Temporal Disorientation in
Alzheimer’s Disease
Orientation is a fundamental cognitive function that allows us to be aware of who we are, where we are, and at what moment in time. There are three main types of orientation: temporal (related to the perception of time), spatial (related to location in the environment), and personal (related to self-identity). These abilities help us locate and coherently relate to our surroundings.
In Alzheimer’s disease, this function is progressively affected, with temporal orientation being one of the first to deteriorate. For patients, family members, and caregivers, this symptom can be disturbing.
What is temporal disorientation?
Temporal disorientation is the loss of the ability to correctly position oneself in time. People with Alzheimer’s may not know what day it is, confuse morning with afternoon, or believe they are in a different stage of their life. This symptom goes beyond simply forgetting dates and worsens as the disease progresses over time. It is a deep-seated change in the perception of time that can impact quality of life, leading to feelings of insecurity and anxiety for both the person with Alzheimer’s and their loved ones.
How does temporal disorientation affect daily life?
For individuals with Alzheimer’s, the progressive loss of their sense of time is a deeply frustrating experience that creates significant daily challenges. As confusion over the day, season, or time of day worsens, the effects on their activities become more pronounced. Depending on the stage of the disease, these may include:
- Missing appointments or arriving at the wrong time.
- Forgetting to take medication or taking it at the wrong time.
- Dressing inappropriately for the weather (e.g., wearing a heavy coat in summer).
- Asking for lunch in the late afternoon, thinking it is midday, and possibly not remembering they have already eaten.
- Waking up in the middle of the night to get dressed and start the day.
- Repeatedly asking when a family member is coming to pick them up, hours before the defined schedule.
- Seeming to live in the past, a common occurrence as the perception of time becomes intertwined with memory loss.
Strategies to support a person with temporal disorientation
As a family member and caregiver, the type of support will depend on the stage of Alzheimer’s disease.
For early to mild stages, consider these strategies:
- Place large, easy-to-read clocks and calendars in prominent places. Calendars where you can cross off each day can be particularly helpful.
- Use clocks with simple displays. For digital clocks, a 12-hour format (e.g., 5:00 PM) is often easier to understand than a 24-hour format (e.g., 17:00).
- Set alarms with clear reminders. In the early stages, a mobile phone alarm with a text reminder can work well. A simple alternative is a traditional alarm clock with a sticky note attached, reading, “Time to take the blue pill” or “Call Peter.”
For late stages, consider these strategies:
Clocks and calendars may become less effective and even confusing. At this stage, constantly correcting the person is often counterproductive. It can lead to frustration for you and cause distress or agitation for the person with Alzheimer’s.
It is more helpful to use gentle, indirect cues to orient them. For example
- Instead of, “No, it’s Tuesday,” try: “What a lovely Tuesday morning!“
- Instead of, “It’s too late for lunch,” try: “Since it’s late afternoon, let’s get ready for a nice dinner soon.“
The objective is to adapt to their reality and understand their perspective rather than forcing them into ours.
Manage confusion with compassion
Temporal disorientation is a challenging but common symptom of Alzheimer’s disease. While it cannot be reversed, its impact can be managed. By creating a structured, supportive, and patient environment, caregivers can significantly reduce the anxiety it causes and improve the quality of life for their loved one. The key is not to force them back into our timeline, but to join them in theirs.
Join them in their timeline!
Who we are
Moleac is a biopharmaceutical company committed to helping patients and their families reconnect with their lives.
Follow us on social media!
References: 1.Orientación temporal: una capacidad afectada pronto por el Alzheimer. Fundación Pasqual Maragall. Noviembre, 2020. 2. Spatial and Temporal Disorientation. Eugeria. February, 2021.
This document does not constitute the practice of medical consultation nor medical advice. Always seek the advice of your treating physician and/or specialist.
All Rights Reserved by Moleac Pte Ltd, Helios #09-08, 11 Biopolis Way, Singapore 138667
