How to Structure Your Day When Living With Early-Stage Alzheimer’s

Often, people with Alzheimer’s “have a harder time processing new or unexpected things, so having a routine that’s somewhat predictable helps reduce the number of unexpected activities and makes transitions a bit easier,” says Stephanie Nothelle, MD, an associate professor of medicine who specializes in geriatric care at Johns Hopkins Bayview Medical Center in Baltimore. “It’s easier for the brain to recognize that pattern and feel comfortable with the familiarity.”

Structure your morning, afternoon, and evening routines with brain-healthy habits — factoring in your personal preferences — to support yourself on this journey.

How you start your morning can set the tone for the rest of the day.

• Wake up at the same time each morning. Keeping a regular sleep-wake schedule by going to bed at the same time each night and waking up at the same time each morning can help support your body’s internal clock, which plays an important role in regulating memory, thinking, and mood.

  [2]

   “Not everyone is a morning person, though,” says Dr. Nothelle, so factor your personal preferences into your routine.
• Eat a nutritious breakfast. Skipping breakfast may negatively impact your cognitive health, so do your best to start your day with a well-balanced meal.

  [3]

   Consider breakfast options that follow a Mediterranean- or MIND-style diet, as both have been shown to support brain health. Build a breakfast plate with options like leafy green vegetables, berries, whole grains, poultry, fish, beans, legumes, nuts, or olive oil.

  [4]

• Get moving. For many people, the morning can be a great time to be active, says Nothelle, because it’s a time of day when your symptoms are less likely to impact your ability to focus on fitness. Staying active can help reduce physical decline and preserve daily function with Alzheimer’s disease. Options like yoga or simply dancing around the kitchen count.

  [5]

• Practice cognitive activities. “Your brain is often freshest in the morning, which can be a good time to do a more cognitively stimulating activity,” says Nothelle. Pick one that suits your personal interests, she adds, whether that’s reading the newspaper or doing a crossword puzzle.

The afternoon is all about balancing socialization, nutrition, activity, and relaxation.

• Stay socially engaged. Late morning or early afternoon, when you’re likely to have more energy and focus, are good times to plan social activities. Consider grabbing a cup of coffee with a friend or calling a loved one to catch up. Aim for quality over quantity, as shorter interactions are often less taxing and more enjoyable than longer ones.

  [6]

• Make lunch count. Many people with Alzheimer’s disease are more alert and have a better appetite in the afternoon than in the evening, so consider making lunch your largest, most nutritious meal.

  [7]

   And be sure to schedule your midday meal for the same time each day to keep it predictable, advises Nothelle.
• Take a walk. If you’re not into morning exercise, the afternoon is another opportunity to get moving. “A lot of people have an afternoon slump,” says Nothelle. While it may be tempting to nap, a midday snooze can contribute to nighttime sleep issues.

  [8]

   Instead, “incorporating some physical activity, like going for a walk around the neighborhood, can be really helpful,” adds Nothelle.
• Factor in time to relax. Mid- to late afternoon can be a tricky time for some people with Alzheimer’s disease, says Nothelle. That’s when sundowning, or an increase in Alzheimer’s symptoms like confusion and agitation, tends to crop up.

  [7]

  Try to get ahead of it by planning a less-stimulating, somewhat relaxing activity like listening to music or coloring, adds Nothelle.

Managing daily life can start to become increasingly difficult as the day goes on, so evenings should focus on relaxing and preparing your body for restful sleep.

• Eat a light dinner. A smaller, lighter evening meal can help you avoid feeling overly full or uncomfortable at bedtime. Also, consider avoiding caffeine and alcohol at night, which can also interfere with quality sleep.

  [9]

   “And again, keep it predictable by scheduling dinner for the same time each day,” says Nothelle.
• Unwind from the day. “The evening should really be as low-stimulation as possible, which can look different from person to person,” says Nothelle. For example, some people may wind down by watching television, while others might find screen time to be very stimulating. In that case, an audiobook or podcast might suit you better.
• Set the scene for quality sleep. Sleep problems are common in people with Alzheimer’s disease, and lack of sleep can contribute to restlessness, agitation, irritability, and confusion.

  [8]

  It’s important to help your body recognize that it’s time to rest. “Think about lighting, set your bedroom to a cool temperature, and really create a relaxing, calming environment to help with the transition to a predictable and regular bedtime,” says Nothelle.