Whether you are dealing with dementia due to Alzheimer’s Disease or some other reason, you should be educated on how to care for your loved one. I will first advise that if you haven’t attended a class or support group on Alzheimer’s, you should. You will gain more valuable information, and you will be together with others who are going through the same difficult time.
Many years ago when I worked in a facility, I was assigned at times to the dementia unit. I learned at that time that in order to be an effective caregiver you first and foremost needed a lot of patience. I also learned it was not my goal in life to work in that environment. It takes special people to work with advanced dementia but in the early stages while patients are still home, it is the family’s responsibility and it can be very stressful.
Here are some tips that will help reduce that stress for both the patient and caregiver.
- Establish a Routine- Changes in food, schedules, and environment can sometimes be more than the patient can handle. Write down a schedule. If using outside help, make sure you specify suggestions that will be beneficial such as “Speak in a quiet tone of voice or Wait for Alice to respond to an instruction.” If the patient becomes incontinent, make sure you include a toileting schedule. Every 2-3 hours remind them or assist them to the bathroom.
- Practice reality orientation- Dementia patients’ short term memory is very limited. Keep telling her the time of day and what activity you are going to do next. For instance say, “Alice, it’s Tuesday morning and we will be eating breakfast soon.” You don’t want to challenge them by saying, “Alice, don’t you know today is only Tuesday?” This will cause unneeded anxiety as they will feel belittled. Remember, although you may have to care for them as a child, they are still adults with dignity.
- Simplify surroundings- Try to decrease noise levels and avoid busy environments like shopping malls and restaurants. The dementia patient may mistake pictures on walls for real people, so you may want to remove them if this happens. They may forget which door is the bathroom. You could provide a picture of a toilet on the door to help. This may also delay problems of incontinence.
- Avoid fatigue- Dementia patients fatigue easily. Plan important activities for the day and less strenuous ones for later. Make sure there are plenty of rest periods. Relaxing in a recliner during the day will be better than in a bed as the patient may confuse the time of day.
- Don’t expect too much- You will need to accept that the patient’s limitations. Do not be too demanding. Trying to force them to remember or continue an activity they used to do will only cause more frustration.
- Prepare for illness- Increases in abnormal behaviors or a decline in cognition may occur when the dementia patient becomes ill. In fact when patients have urinary tract infections (UTIs), this may be the first sign they have. If you notice a change in behavior or cognition, contact her physician or home care nurse immediately.
- Use a sense of touch- In addition to losing memory, dementia patients may also lose vision and hearing senses. You should approach from the front as to not frighten her which may provoke aggression. The need for increased closeness can be addressed by touching her hands and arms at first. Dementia patients can feel a sense of isolation and touch can ease that sensation.
- Handle problem behavior- Dementia patients can exhibit inappropriate behaviors such as aggressiveness, hallucinations, agitation, yelling, exiting, etc… Practice good diversion tactics such as going for a walk, rocking in a rocking chair, sanding wood, or folding laundry. Repetitive activities do not require any sequence or planning and can make the patient feel like they are completing a task. Having a basket full of towels handy at all times can help.
If your loved one tries to wander or exit the home frequently, you can camouflage doors with murals or posters so they don’t look like doors.
- Remove potential safety hazards- Move knives, forks, scissors and other sharp objects away from the patient’s reach. Serve food on unbreakable dishes. Remove knobs on the stove and any other dangerous small appliances. Adjust water heater temperature to no higher than 120 degrees F. Cover unused electrical outlets. Remove throw rugs. Keep floors and stairways clear of clutter or objects that the patient can trip over. Barricade stairways with gates. Store all medications in a locked container and out of reach of the patient.
- Install assistive devices- Provide a low bed to prevent injuries from falling out of bed. Keep nightlights on. Install grab bars near toilet and in bath or shower. Provide an ID bracelet with vital information. Give local police a picture and contact information in case the patient is found wandering in the streets.
I hope these tips are useful. If you have some to add, please post them below. Watch for the next article on taking care of yourself!