Dementia Care

Caring for people with Dementia 

About Dementia

Tips for handing persons with Dementia

Tips for managing problem behaviour in Dementia

Caring for a person with Dementia at home is a difficult task and can become overwhelming at times. Each day brings new challenges as the caregiver copes with changing levels of ability and new patterns of behavior. Research has shown that caregivers themselves often are at increased risk for depression and illness, especially if they do not receive adequate support from family, friends, and the community.

One of the biggest struggles caregivers face is dealing with the difficult behaviors of the person they are caring for. Dressing, bathing, eating—basic activities of daily living—often become difficult to manage for both the person with Dementia and the caregiver. Having a plan for getting through the day can help caregivers cope.Bathing may be a frightening, confusing experience for a person who has Dementia. Having a plan can help make the experience better for both of you.

Communication

Trying to communicate with a person who has Demetia can be a challenge. Both understanding and being understood may be difficult.

  •  Choose simple words and short sentences and use a gentle, calm tone of voice.
  •  Avoid talking to the person with Alzheimer’s like a baby or talking about the person as if he or she weren’t there.
  •  Minimize distractions and noise—such as the television or radio—to help the person focus on what you are saying.
  •  Make eye contact and call the person by name, making sure you have his or her attention before speaking.
  •  Allow enough time for a response. Be careful not to interrupt.
  •  If the person with Alzheimer’s is struggling to find a word or communicate a thought, gently try to provide the word he or she is looking for.
  •  Try to frame questions and instructions in a positive way.
  •  Be open to the person’s concerns, even if he or she is hard to understand.

Bathing

  • Find the right routine. Some people prefer showers, while others prefer tub baths. Time of day is often important as well. Experiment with morning, afternoon and evening bathing.
  • Make it comfortable. Make sure the bathroom is warm, and keep towels or bath blankets handy.
  • Keep it private. If your loved one is self-conscious about being naked, provide a towel for cover when he or she gets in and out of the shower or tub.
  • Help your loved one feel in control. Explain each step of the bathing process to help your loved one understand what’s happening.
  • Be flexible. If daily bathing is traumatic, alternate tub baths or showers with sponge baths.

Dressing

The physical and mental impairment of Alzheimer’s can make dressing a frustrating experience — but helping your loved one maintain his or her appearance can promote positive self-esteem.
  • Establish a routine. Help your loved one get dressed at the same time each day.
  • Limit choices. Offer no more than two clothing options each morning. Empty closets and drawers of rarely worn clothes that may complicate the decision.
  • Provide direction. Lay out pieces of clothing in the order they should be put on — or hand out clothing one piece at a time as you provide short, simple dressing instructions.
  • Be patient. Rushing the dressing process may cause anxiety.
  • Consider your loved one’s tastes and dislikes. Don’t argue if your loved one doesn’t want to wear a particular garment or wants to wear the same outfit repeatedly.

Eating

A person who has Alzheimer’s may not remember when he or she last ate — or why it’s important to eat. Some people who have Alzheimer’s want to eat all the time, while others need encouragement to eat.
  • Eat at regular times. Don’t rely on your loved one to ask for food. As Alzheimer’s progresses, your loved one may not respond to hunger or thirst.
  • Vary the menu. Offer limited but healthy food choices with varied textures, colors and spices.
  • Choose foods that contrast with the color of the plate. Alzheimer’s disease may compromise your loved one’s visual and spatial abilities — sometimes making it tough to distinguish food from the plate.
  • Serve things one at a time. Placing only one item on the plate at a time can help keep meals pleasant and simple.
  • Be careful when serving hot food. Your loved one may not recognize that a food is too hot to eat.
  • Limit distractions. Turn off the television or radio and the ringer on the telephone to help your loved one focus on the task at hand.
  • Eat together. Make meals an enjoyable social event so that your loved one looks forward to the experience.

Toilet

As Dementia progresses, problems with incontinence often surface. Help your loved one maintain a sense of dignity despite the loss of control.
  • Make the bathroom easy to find. A sign on the door that says “Toilet” may be helpful. You can even use a picture of a toilet.
  • Be alert for signs. Restlessness or tugging on clothing may signal the need to use the toilet.
  • Establish a schedule. Schedule bathroom breaks every two hours, before and after meals and before bedtime. Don’t wait for your loved one to ask.
  • Make clothing easy to open or remove. Replace zippers and buttons with Velcro. Choose pants with an elastic waist.
  • Take accidents in stride. Praise toileting success — and offer reassurance when accidents happen.

