November is Alzheimer’s Awareness Month. It can be stressful to care for someone with dementia. Caregivers who understand the disease process of dementia and how to approach the person as the disease progresses are better able to provide an environment that helps the person live as full a life as possible. Remember that everyday activities become more challenging and confusing to a person with Alzheimer’s. Here are some practical tips for caregivers.
When performing daily activities like bathing, it is best to maintain old routines and make bathing relaxing. Simplify the task by assisting as much as needed. Don’t expect participation — even if yesterday they were willing. Every day is different. Assure safety to avoid falls. The person may be more frightened of getting into a tub or shower. A safety assessment should be done regularly as the disease progresses. In addition, people with dementia do not tolerate the cold so make sure the bathroom is warm.
If you are helping someone get dressed, lay out clothes in the order they are to be put on and avoid clothes with complicated fastenings. If the person has “favorites” they insist on wearing, consider buying multiples of the same garments. You’ll also want to assess footwear to assure it provides support and safety as the disease progresses. For example, loose-fitting slippers may become dangerous.
Issues that come along with using the bathroom may arise, and for a person with dementia, it can be frightening and embarrassing. People with Alzheimer’s may lose their ability to recognize when to go to the bathroom, forget where the toilet is or what to do when they get there. Hand over hand assistance will be needed.
Tips for assisting in the bathroom include creating a bathroom schedule, leaving the bathroom door opened so the toilet is always visible and making sure clothing can be easily pulled down.
When assisting with eating, people with dementia often forget they have eaten and demand more food or refuse to eat at traditional meal time. They also may forget how to use utensils. Chewing and swallowing challenges will most likely arise as the disease progresses.
To make mealtime go smoothly you may have to remind the person how to eat and try using finger foods as much as possible, serving one type of food at a time. Make sure diet consistency is reassessed regularly. Allow the person to eat what they want as long as it is integrated into the person’s daily plan.
With regards to sleeping, wandering is not uncommon at night. This is a safety concern and can also be disruptive to others. Lack of sleep can also cause behavioral challenges during the day. As a caregiver, you can discourage sleep during the day. To make sure the person sleeps soundly at night, try and schedule long walks or add more physical activity to the day. Also, assess what makes the person comfortable in their room as well as what bothers them.
Delusions and hallucinations may accompany dementia. A delusion is a fixed false belief — such as the person believing someone wants to harm them or that someone is stealing from them. The delusions are very real to a person with dementia. Hallucinations are seeing things or hearing things that are not there.
When these happen don’t argue with the person you’re caring for about what is real or not; give comfort with a calm voice and gentle touch. Try and distract from the delusion or hallucination by drawing attention to something else. You may want to remove unnecessary furniture or items that can cause hallucinations in the dark.
A person with Alzheimer’s may be aggressive or become violent as a result of the disease. The sense of realizing something is happening to them that is causing loss of control can cause anxiety that leads to aggression. This can also be due to a loss of control, loss of ability to understand their environment and loss of ability to understand actions of others around them. If this happens, give the person space and stay calm. Search for what is causing it so you can find solutions and avoid future issues.
Shelley VanLare is a registered nurse at The Arc of Monroe. She has been with The Arc for seven years. VanLare encourages anyone with questions to email her at svanlare@arcmonroe.org.