DEMENTIA CARE IN THE HOME
Although most Dementia is caused from irreparable causes, there is still plenty that families can do to assist their loved ones in continuing to function to the best of their abilities. Creating a comfortable and safe environment that’s supportive for someone with Dementia can be realized via these best practices.
DEMENTIA: GENERAL CARE PRACTICES
Doctors, Researchers and Eldercare Specialists are still discovering what works and what does not when it comes to Dementia care, but the following strategies have been proven effective:
CHEER ON INDEPENDENCE Research has shown that “Graded Assistance,” a method designed for dementia patients can go a long way to maintaining functional independence when combined with daily practice and positive reinforcement. Graded assistance is a technique that assists someone in accomplishing tasks with the least amount of assistance possible, using a spectrum of aid from verbal prompts & physical demonstration, physical guidance, partial physical help and complete physical help.
DAILY ROUTINES Start with an assessment, of daily routines, that you may be able to put in place to make things go more smoothly. Most folks like to have an idea of what’s happening next, that’s where a “daily rhythm” can be particularly useful for those dealing with the general confusion symptoms. If there are times of day when your loved one is less confused or more likely to be cooperative, so plan your important activities or therapies around those times.
TRY MUSIC Research has proven music soothes and reduces behavioral issues, like agitation and aggression (especially during key periods like mealtimes and bathing). Nonetheless, it's imperative to note that the music must be something that the person with dementia desires, not necessarily what the caregiver assumes would be nice to listen to. Playing your precious one's preferred types of music is naturally the most effective form of Dementia therapy.
COMMUNICATION. COMMUNICATION. COMMUNICATION.
Reduce Distractions: When you're attempting to have a focused conversation, turn off the TV, radio, and/or anything else that can cause your loved one to become distracted.
Speak Simply & Directly: For better results try choosing simpler words and shorter sentences while using a calm, gentle tone of voice. Note: Be sure to approach the person with dementia like an adult; avoid taking a superior tone.
Have Patience: Be sure you allow enough time for their response. Be cautious not to interrupt. If they are truly struggling to find the right words or communicate their thoughts, gently attempt to provide the words they are looking for.
Get Their Attention: Call your loved one by name, making sure they are looking at and listening to you before and while you are speaking.
CLEANING & BATHING
Dementia can make baths confusing and often times frightening. Planning in Advance will make bath time better on both of you…
Plan Ahead: Be sure to get everything you need ready ahead of time, including all the cleaning supplies, a towel and change of clothes. Get the water flowing ahead of time and be sure to set the right temperature and check it on your own skin first, but try using your forearm instead of your hand to get the real feel of the temp.
Minimize Safety Risks: Use a hand-held shower device, a sturdy shower bench, reinforced grab bars, and most importantly non-skid bath mats. Never leave anyone unattended in the bath or shower.
Warm the Bathroom: Undressing can be especially unpleasant when it's cold and even worse once they emerge from bathing wet. Turn up the heat as needed.
Limit Bathing: Try substituting every-other shower with sponge baths. This should depend on how active or sedentary your loved one is, they may not need a full shower every single day.
Narrate Their Bath Time: Tell your loved one what you are doing, step by step, and allow them to assist as much as possible.
For patients battling Dementia, getting dressed offers a series of problems, from picking out clothes, to determining how to properly take things off, as well as putting other things on and even how to use buttons and zippers. Here are some things you can do to streamline the process:
Encourage Free Choice: Encourage your loved one to choose from a selection of outfits that you make. If they have a favorite outfit, consider purchasing multiple identical sets.
Organize Clothes in the Right Order: A great help indeed is eliminating the need for decision-making by placing clothing items out in the order they are to be put on.
Provide Instructions only if Needed: If your loved one needs encouragement or instruction, provide clear, step-by-step directions.
Choose Suitable Clothes: When choosing clothing for dementia patients it’s recommended that the clothes you choose be comfortable and easy to get on and off. A great tip: Elastic waists and Velcro closures minimize struggles with buttons and zippers.
Make Eating Easy: Make use of straws or cups that have lids to make drinking easier and cleaner. Serve easily grabbed, finger foods or bite sized portions if the person has trouble with utensils. Also, try using bowls instead of plates which may also help encourage independent eating.
Serve Snacks and Small Meals: Patients with Dementia may have a limited appetite and/or attention spans… Always plan on serving smaller portions and supplementing these smaller meals with snacks.
Limit Disruptions: Ensure a calm, quiet atmosphere for mealtime by limiting distractions and other noise, may help the person focus on the meal.
Don’t Skip the Dentist: A healthy mouth and healthy teeth is key to helping dementia sufferers eat more “appropriately.”
EXERCISE & STAYING ACTIVE
It is important to incorporate physical and mental stimulation into daily routines for both caregivers and their patients. Here are a few tips for making regular exercise and other activities a routine part of daily life:
Keep Expectations as Realistic as Possible: You may need to modify their favorite activities to suit their current abilities… Go slowly, be sure to take things step-by-step, and avoid their frustration and overexertion.
Take Advantage of Organized Programs: Local senior centers usually offer classes and often times activities suitable for those with dementia. You can also check into adult day services occasionally, which can be a worthy source of daily socialization for those with dementia and for relief for caregivers.
