How to Care for Someone with Dementia

20 November 2019 Assisted Living

Dementia care can be a daunting task to take on, but with the right knowledge, there is a lot you can do to ease the burden. Whether you're taking on the care for a senior loved one or a parent with dementia or Alzheimer's disease, knowing your role is essential. The right attitude is also critical for your success.

Taking time to educate yourself about dementia care while keeping a realistic and positive attitude lets you keep an element of control. It can remove the sting of any surprises you may encounter while you improve your care levels.

Eight Tips for Communicating During Dementia Care

You aren't born knowing precisely how to communicate with someone who has dementia. Learning how to communicate effectively can help make your caregiving experience less stressful. It'll also improve your ability to handle any problematic behavior you may encounter.

  1. Get the Person's Attention

    Take steps to limit the noise and distractions. Turn off the TV or radio, shut the door, close the curtains, or move to a quieter area of your home. Before you start talking, make sure you have the person's attention. Identify yourself, address them by name, tell them your relation, and keep them focused by using touch and nonverbal cues. If the person sits down, maintain eye contact and go to their height level by sitting down as well.

  2. Set a Positive Mood

    Your body language and attitude usually communicate your thoughts and feelings more powerfully than words. Speak respectfully and cheerfully. Use your tone of voice, facial expressions, and touch to show your feelings of affection and get your message across.

  3. Learn to Distract and Redirect

    Part of dementia care is distracting and redirecting, especially if the person becomes agitated or upset. You can ask them to go for a walk to change the environment. You must connect with the person on a feeling level. You could tell them that you know how they feel like, "I know you're feeling sad, and I'm sorry you're upset. Let's go for a walk."

  4. Ask Simple Questions

    Ask simple yes or no questions if you can, and ask one at a time. Don't make a habit of asking open-ended questions, and don't give a lot of choices. For example, you could ask, "Would you like to wear the green or red shirt today?" It's even better to show them the choices as you ask them. Having visual cues can help you guide a person's response.

  5. Break Down Your Activities Into Steps

    Breaking down everything into small steps makes all of the tasks you try to do more manageable. Encourage your loved one to do whatever they can and gently guide them through the steps. If they're not able to do all of the tasks by themselves, assist them. Using visual cues can help guide the process along.

  6. Remember the Past

    Remembering the past can be an affirming and soothing activity. Many people who have dementia might not be able to remember what happened an hour ago, but they can easily recall their lives decades earlier. Avoid asking questions that use their short-term memory, like asking when they last ate. Instead, ask about their distant past.

  7. Respond with Reassurance and Affection

    People who have dementia typically feel anxious, unsure, and confused. Reality gets confused, and they recall things that never happened. Don't try to convince them that they're wrong. Focus on the feelings they have, and respond with physical and verbal expressions of reassurance, comfort, and support. Things like touching, holding hands, and praise will get a positive response.

  8. State Clear Messages

    Use simple sentences and words. Speak distinctly, slowly, and use a reassuring tone. Don't raise your voice, but pitch it lower. If they don't understand you the first time, repeat your message. If they still don't understand, give them a few minutes and rephrase your original question. Use the names of places and people instead of abbreviations or pronouns.

Handling Troubling Behavior

Some of the biggest obstacles of dementia care are the behavior and personality changes that often happen. Flexibility, compassion, creativity, and patience are the best ways to meet these challenges. Consider these rules:

Changing the Person Isn't Possible

A person with dementia has a brain disorder and this shapes who they are now. When you try to change this behavior, you'll get resistance. You want to try and accommodate the new behavior. It's good to remember that you can change your behavior or environment, and this can result in a change in your loved one's behavior.

All Behavior Has a Purpose

Someone with dementia usually can't tell you what they need or want. They may start doing something new, like removing all of the clothing from the closet every day. If they do, they may be trying to meet a need to be productive and busy. Take a few minutes and consider why they're displaying a new behavior.

What Works Now, May Not Work Again

Dozens of factors influence behavior. With dementia's natural progression patterns, solutions that work wonderfully today may not work the next day. They may never work again. Bringing flexible and creative strategies can help you address any issues.

Get Support

Many times, people try to do everything for their loved ones on their own. This can lead to stress, burnout, and resentment. Seek out your local Agency or Unit on Aging, your local Alzheimer's Association chapter, or find support groups from the Family Care Navigator. The person you're caring for has bad and good days, and you have to develop coping strategies.

Check With Their Doctor

Many times, behavioral changes can indicate a medical reason. Maybe they're experiencing medication side effects or they're in pain. Their doctor may be able to suggest treatments or medications for problems such as incontinence or hallucinations, which can help you manage the problem.

Handling the Most Common Dementia Behaviors

Dementia comes with several common behaviors, and we've put together useful suggestions for handling them.

