UPDATE YOUR LISTING: To update information, resubmit your health notes by email to tmunnell@tribtoday.com.

SUGGESTIONS FOR ALZHEIMER’S HELP: For people on a regular routine, the end of Daylight Saving Time was a noticeable change. Sunset arrives one hour earlier, so it is darker in the evening.

Sundowning, also known as late-day confusion, occurs in some Alzheimer’s patients, meaning that their confusion or agitation could be worse in the late afternoon or evening hours. Some known factors that cause sundowning are end-of-day exhaustion (both mental and physical) and an upset in the “internal body clock,” causing a biological mix-up between day and night.

Caregivers may need a plan to help their loved one get accustomed to darkness arriving earlier. Experts recommend scheduling out-of-home activities in the morning and keeping the home well-lit in the evening hours.

Experts also say night-time restlessness typically peaks in the middle stages of Alzheimer’s, and then diminishes as the disease progresses. Scientists don’t completely understand why sleep disturbances occur with Alzheimer’s disease, which is a fatal brain disease that cannot be prevented, cured or slowed. As with changes in memory and behavior, sleep changes somehow result from the impact of Alzheimer’s on the brain.

Research indicates that up to 45 percent of people with dementia may have sleep problems. Many people with Alzheimer’s wake up more often and stay awake longer during the night. Those who cannot sleep may wander, be unable to lie still, or yell or call out, disrupting the sleep of their caregivers. Experts estimate that in late stages of Alzheimer’s, individuals spend about 40 percent of their time in bed at night awake and a significant part of their daytime sleeping. For sleep issues due primarily to Alzheimer’s disease, most experts encourage the use of non-drug measures, rather than medication.

Here are some tips if a person is awake and upset at night time: Approach him or her in a calm manner; find out if there is something he or she needs; gently remind him or her of the time; avoid arguing; offer reassurance that everything is all right; don’t use physical restraint. If the person needs to pace, allow this to continue under your supervision.

The Alzheimer’s Association is the leading voluntary health organization in Alzheimer’s care, support and research. Visit www.alz.org or call the 24/7 Helpline at 800-272-3900.

OPEN ENROLLMENT FOR HEALTH: The Ohio Association of Health Underwriters issued a reminder that health care open enrollment is underway. For those 65 and older, Medicare enrollment ends Nov. 7; for those younger than 65, Marketplace or ObamaCare enrollment is now to Dec. 15

Employer plans are generally enrolled in the last quarter.

For assistance with enrollment choices, seek a professional health care insurance agent licensed within Ohio at www.healthbenefitsohio.org or by calling 888-210-4060.

TALK ABOUT LGBTQIA: The Mahoning County Juvenile Court and the Mahoning County Mental Health and Recovery Board are hosting a webinar titled “Community Summit: Let’s Talk about LGBTQIA” 9 a.m. to noon Friday. The webinar is free and offers three hours of approved continuing education for attorneys, teachers, social workers and counselors.

Derek Steyer, TV-21 news anchor, will moderate the summit, which features Youngstown State University professor Amanda Fehlbaum, YSU student adviser Brian Wells, Jan Baharis of PFLAG and Daniel Tirabassi of Full Spectrum. Three individuals with lived experiences will discuss their personal stories.

Registration is free but required at docs.google.com/forms/d/e/1FAIpQLSfQpgz2geIlSgYBghgqapFNQ-QgOAc6sHbHY-fXxasl9k6yFQ/viewform.

FREE FITNESS PROGRAM: The Stepping Out Program, provided through a grant from the Mercy Health Foundation, offers free fitness classes and activities online and throughout the Mahoning Valley.

For information, call Doris Bullock, project coordinator, at 330-720-3293 or email her at dibullock@mercy.com.

SUICIDE SUPPORT: Help Network of Northeast Ohio will hold a survivors of suicide support group 6 p.m. Wednesday by conference call. Anyone grieving the death of a loved one to suicide may join by emailing cgrizinski@helpnetworkneo.org to register for the conference call.

CAREGIVER SUPPORT: The Alzheimer’s Association Greater East Ohio Area Chapter makes Alzheimer’s caregiver support groups available free to all caregivers, family members and friends with a loved one affected by the disease or another form of dementia.

For more information on updated times and dates, or to confirm, contact the Alzheimer’s Association 24/7 Helpline at 800-272-3900.

FAMILY SUPPORT GROUP: Family Recovery Center’s Oxford House (also known as Eloise V. Traina Center of Hope), 320 Benton Road, Salem, began a Families Anonymous meeting as fellowship for the family and friends of those individuals with drug, alcohol or related behavioral issues.

To learn more about the support meetings offered, contact 330-424-1468.

VALLEY COUNSELING OPERATING: Valley Counseling Services continues to provide mental health services to residents of the Mahoning Valley throughout the viral outbreak. Necessary precautions will be taken to keep clients and staff safe.

Most services will be phone-based or video-based. Clients do not need to cancel their appointment. Instead they will receive therapy, case management, nursing and psychiatry services in the safety of their home.

Visit the website at vcs.fcsserves.org or call 330-399-6451 for more information.

PEER-TO-PEER SUPPORT: Domestic abuse support groups are available for all types of abusive relationships — emotional, verbal or physical. For more information, contact 330-856-3463.

SUPPORT GROUP: For information about the Circle of Hope, a support group for those with a mental health diagnosis, call 330-502-8103.

LUPUS SUPPORT: For information about the Trumbull Mahoning Lupus Support Group, call Rhonda at 330-978-3749. Meetings are the second Tuesday of each month.

ADDICTION SCREENINGS: Narconon can help families take steps to help someone overcome addiction. Call 800-431-1754 for free screenings or referrals.

For information, visit www.narcononnewliferetreat.org/blog/intervention-101.

PSYCARE OFFERING TELEHEALTH: PsyCare is providing phone-based or video-based mental health services through its clinics in Austintown, Boardman, Cortland, East Liverpool, Howland, Liberty and Struthers. Visit the PsyCare website at www.psycare.com or call 800-242-4604.

ADDICTION THERAPY AVAILABLE: PsyCare Inc., 2980 Belmont Ave., Liberty, offers a clinical therapy program to treat individuals with substance abuse and drug addiction issues. Family members are also welcome. Assessments can be scheduled by calling 330-759-2310.

ONE HEALTH OFFERS TELEHEALTH: ONE Health Ohio offers telehealth appointments to patients for medical, behavioral health, chronic care management, dietetics and medication-assisted treatment services. Call 877-722-3303 or visit www.onehealthohio.org.

Telehealth appointments for medication-assisted treatment and counseling are available through RISE Recovery by contacting 844-652-8219. RISE Recovery also remains open for in-office visits, dependent on appointment type.