Practical Suggestions for Everyday Concerns
Providing care for someone with dementia can be both rewarding and challenging at times. Below are some common issues caregivers experience and some suggested approach strategies. It is important to remember that each person living with dementia is unique, so creativity and patience are essential for care partners.
Celebrate small achievements. Set expectations at a level the person with dementia can actually perform to help them feel a sense of accomplishment.
Stay calm and avoid physical confrontation. Notice nonverbal cues. Remove potentially harmful items from the immediate environment. Try reassuring comments such as, “I’ll stay with you until you feel better.” When appropriate, provide the person with an opportunity to experience a sense of control. Consult the family physician if the behavior continues or gets worse.
Your attitude and facial expression will likely be mimicked by the person with Alzheimer’s disease. Take a minute to calm yourself and prepare for every interaction.
Bathing can be a difficult time for a variety of reasons including modesty, feelings of vulnerability, and lack of understanding that the person needs assistance with this task. Do not try to force someone to bathe. If they refuse, try again later. Try using a bath towel or pancho to keep the person covered as much as possible, ensure that the room temperature and water temperature are comfortable for them, and allow them to assist in the bathing process as much as possible. Be aware of any pain that could be present.
As vision changes and the person with dementia becomes more uncertain, they may cling to you for support. Reassure them of your presence, give them something to do where they can see you, and don’t be afraid to ask for support from family and friends.
As dementia progresses, changes may occur in the person’s ability to effectively express thoughts and understand language. When this happens, it may be helpful to use gestures, simplify communication, repeat messages as needed, and allow the person time to process and produce language. Apologize for having such a hard time and show them what you want rather than speaking it.
A routine can be beneficial for the person with dementia, but flexibility is essential. When faced with the inability to control the progression of the dementia, a common response is to try to control as much as possible related to the person’s actions and care. Give up the need for control and the need to be “right”. Educate yourself about the disease and learn to predict behavior triggers whenever possible.
Use illustrated signs for rooms in the home. Perform the task you are requesting from them, then point to them. They may be able to mimic the behavior when they can’t understand the words.
This is a very sensitive topic for many families, as driving often equates to independence and ability to come and go as wanted. Reasoning about safety concerns with the person with dementia may not be effective. Consider a driving assessment form a local organization. Involving a healthcare professional may help, if the provider is willing to write a note stating that the person is no longer safe to drive. If this is not possible, hide the keys or disable/remove the car.
Where memory fails, expressions of thoughts and events are intermingled with fictitious comments as the person tries to fill in the gaps. This behavior is not malicious, but a part of the disease process.
If spirituality was an important part of a person’s life before having dementia, make sure they continue to have outlets for spiritual expression. To avoid overstimulation, you may consider attendance at a smaller church, televised sermons/music, and family Bible reading.
Falls often occur due to poor vision and changes in depth perception due to the progression of dementia. Remove unnecessary obstacles on the floor and tables, secure rugs and cords, and don’t move furniture unless it is necessary. Never leave your loved one alone if they can’t respond appropriately in case of emergency.
Incontinence may occur due to forgetfulness or inability to control one’s bodily functions. Make more frequent trips to the bathroom. Use adult incontinence briefs. Fidgeting is a common indicator of discomfort or physical need.
A person with dementia may put things away to secure them and forget where they put them. Get to know their hiding places by helping them look for lost objects. A person with dementia may also have suspicions or thoughts that someone is trying to steal from them or harm them in some way. Use a calm, reassuring approach and express that the intention is to provide support. When thoughts get stuck on a specific issue, it may help to distract them with reminiscing, or sensory stimulation.
Reminiscing and Connecting
Get creative about using every possible moment for connecting. Use music that is familiar to them, pictures, art, and storytelling to spark memories for both of you. There are still ways to connect, despite the cognitive changes they are experiencing.
Physical exercise is very important to keep muscles and joints working. Walking and stretching are good exercises.
Everyday activities that could previously be done quickly and with ease, may become more challenging and take more time. Simply put, allow the person living with dementia more time to accomplish tasks. Trying to rush will only heighten anxiety for both the caregiver and the person with dementia.
Talk About It
Comments made by family, friends, and strangers can be hurtful. If given the opportunity, tell others how you are feeling rather than letting it build up inside you. Educate them about the disease and the impact of caring for someone with dementia.
Undressing inappropriately may be a cue that the person with Alzheimer's diseas is anxious or uncomfortable. Assess and treat the discomfort as appropriate and provide distraction.
Assess the reason for wanting to leave (e.g. looking for a bathroom, looking for “home”). Place a dark mat in front of exit doors as this may be perceived as a hole. Put curtains over the doorway and close the curtains in the evening.