Are you unable to take time off your caregiving duties because your loved one living with dementia is experiencing sundowning? Fortunately, there are night respite and home-based overnight care services that are available for caregivers like yourself. These services will be helpful in supporting you with caring for a loved one living with dementia who is experiencing sundowning (e.g. being restless at night).
This article outlines the Night Respite service, and how caregivers can be supported to get their much-needed respite while their loved ones living with dementia are in a safe environment that allows them to continue to be meaningfully engaged in activities overnight.
Caregiver Teo Lay Shuang's Story
In 2021, Lay Shuang became the sole caregiver for her father, Mr. Teo, who had been diagnosed with dementia two years prior. Mr. Teo was experiencing sundowning symptoms, and was often unable to distinguish day and night. At night, he was restless, agitated and had difficulties sleeping. He often wanted to leave the house for walks at night, but as his vision and hearing are impaired, Lay Shuang had to accompany him to ensure his safety. He could go without sleep for two days and developed hallucinations that he was being locked up in an unfamiliar place.
Although Lay Shuang utilised home care services in the day, caregiving for her father at night left her exhausted and overwhelmed.
Sometimes, I get feelings of depression… It is only when he [is] asleep that I [am] able to have some time to myself and do my own things. Being a caregiver can feel so lonely and scary at times.
During one of Mr. Teo’s appointments at a polyclinic, she chanced upon Vanguard Senior Care Centre at Senja. The staff informed her of the Night Respite service, where her father could be engaged with physical exercise such as hand pedaling, as well as cognitive, sensory and reminiscence activities such as colouring and puzzles. She decided to enrol her father for the service and is glad she made that choice.
Now, Mr. Teo attends the Night Respite service four times on weekdays, excluding Wednesdays. She has been able to get much-needed rest at night without the worry that her father is unattended.
As the Vanguard staff are all trained and experienced in caring for persons living with dementia, I feel assured and comfortable with handing over the care of my father in the night to the centre. He is also able to sleep better now.
Lay Shuang encourages other caregivers to make use of services that can lighten their load, especially if they have other responsibilities such as caring for children or work commitments.
Story provided by Vanguard Woodlands.
Read the full story here: A Little Respite Goes a Long Way – By Caregiver Teo Lay Suang
Sundowning and its Impact on Caregivers
Persons living with dementia may display changes in their behaviour in the evening that may last throughout the night. During this time, your loved one may experience some, if not most, of the following behaviours:
- Heightened activity levels
- Visual or auditory hallucinations
This is known as sundowning, which often occurs in the moderate to severe stages of dementia. While this primarily affects the sleep patterns of your loved one, it is important to acknowledge the ways in which sundowning may affect yourself as well. Caregivers often have to forego their sleep to ensure that their loved one is engaged and safe, and are unable to take time to themselves to recuperate from their caregiving duties in the day.
Find out more about the causes of sundowning and ways to manage it.
How can the Night Respite Service Help?
Night Respite is an overnight respite option for caregivers of persons living with dementia who are displaying sundowning behaviours. This service was introduced to provide caregivers much-needed time off from their caregiving duties at night and ensure that persons living with dementia are well cared for during this time.
Caregivers will also be informed by care staff on ways to better manage their loved ones’ sundowning behaviours. Caregivers may bring their loved one with dementia to the respective service providers. At the service provider’s premises, care staff who are trained and experienced in caring for persons with dementia will attend to them and provide custodial care.
They will engage the clients in exercises and meaningful activities including cognitive, sensory and reminiscence modalities such as colouring, puzzles and games to meaningfully engage the person living with dementia. There is no formal schedule or timetable during Night Respite sessions, so the activities chosen are often dependent on the mood and energy levels of your loved one.
Applying for Night Respite Services
Before applying for night respite, you may want to speak to your social worker, case manager or doctor. You can also call the AIC hotline (1800-650-6060) to find out more about your options and whether night respite is suitable for your loved one. Night respite programmes typically cost between $75-$130 per night before subsidies, depending on whether transport for your loved one is required. The service is not available on weekend nights and public holidays.
To qualify for night respite programmes, your loved one must be diagnosed with dementia by a medical practitioner registered with the Singapore Medical Council. They must also display sundowning behaviours. Caregivers can find more information at https://www.aic.sg/caregiving/night-respite.
If you are eligible, AIC will connect you with one of the night respite care providers, who will then conduct a pre-admission assessment with both you and your loved one to determine their care needs. They will also advise you on the final price and subsidies available during the assessment.
Night Service Care Providers
2 Woodlands Rise
Tel: 6540 9200
Peacehaven Nursing Home
9 Upper Changi Road North
Tel: 6546 5678
Your First Visit to the Night Respite Service Provider
Remember to bring the hospital discharge summary and pack your loved one’s medication and medication instructions for the care staff. If centre-based programmes are unsuited for your loved one, you may want to consider overnight care instead of night respite.
Overnight care programmes involve a trained care professional coming over to provide care to your loved one in their home throughout the night. It is hence more suitable for persons living with dementia who require complex care or are bedbound.
Enabling Festival 2022 – Interview with Angeline Gan from Vanguard Woodlands about Night Respite
Source: Enable Asia
Living with Dementia: A Resource Kit for Caregivers – Providing Care
Source: Agency of Integrated Care
This booklet offers tips for effective communication, designing a daily routine, managing behavioural changes (including sundowning and wandering). It also links caregivers to resources that may be helpful as their loved one’s dementia progresses.
Is Your Loved One Experiencing Sundowning?
Source: Agency of Integrated Care
This resource features information on the possible causes of sundowning & tips for caregivers to cope with it.
- Agency for Integrated Care. A little Respite Goes a Long Way [Brochure].
- Agency for Integrated Care. (2021). Night Respite Brochure [Brochure]. Agency for Integrated Care.
- Agency for Integrated Care. (2020, February 01). Respite Care in Singapore: What you need to know. https://iepa.org.au/network-news/it-doesnt-need-to-be-this-way-the-promise-of-specialised-early-intervention-in-psychosis-services/
- St. Joseph’s Home. (2020). Dusk-to-Dawn Official Brochure [Brochure].