Find Enjoyable Activities for both of you: Choose from strolls around the neighborhood, game nights and other regular outings, activities should be simple and fun for everyone.
As the Dementia advances, many patients begin to experience incontinence. Occasionally incontinence is due to physical illness, so be sure to discuss it with the patient’s doctor. Beyond that, here are some tips for managing restroom care:
Seek Signs of Discomfort: Are they unusually restless, all-of-a-sudden introverted or even tugging at their clothes? It’s probably time to take them to the bathroom.
Be Calm. Be Positive: When accidents occur, you can minimalize humiliation by dealing with them matter-of-factly.
Go Regularly: The best policy is to take your loved ones to the bathroom with regular breaks. Don't wait for them to tell you they need a restroom break, or it may be too late.
Preventing Accidents: Some great ways to avoid accidents from incontinence are: avoiding liquids after a late in the evening. If you are out with the patient, plan ahead, by knowing where bathrooms are located, and by having your loved ones wear easy-to-remove clothing.
Getting enough rest helps to ensure optimal mental capacity, including those with Dementia. Try some of these methods to increase the chance of everyone getting a great night's sleep:
Be Consistent at Bedtime: You can help your loved one cultivate an optimal “internal clock” through keeping bedtime within 15 minutes of the same-time every evening.
Try to Avoid Caffeinated Beverages: Limit coffee, tea and soda, especially after lunch and into the evening.
Keeping Evenings Peaceful: When it's approaching bedtime, dimming the lights and avoiding activities that stimulate like watching television, being online or playing games. You might also find that putting on relaxing music or reading to your loved one helps them relax.
Try Exercise: Just like when we are children, getting adequate physical activity each day is crucial to sleeping deeply at night.
HELP WITH HALLUCINATING AND DELUSIONS
As the Dementia advances, people with Dementia may experience delusions and. The following practices can be used to help manage these types of experiences:
No Television: Programming that is dark, sad or filled with violence will be especially damaging for those who have hardships differentiating what is reality and what is fantasy.
Try Offering Diversions: Try suggesting a change of activity or change the subject... Sometimes even just going into another room or transitioning outside for a walk can help.
Avoid Arguing: Find a way NOT to disagree with the person about what they hear or see. Instead try responding to the feelings they are expressing, and providing comfort & reassurance.
Ensure Their Safety: Always remember to make sure the environment they occupy is free from things that could cause them harm.
SAFETY IN THE HOME & WANDERING
Especially for Dementia sufferers creating a safe setting is at the top of the list as one of the most important aspects as a caregiver and may help prevent many stressful and dangerous situations. Caregivers of folks suffering from Dementia often have to look at their houses with “new eyes” in order to recognize and fix safety risks in the patient’s home.
Eliminate Hazardous Objects: Always address anything that could possibly create a tripping, fall or poisoning hazard and remove anything that could be used to accidentally or intentionally cause personal harm.
Try Installing Child-Proof Latches: To avoid accidents and harm, secure doors on kitchen cabinets, linen closets and other storage spaces.
Get Rid of Interior Locks: A great way to avoid your loved one to locking themselves into any room, including the bathroom, is by getting door hardware that is free from interior locking mechanisms... He or she may not remember how to unlock the door and could get trapped.
Try Installing Locks on ALL Possible Exits: This includes all windows and doors having appropriately secured locks to prevent wandering away from the home. This will usually involve mounting new and/or unfamiliar locking systems, or by placing new locks where the patient can't reach them.
Always Ensure They Have Proper I.D.: A great practice, in the event a loved one gets out, is to make sure that they carry some kind of photo identification or is wearing an engraved medical bracelet. If they get lost and/or is incapable of communicating effectively, this will alert others to their identity and medical issues. Also, try keeping a recent photo or video of the Dementia sufferer on-hand.
It should be no surprise that driving normally isn't safe for those, except maybe those in the earliest stages of dementia. Here's how you can more effectively help their transition:
Be Very Firm About Driving: It’s hard, but never allow your loved ones to drive a vehicle on "good days" and expressly forbid it on "bad days." Instead try offering sympathy when they are expressing misery with the situation, but never give in.
Take their Car Keys: This should solve the problem altogether, but if just having care keys is important to the patient, try substituting a different set of keys.
Try Moving the Car: If all else fails, you can disable the car or attempt to move it to a place where the person can’t see or gain access to it.
Enlist Your Doctor's Help: Hopefully your loved one views the doctor as an "authority" and will be willing to stop driving on their recommendation alone. In addition, the doctor can also contact the Department of Motor Vehicles and request that the person be re-evaluated and/or stripped from.
VISITING THE DOCTOR
Here are a few tips for managing medical appointments:
Give Them Little Notice: With Dementia patients, it works best if you don't tell them about the appointment until the day of or even just shortly before it is time to get going to the appointment, but be positive and matter-of-fact about it for even better results.
Plan Cleverly: Schedule their appointment(s) based on their “best” time of day, and/or try setting visits based on inquiring with the office staff about what time of day the office is least crowded.
Bring Someone Who Can Help: It’s even easier to manage visits if you have another family member or friend go with you, so that one of you can be with the patient while the other is speaking with the doctor.
Bring Activities and/or Snacks: Try bringing along something for the patient to eat or drink and any activities that they may enjoy while waiting.