Written by the Activity Connection Team
Shift changes are a necessary part of life in any senior living community. Staff members need to exchange important information, gather supplies, check schedules, and prepare for the next part of the day. But for people living with dementia, the noise and activity surrounding a shift change can feel confusing, stressful, or even frightening.
What seems like a normal workplace transition to staff can feel like a dramatic change to participants. By understanding what participants may be experiencing and making a few intentional adjustments, teams can help keep this part of the day calmer and more reassuring.
Why Shift Changes Can Feel Overwhelming
Shift change often brings two groups of employees into the community at once. Staff members may speak more loudly as they greet one another, share updates, and prepare to begin or end their workday. Doors open and close. Phones ring. Carts and equipment move through hallways. People gather their belongings or move quickly from one area to another.
Each of these things may seem minor on its own, but together they create a sudden change in the environment. A person living with dementia may not understand why the community has become busier or why familiar staff members appear to be leaving. They may sense that something is happening without being able to make sense of it.
That uncertainty can lead to anxiety, restlessness, agitation, or attempts to leave.
When Shift Change and Sundowning Overlap
In many communities, a major shift change takes place in the late afternoon. This can already be a challenging time for participants who experience sundowning, a pattern of increased confusion, anxiety, restlessness, or agitation later in the day.
Participants may be more fatigued by this point. Changes in natural light can make their surroundings feel unfamiliar. Seeing staff gather their belongings and leave may also create the feeling that they need to go home, pick up their children, prepare dinner, or complete another familiar responsibility from earlier in life.
The combination of fading daylight, fatigue, increased noise, and visible departures can make an ordinary staffing transition feel unsettling. Although shift changes cannot be eliminated, their effect on participants can often be reduced.
Create a “Low and Slow” Shift Change
Staff members are busy and multitasking, and they are not trying to be disruptive. In the energy of arriving, leaving, and reconnecting with coworkers, however, it is easy to forget how voices and movements may affect participants.
A simple “Low and Slow” reminder can help staff pause and become more aware of the environment:
- Keep voices low. Use calm, conversational tones in hallways, common spaces, and near participants’ rooms.
- Move slowly. Avoid rushing when possible, and move carts, equipment, and personal belongings carefully and quietly.
- Close doors gently. Small sounds can feel much larger to someone who is already tired or uncertain.
- Reduce competing noise. Silence or lower the volume on phones, radios, televisions, and other devices when appropriate.
- Keep handoff conversations private. Conduct shift reports away from gathering areas whenever possible.
Signs can offer a quiet reminder without requiring someone to repeatedly correct staff. Consider posting a message in the area where shift change takes place:
During shift change, participants may not understand why the environment suddenly feels different. When staff keep their voices calm and movements gentle, they can help them feel safe and supported throughout the transition.
For this approach to work, staff need to understand why it matters. “Low and Slow” is not simply another rule. It is one way every department can help participants living with dementia feel safe and supported.
Prepare Participants with Positive Sensory Experiences
What happens before a shift change matters, too. Offering positive sensory experiences and meaningful engagement ahead of time can help participants feel calm, confident, and ready for what comes next.
The best approach will depend on each individual’s preferences, history, abilities, and sensory needs. Options may include:
- Tactile programming, such as folding soft towels, handling familiar objects, using textured materials, or completing another purposeful task with their hands
- Simple, calming music with a steady rhythm and without competing melodies, abrupt changes, or excessive volume
- Familiar scents, such as lavender, when essential oils are appropriate for the individuals in the space
- Intergenerational programs or doll therapy that offer opportunities for nurturing, connection, and shared experiences
- Pet therapy, visits with a community pet, or animatronic pets for participants who find comfort in animals or respond positively to lifelike movement, sound, and touch
Not every experience will work for every individual. A scent, sound, animal, or object that comforts one person may be unpleasant or distressing to someone else. Staff should watch how each person responds, honor personal preferences, and follow care plans and safety practices.
Timing matters, too. Offering a familiar sensory or engagement experience before shift change can help participants feel calm and settled as the transition begins.
Routine and consistency benefit both participants and staff. When participants have a consistent routine, the environment can feel safer and more predictable. When staff have an established plan for this part of the day, they can feel more confident in the support they provide and respond more consistently as a team.
Plan Meaningful Engagement During the Transition
Meaningful engagement can continue while staff members complete their shift change responsibilities. This gives participants something familiar and enjoyable to focus on during a time that might otherwise feel stressful. The goal is not simply to distract them. It is to create a sense of comfort, purpose, and connection.
Depending on participants’ interests and abilities, consider:
- Serving a familiar snack or beverage
- Playing calming or familiar music
- Reading a short story, poem, or daily feature aloud
- Showing a lighthearted video or familiar television program
- Inviting participants to fold towels, sort objects, or assist with another purposeful task
- Offering simple puzzles, coloring pages, or conversation prompts
- Leading a gentle stretching, breathing, or sensory activity
- Creating a reminiscence experience for a small group in a quieter area
Consistency can be especially helpful. When participants begin to associate shift change with a familiar snack, favorite music, or another pleasant routine, the transition can feel more predictable and less unsettling.
Activities should reflect participants’ energy levels throughout the day. Earlier in the day, when energy and focus may be higher, cognitive programs and exercise may work well. Later in the afternoon, familiar and easy to follow activities can provide comfort, create a calmer environment, and reduce the risk of overstimulation.
Choose Reassuring Language
Words can also affect how participants interpret a staff member’s departure. A cheerful “Goodbye!” may unintentionally emphasize that someone is leaving and cause worry that they should be leaving, too.
When appropriate, try reassuring phrases such as:
- “I’ll see you soon.”
- “You’re all set. I’ll check in with you later.”
- “You’re in good hands.”
- “The team is right here with you.”
The right words will depend on the individual and the relationship. A warm, confident tone can reassure the person that they are safe, supported, and not being left alone.
Shift Change Reminders
As your team considers its own routines, these practical reminders can provide a starting point:
- Keep shift reports away from gathering areas whenever possible.
- Use calm, conversational voices in hallways and common spaces.
- Avoid group conversations near participants’ rooms.
- Move carts and equipment slowly and quietly.
- Silence or lower the volume on phones and devices when appropriate.
- Close doors gently.
- Have a calming activity ready before the transition begins.
- Incorporate familiar sensory experiences based on participants’ individual preferences.
- Use reassuring language, such as “See you soon,” instead of emphasizing a departure.
- Watch participants for signs of anxiety and respond to the emotion behind their words or actions.
- Make calm shift changes a shared expectation across departments.
Small Changes Can Create a Calmer Community
Shift changes may be routine for staff, but they happen in the participant’s home. Paying attention to noise, movement, language, and timing can make this part of the day feel calmer, especially for people living with dementia.
A quieter hallway, a familiar song, a gently closed door, or a reassuring “See you soon” may seem like a small gesture. For a participant who is tired, confused, or unsure of what is happening, it may make all the difference.
Creating calm, meaningful routines is easier when your team has the right resources ready to use.
Looking for support to keep your activity program organized, varied, and individualized? Activity Connection offers ready-to-use programming and planning tools to help your team create meaningful engagement every day.
Explore the Discovery Pass for a free look at Activity Connection and the resources available to support your programs.
How does your team help keep shift changes calm and comfortable for participants? Share your ideas and experiences in the comments.
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