Agitation

Agitation refers to sleeplessness, irritability, physical aggression, or verbal aggression. As dementia progresses, so can these types of behaviors. Several things can trigger this behavior, including fear, environmental factors, or fatigue. Losing "control" is another big trigger. You can deal with it by:

  • Acknowledge their feelings
  • Allow them to do as much as they can for themselves, and support their independence
  • Distract them with an activity or snack
  • Keep dangerous options out of reach
  • Maintain structure by sticking to a routine
  • Reduce sugar, caffeine intake, and foods that cause energy spikes
  • Reduce clutter, noise, and the number of people in their environment
  • Try soothing music, gentle touch, or walks

Bathing

Good hygiene is typically a challenge for people with dementia. Being cleaned and undressed by another person can be embarrassing, frightening, or humiliating. As a direct result, bathing can cause distress for all involved.

  • If hair washing is a huge struggle, try dry shampoo.
  • Historically, did your loved one like showers or baths? Evenings or mornings? Did they wash their hair or have a salon do it? Did they have a favorite scent? Try adopting as many of these things as possible. It may only be necessary to bathe two or three times a week instead of every day.
  • If your loved one is very modest, make sure the curtains and doors get closed. Keep a towel over their front, and have a robe ready when they get out.
  • Be mindful of the temperature and the lighting. Get non-slip mats, bath or shower seats, and grab-bars. Another good idea is a hand-held shower head.
  • Never leave them unattended. Lay out everything you need before you start. Draw the water first and reassure them that it's warm water.
  • A towel bath could be a soothing alternative. Use a large towel with a washcloth that you get damp with a bag of water and no-rinse shampoo. Bath-blankets cover the patient and keep them warm and dry while you massage the washcloth over their body.

Eating or Nutrition

Getting your loved ones to drink and eat enough to stay healthy can be difficult because they forget they need to eat and drink. Medications and dental problems can complicate this further. Irritability, weight loss, bladder or bowel problems, and disorientation are consequences of poor nutrition.

  • Make snack and meal times part of a daily routine, and schedule them at the same time.
  • Add soft music or flowers to make meals special.
  • Try finger foods because they support independence.
  • Sit down and eat with them because they usually mimic your actions.
  • Prepare your meals with your loved ones in mind. If they have trouble chewing, try soft foods.
  • Offer high-calorie snacks if weight loss is an issue. If the problem is that they gain weight, keep veggie trays, fresh fruits, and low-calorie snacks on hand.

Incontinence

Bowel or bladder control loss is common in the later stages of dementia. Environmental factors can play a role. For example, the person may forget where the bathroom is.

  • Establish a toileting routine and take your loved one to the bathroom every two hours.
  • Schedule consistent fluid intake to prevent dehydration, but limit it before bedtime.
  • Use colorful signs to point out the bathroom.
  • Use a commode at night to give them easy access to the bathroom.
  • Incontinence products and pads can be useful. You can get them at the pharmacy or a urologist can prescribe special ones.
  • Buy clothing that is easy to remove with velcro or elastic waistbands, and clothing that is easy to clean.

Repetitive Actions or Speech

It's not unusual for a person with dementia to repeat a question, word, activity, or statement again and again. It's usually harmless, and common triggers include boredom, anxiety, environmental factors, or fear.

  • Try distraction with an activity or snack
  • Provide comfort and reassurance
  • Don't discuss plans ahead of time
  • Avoid telling your loved one they just asked the question a few minutes earlier
  • Try putting a sign on the table to help remove the anxiety. It could say, "Dinner at 5:30," or "Mary comes home at 4:00."
  • Take time to learn certain behaviors. Pulling on clothing or getting agitated could signal that the person has to go to the bathroom.

Sundowning

Sundowning is when people with dementia become disoriented, agitated, restless, and have troubling behaviors at the end of the day and into the night.

  • Increase daytime actives while encouraging naps
  • Limit caffeine, sugar, and junk food
  • Plan to have calm evening and afternoon hours with quiet, structured activities
  • Turn on the lights well before the sun goes down and shut the curtains to eliminate shadows
  • Block the stairs with gates, put away dangerous items, and lock the door
  • Consider medications as a last resort

Wandering

People who have dementia tend to aimlessly walk out of boredom, because they are searching for someone, or from medication side effects. They might also try to fulfill some physical needs like hunger, thirst, exercise, or the need to use the toilet.

  • Minimize wandering by incorporating regular exercise
  • Consider installing locks that need a key, and put them either higher or lower than eye level.
  • Try a colored streamer or curtain barrier over a door. Signs might also help.
  • Put a black mat just outside your door on your porch to deter your loved one from walking outside without you.
  • Add child-safe plastic covers to the doorknobs.
  • Install a monitoring or home security system. Newer technology lets you clip a GPS device to their belt or put it on like a watch. This can help you locate them if they wander off.
  • Put away their glasses, purse, or coat.
  • Put an ID bracelet on your loved one and have a current photo available if you need to report them as missing. Consider registering them with the Alzheimer's Association Safe Return program.
  • Inform your neighbors if your loved one wanders, and give them your contact information.

Contact Bethany Homes for Dementia Care and Tips

 If you need assistance with dementia care, contact Bethany Homes. We'll give you tips and suggestions, or you can schedule a visit today!