sadness, so staying connected is essential. You might have to be a little more creative to stay connected if your family member can’t be left alone.
Schedule regular check-ins with friends or family, whether through phone calls, text threads, or virtual coffee chats. Join an online caregiver community or support group where others understand your challenges without explanation. These connections provide a sense of belonging, reduce emotional load, and remind you that you’re not alone in your experience.
If you prefer in-person interactions, try inviting a friend over for tea or asking someone to join you on a short walk. Nurturing these social ties helps counteract winter’s isolating effect.
- Ask for—and accept—help without guilt.
Caregivers often shoulder more than they should, which increases the risk of burnout. Winter’s demands can make things feel even heavier. This season, challenge yourself to ask for help early and often.
Consider delegating small tasks to family members, neighbors, or friends, such as picking up groceries, helping with transportation, or covering an hour of care so you can rest. Explore community resources like respite services, volunteer visitor programs, or adult day programs if available.
Most importantly, release the idea that accepting help means you’re not doing enough. Seeking support is a sign of awareness and strength, not weakness.
- Create moments of joy and meaning.
Winter doesn’t need to just be a season you endure. Instead, find ways to infuse it with simple joys that brighten the season. Start by identifying activities that genuinely make you feel good: listening to favorite music, watching a comforting movie, baking something fragrant, or doing crafts with the person you’re caring for.
Small, intentional moments of joy help counterbalance stress and create emotional resilience. Consider introducing seasonal traditions, such as lighting a candle at dusk, writing in a gratitude journal, or planning a weekly “cozy night” with blankets and warm foods. These rituals give you something to look forward to and offer a sense of grounding.
Consider Respite When You Need a Winter Break
If you are feeling overwhelmed with and exhausted by the demands of caregiving, a weekend away or a staycation at home might be the solution. Utilizing the respite services of a senior living community can make that possible. Your family member will receive the same care and support as long-term residents, and you’ll have peace of mind knowing they are in good hands.
We encourage you to call a Heritage location near you to learn more about our respite care programs and schedule a visit to one of our communities!
by Shelley | Dec 29, 2025 | Alzheimer's and Dementia
Dear Donna:
My mom has Alzheimer’s and has been living with my family for the past few years. While her disease is still considered to be mid-stage, one concern we have trouble managing is when the time changes here in Michigan. It seems to really disrupt her sense of well-being and ramps up her agitation.
In anticipation of the spring time change, I’m wondering if you have any tips for helping us better support her. We would appreciate any suggestions.
Sincerely,
Lisa in Saugatuck, MI
Tips to Help a Senior with Alzheimer’s Navigate Seasonal Time Changes
Dear Lisa:
This is a great observation! As one of the largest providers of Alzheimer’s care in Michigan, it’s a change in behavior we see often, too.
For most people, the shifts caused by Daylight Saving Time—either gaining or losing an hour—pass with only minor inconvenience. But for individuals living with Alzheimer’s or other forms of dementia, even a small disruption in daily rhythm can cause confusion, agitation, or a temporary worsening of symptoms. Understanding why this happens and knowing how to prepare can make this seasonal transition much smoother.
Why Time Changes Can Be Hard for People with Alzheimer’s
Because memory is impacted by this disease, people living with Alzheimer’s often rely heavily on routine. Predictable schedules offer structure and emotional security, helping them feel anchored throughout the day.
A sudden change in light patterns, such as darker mornings in fall or brighter evenings in spring, can confuse the body’s natural clock. This internal clock, known as circadian rhythm, regulates sleep, hunger cues, energy levels, and even mood.
Because Alzheimer’s disease affects the parts of the brain that manage time perception and sleep-wake cycles, these changes can be especially disruptive. It’s common to see:
- Increased confusion, particularly in the late afternoon or early evening
- Sleep disturbances, such as waking up earlier or having trouble falling asleep
- Worsening of “sundowning” symptoms, including agitation, pacing, or restlessness
- Irritability or anxiety as the person struggles to understand why the environment feels “off”
Even though the clock changes by only one hour, the shift in daylight can feel much more dramatic for someone already coping with cognitive changes.
How Caregivers Can Prepare and Reduce Stress
The good news is that with a few thoughtful adjustments, you can help ease the transition for a loved one with Alzheimer’s and minimize the impact.
- Adjust routines gradually.
In the week leading up to a time change, try shifting daily activities by 10–15 minutes each day. Adjust wake-up times, meals, medication schedules (if appropriate), and bedtime slowly rather than all at once. This gentle transition helps the body adapt more naturally.
- Use light to your advantage.
Light is one of the strongest tools for regulating circadian rhythm. A well-lit environment can reduce restlessness and support clearer thinking.
- In the fall, when evenings become darker earlier, add indoor lighting in the late afternoon to reduce confusion.
- In the spring, when mornings become brighter, open blinds early to help the body wake up naturally.
- Maintain familiar rhythms.
Even when the clock changes, the overall pattern of the day should remain as steady as possible. Keep meals, walks, bathing, and relaxing activities in the same order and general timeframe. Consistency builds comfort.
- Reduce stimulation during the transition.
If your loved one experiences sundowning, keep evenings calm. Lower noise levels, limit screen use, and choose soothing activities such as listening to music, folding towels, or looking at photo albums.
Predictability helps reduce anxiety.
- Monitor sleep and adjust gently.
A slight change in sleep patterns after a time shift is normal. If your loved one wakes too early or struggles to settle at night, encourage restful habits. Those can include soft lighting, warm beverages without caffeine, and a quiet pre-bed routine. Avoid forcing sleep, which may increase agitation.
- Be patient and reassuring.
A calm, steady presence is one of the most valuable tools you have. Offer reassurance, speak gently, and expect that your loved one may need extra support for a few days.
One final tool you might find helpful is this article, “How to Manage Sleep Problems in Adults With Alzheimer’s.” It has ideas you might find useful.
Kind regards,
Donna