Patience is the key

Through trial and error you will find that some of the tips work, while others do not. Each person with Alzheimer’s is unique and will respond differently, and each person changes over the course of the disease. Do the best you can, and remind yourself to take breaks. As you help your loved one meet daily challenges, be patient and compassionate. If a certain approach stops working, don’t be discouraged. Simply try something new. As the Dementia progresses, every bit of understanding, flexibility and creativity you can muster will make life easier for both you and your loved one.
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Safety:

Keeping the person safe is one of the most important aspects of caregiving. Some people with Alzheimer’s disease have a tendency to wander away from their home or their caregiver. Knowing how to limit wandering can protect a person from getting lost.

  • Make sure that the person carries some kind of identification or wears a medical bracelet.

  • Consider enrolling the person in the Alzheimer’s Association Safe Return program if the program is available in your area (see “For More Information” to contact the Association). If the person gets lost and is unable to communicate adequately, identification will alert others to the person’s medical

  • Notify neighbors and local authorities in advance that the person has a tendency to wander.

  • Keep a recent photograph or videotape of the person with Alzheimer’s to assist police if the person becomes lost.

  • Keep doors locked. Consider a keyed deadbolt or an additional lock up high or down low on the door. If the person can open a lock because it is familiar, a new latch or lock may help.

  • Install an “announcing system” that chimes when the door opens.

    Install secure locks on all outside windows and doors, especially if the person is prone to wandering. Remove the locks on bathroom doors to prevent the person from accidentally locking himself or herself in.

  • Use childproof latches on kitchen cabinets and anyplace where cleaning supplies or other chemicals are kept.

  • Label medications and keep them locked up. Also make sure knives, lighters and matches, and guns are secured and out of reach.

  • Keep the house free from clutter. Remove scatter rugs and anything else that might contribute to a fall.

  • Make sure lighting is good both inside and outside the home.

  • Be alert to and address kitchen-safety issues, such as the person forgetting to turn off the stove after cooking. Consider installing an automatic shut-off switch on the stove to prevent burns or fire.

  • Be sure to secure or put away anything that could cause danger, both inside and outside the home.

Sleep:

For the exhausted caregiver, sleep can’t come too soon. For many people with Dementia , however, the approach of nighttime may be a difficult time. Many people with Dementia become restless, agitated, and irritable around dinnertime, often referred to as “sundowning” syndrome. Getting the person to go to bed and stay there may require some advance planning.

  • Encourage exercise during the day and limit daytime napping, but make sure that the person gets adequate rest during the day because fatigue can increase the likelihood of late afternoon restlessness.
  • Try to schedule physically demanding activities earlier in the day. For example, bathing could be done in the morning, or the largest family meal could be served at midday.
  • Set a quiet, peaceful tone in the evening to encourage sleep. Keep the lights dim, eliminate loud noises, even play soothing music if the person seems to enjoy it.
  • Try to keep bedtime at a similar time each evening. Developing a bedtime routine may help.
  • Limit caffeine.
  • Use night-lights in the bedroom, hall, and bathroom if the darkness is frightening or disorienting.
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Activities

Finding activities that the person with Dementia can do and is interested in can be a challenge. Building on current skills generally works better than trying to teach something new.
  •  Don’t expect too much. Simple activities often are best, especially when they use current abilities.
  •  Help the person get started on an activity. Break the activity down into small steps and praise the person for each step he or she completes.
  •  Watch for signs of agitation or frustration with an activity. Gently help or distract the person to something else.
  •  Incorporate activities the person seems to enjoy into your daily routine and try to do them at a similar time each day.
  • Try to include the person with Dementia in the entire activity process. For instance, at mealtimes, encourage the person to help prepare the food, set the table, pull out the chairs, or put away the dishes. This can help maintain functional skills, enhance feelings of personal control, and make good use of time.
  • Take advantage of adult day services, which provide various activities for the person with Dementia, as well as an opportunity for caregivers to gain temporary relief from tasks associated with caregiving.