Blog – Dementia Winter Care

It’s that time of year again. Short days, cold mornings spent de-icing the car… it feels like we’ve had about 3 minutes of autumn and now winter has come in full force. I had to spend 15 minutes clearing snow and ice of my windshield before I could head to work today. I do like winter in the run-up to Christmas but it does come with extra admin and a lot more layers.

However, I recognise that I am fortunate because admin is the only thing I have to worry about in winter. For the half a million people in the UK (probably closer to a million with many undiagnosed) living with dementia this winter, it’s a lot more complicated than that.

Winter and dementia are not something you commonly hear linked in terms of risk but there is a very real link between the cold weather and a worsening of symptoms. I want to use my blog today to try and raise a bit of awareness about this. Increased knowledge will always lead to better standards of care. The medical professionals likely know what to do and not to do for people with dementia in winter so I am really hoping to send this out to those of us who are not in a medical care setting. Hopefully it can help ease the difficulties of people living with such a cruel condition in the coldest of months.

So What is the Risk?

The most obvious risk is the fact that it is icy in winter. This is a risk for anyone who is old. If someone in their 20s slips and falls on ice they will probably be okay. If someone old does it can be a lot more disastrous. Extrapolate that to an old person with dementia and the risk goes up even more. As dementia advances, the person can become less able to coordinate their movements. They are unsteady on their feet and prone to falling. My grandfather had multiple falls simply getting out of his chair as things progressed.

Furthermore, that instinct to catch ourselves and find a way to cushion the fall diminishes too. If a patient with dementia slips on an icy surface the likelihood of a serious injury is through the roof. That, consequently, leads to another factor that can make things worse for the patient. To avoid any nasty falls, people with dementia are commonly kept inside for longer periods in winter to keep them safe from questionable surfaces. This certainly does protect them from falls but it can lead to isolation and depression.

We have all heard of seasonal depression. As the long nights draw in, the sunshine fades and we start to struggle to get our required vitamin D a feeling of gloominess can take over. This is especially true when the excitement of the festive period has died out and we are now longing for spring. This hits people living with dementia extra hard. They can find themselves feeling lonely and lacking social interaction. Depression can set in, and they can miss out on opportunities for mental engagement. After the lockdowns we had record levels of dementia diagnoses and, while we can probably explain this partly by the lack of regular medical appointments, there is no question that the persistent isolation of lockdown contributed significantly. The same phenomenon can happen during winter. The brain needs stimulation. It needs interaction, especially when it is battling the onslaught of dementia.

On top of that, as the days get shorter and shorter, people with dementia can find it hard to distinguish between day and night. My grandfather would look out at 4:30, see that it was dark and think it was the middle of the night. He slept much worse during the winter months. He would wake frequently and this worried us greatly. Dementia can progress at an accelerated rate in someone who is sleep deprived. You’re also more likely to develop dementia if you have a history of bad sleep. Some of the repair mechanisms that our brain uses to protect against the build up of dementia-causing proteins do most of their work as we sleep. A good nights sleep is incredibly important for brain health.

In people living with dementia this lack of sleep leads to worsening symptoms, mood swings and ‘sundowning’ – where the person becomes more confused and agitated as daylight fades. Moreover, they become more susceptible to falls and immunogenic pathogens. Winter is not a good time for someone with dementia.

So What is the Solution?

The solution is simple. It’s human. Individuals with dementia need to see people, especially in winter. Those who care for people with dementia in the various medical/social facilities across the UK do an absolutely wonderful job. My grandfather was encouraged to paint, interact with residents and go to things like the Christmas dinner. But… there is only so much that the care system can do. The person also needs to see their friends and family. My grandfather particularly loved seeing my dog. I would get there and find him difficult to comprehend and speak to. Then he would stroke my dog and he would give me a full account of all the dogs he showed and all the ones he judged. It would reignite his passion for flat coat retrievers and border terriers. I would leave and he was a different person to when he arrived.

I guess what I am trying to say is winter is a challenging time for people with dementia and the people who care for them. If we understand the challenges and what they need, maybe we can make their environment better for them. Invite them for Christmas, go and see them a bit more, bring a dog… anything that can make things a little brighter in these dark, winter months.

Dr Sam Moxon

Author

Dr Sam Moxon is a Research Fellow at the University of Birmingham. His expertise falls on the interface between biology and engineering. His PhD focussed on regenerative medicine and he now works on trying to develop 3D bioprinting techniques with human stem cells, so that we better understand and treat degenerative diseases. Outside of the lab he hikes through the Lake District and is an expert on all things Disney.

Follow @DrSamMoxon