74 tips for coping with the many faces of dementia
Dementia caregivers have to deal with somebody who cannot communicate, with a paranoid individual, with someone who can’t sleep at night, and another who wets the bed when they do sleep, and an overall unpredictable person – all of them embodied by a single loved one. The following pieces of advice may come in handy when tackling each different area.
1. Establish a positive setting for interaction. Communicate pleasantly and respectfully, including words as well as body language and facial expressions.
2. Grab the person’s attention. Make sure you’re the center of attention – turn off the television and radio, close the curtains, close the door.
3. Name names. State your name and relation to the person, and address them by their name.
4. State your purpose clearly, slowly, concisely, distinctly, in a low pitch.
5. Repeat and rephrase.
6. Ask one simple, yes/no question at a time.
7. Distract and redirect.
8. Break down tasks.
9. Reassure the person.
11. Laugh with the person (not at them).
12. Find the purpose. Behavior is linked to communication in the sense that the person may be trying to tell you something by performing a certain action; generally, it may simply be a need to be busy or productive, but there may be other specific reasons.
13. Find the trigger. Dementia behaviors are usually caused by something else; it might be pain or a medication side effect acting up, or something in the environment like loud noises, or something that you or someone else inadvertently said or did. Finding the trigger may help prevent the behavior.
14. Go one day at a time. In spite of the above, the progressive nature of the disease means that yesterday’s answers may have nothing to do with today’s questions. Hence the importance of trying new, different approaches constantly.
15. Join a support group.
16. Look for local organizations that provide caregiving services.
17. Schedule regular workout – according to the person’s physical capacity.
18. Think about installing locks – requiring a key – high or low on doors.
19. Mask doors with a barrier-like curtain or streamer.
20. Place STOP or Do Not Enter signs on doors.
21. Placing a black mat or painting a black space on the front porch may work like the proverbial ‘portable hole’ that some cartoon characters can go through while others can’t.
22. Place ‘child-safe’ plastic covers on doorknobs.
23. Consider a home security or monitoring system.
24. Hide the person’s coat, purse, glasses, and other items that your loved one would not leave home without.
25. Fit the person with an ID bracelet.
26. Let the neighbors know about your loved one’s tendency to wander.
27. Schedule toilet trips every two hours.
28. Monitor fluid intake so that the person does not dehydrate.
29. Avoid coffee, tea, cola, and beer.
30. Restrict liquid intake in the evening.
31. Mark the bathroom doors so it is easily identifiable.
32. Obtain a commode, pads, and other incontinence products.
33. Have the person wear clothes that are easy to remove and to wash.
34. Limit caffeine, sugar, and junk food.
35. Minimize noise, objects, and people in a room.
36. Do not move household items or furniture around lest you confuse the person.
37. Play music, read to the person, gently touch them, or take them out for a walk, but do not try to restrain or confront them during an agitation episode.
38. Move dangerous objects away from the reach of the person.
39. Distract your loved one with food or an activity until they forget the incident.
40. Allow the patient a measure of independence – since agitation is often caused by a feeling of losing control.
41. Let the person know that you understand their frustration.
42. Reassure the person with words and touch.
43. Distract the person.
44. Do not remind them that they have asked the same thing before.
45. Discuss plans with the person only right before an event.
46. A repeated action could be a way of trying to say something; e.g., pulling at clothing may mean they need to go to the toilet.
47. Allow the person to have small quantities of money in a pocket/wallet/purse so they are assured that no one is stealing from them.
48. Identify the spots where the person stashes ‘lost’ items.
49. Help the person look for a lost item but then lure them into a different activity.
50. Tell friends and relatives not to take accusations personally.
51. Increase daytime exercises and activity.
52. Limit daytime napping.
53. Restrict caffeine, sugar, and junk food to early in the day.
54. Schedule small meals through the day plus a light meal before going to bed.
55. Plan quiet and calm afternoons and evenings with structured activity like a walk outdoors, a card game, or listening to relaxing music.
56. Turn lights on before sunset and close curtains at dusk to reduce confusing shadows.
57. If necessary, talk to your doctor about the benefits and risks of sleeping pills or tranquilizers.
58. Make sure you get enough sleep yourself.
59. Schedule meals and snack times at about the same time every day.
60. Try 5-6 small meals as opposed to 3 big meals.
61. Make meals special with flowers or music – after all, they may take quite a bit of time which you must allow for.
62. Emphasize independence over manners.
63. Finger foods and sippy cups favor independence.
64. Offer assistance only when necessary.
65. Eat together with your loved one.
66. Cook food so that it accommodates the person’s needs and shortcomings; for example, soft food if they can’t chew very well.
67. Move their chin in an up-and-down motion or gently stroke their throat to encourage chewing and swallowing.
68. Provide high-calorie, carbohydrate-rich snacks between meals to prevent weight loss.
69. Conversely, offer fruits, vegetables, and low-calorie snacks in case weight gain is a problem.
70. Keep your loved one’s pre-dementia bathing routine; that is, did they prefer baths at night or showers in the morning?
71. Make sure the person has enough privacy but never leave them in the bath or shower unsupervised.
72. Check that the water is neither too hot nor too cold.
73. If bathing is particularly problematic, consider alternatives such as bathing twice a week instead of daily, washing the hair as a separate activity or using a dry shampoo, or bed baths.
Make use of grab bars, non-slip mats, shower seats, handheld showers, and other bath and shower safety supplies.