Dementia care guide
Dementia Care Guide: Understanding, Supporting, and Navigating
Dementia isn’t just one single condition. It’s a general term that describes a range of symptoms affecting memory, thinking, and social abilities severely enough to interfere with everyday life. Here are its main types:
- Alzheimer’s Disease: The most common form of dementia. It involves gradual memory loss, confusion, and problems with thinking and reasoning.
- Vascular dementia: This happens after a stroke or a series of mini-strokes. People might experience sudden changes in their thinking skills or have trouble with planning and organizing.
- Lewy body dementia: People with this type might see things that aren’t there or experience muscle stiffness, much like Parkinson’s disease.
- Frontotemporal dementia: This affects younger people more and can change their personality, making them act differently or have trouble speaking properly.
- Mixed dementias: Some people show signs of several types of dementia at the same time.
This guide aims to provide care strategies to help you manage those with dementia.
Recognising symptoms
Dementia’s signs creep in subtly. Being aware can lead to timely intervention:
Cognitive changes: Not all forgetfulness is a sign. But when daily tasks become challenging, when someone frequently gets lost in familiar places, or struggles with time and place, it might be time for evaluation.
Mood and behaviour changes: Dementia can alter one’s emotional state. Rapid mood swings without apparent reason, withdrawing from once-loved activities, or unexplained paranoia can indicate deeper issues.
Physical symptoms: As dementia progresses, physical manifestations become apparent. This can range from an altered walk to increased muscle rigidity, or even difficulty swallowing in later stages.
Communicating with Dementia Patients
Effective communication with a dementia patient is crucial for their well-being and for a smoother caregiving experience.
- Active Listening:
- Importance: It gives the individual a sense of importance and makes them feel heard.
- How-to: Maintain eye contact, nod occasionally, and respond appropriately. Be patient, even if the story is repetitive or takes time to unfold.
- Clear Language:
- Importance: Simple language can prevent confusion and reduce anxiety.
- How-to: Use short, straightforward sentences. Avoid using slang or idioms. Instead of “Do you want to hit the hay?”, you might ask, “Are you ready for bed?”
- One Topic at a Time:
- Importance: Discussing multiple topics can overwhelm and confuse a dementia patient.
- How-to: If you’re talking about their lunch, for instance, finish that topic before moving onto plans for the evening.
- Avoiding Confrontation:
- Importance: Arguing or trying to correct a dementia patient can lead to agitation.
- How-to: If they recall an event differently, it’s often better to go along with their version unless it’s causing harm. Remember: it’s about their comfort, not factual accuracy.
- Using Non-Verbal Cues:
- Importance: As verbal communication skills decline, body language and facial expressions become even more critical.
- How-to: Use gestures, touch (if appropriate and comforting), and maintain an open posture. Be mindful of their non-verbal signals as well, as it can give you insights into their feelings and needs.
- Rephrasing Instead of Repeating:
- Importance: If they didn’t understand a statement or question the first time, merely repeating it can be fruitless.
- How-to: If they seem confused by “Do you want a sandwich?”, try “Would you like something to eat?”
- Using Distraction or Redirection:
- Importance: Sometimes, dementia patients can fixate on a particular idea or become upset. Changing the subject can alleviate this.
- How-to: If they become agitated about wanting to “go home” when they are home, try redirecting by mentioning a favourite activity or memory, like “Remember when we baked cookies last week? Would you like to do that again?”
Activities and Engagement
Staying mentally and physically active can help maintain a dementia patient’s skills and improve their mood. Finding suitable activities requires creativity and patience, tailored to the individual’s interests and capabilities.
- Memory-stimulating activities:
- Importance: They can help retain cognitive functions and evoke pleasant memories.
- Examples:
- Photo albums: Create or browse through albums, reminiscing about past events.
- Music: Play their favourite songs from their youth or learn new ones together.
- Storytelling: Encourage them to tell stories from their past, or read familiar tales to them.
- Physical exercises:
- Importance: Physical activity can reduce the risk of depression, improve sleep, and enhance overall well-being.
- Examples:
- Walking: A gentle walk around the garden or park, which also offers fresh air.
- Chair exercises: Movements that can be done while seated, offering low-impact ways to stay active.
- Dance: Play some music and dance, even if it’s just swaying to the rhythm.
- Art and Creativity:
- Importance: Expressing oneself through art can offer emotional release and cognitive stimulation.
- Examples:
- Painting or drawing: Even simple doodling can be therapeutic.
- Crafts: Activities like knitting, pottery, or creating collages.
- Gardening: Planting flowers or herbs provides tactile and sensory stimulation.
- Social connections:
- Importance: Socialising combats feelings of isolation, common in dementia patients.
- Examples:
- Group activities: Join them to a local dementia-friendly community group.
- Family visits: Regular visits or calls from family members can be a source of comfort.
- Pets: Interaction with animals, whether owning a pet or scheduled pet therapy, can provide companionship and reduce stress.
- Routine tasks:
- Importance: Participating in daily tasks provides a sense of purpose and normality.
- Examples:
- Cooking: Simple tasks like stirring a pot, washing vegetables, or setting the table.
- Housekeeping: Dusting, folding laundry, or organising can be engaging.
- Games: Simple board games, card games, or puzzles suited to their cognitive level.
Dealing with Behavioural Challenges in Dementia Care
As dementia progresses, behavioural changes can be some of the most challenging aspects to manage. These changes often result from frustration, confusion, or physical discomfort. Recognising the cause and addressing it compassionately can mitigate these challenges.
Agitation and Aggression:
- Reasons: Overstimulation, physical discomfort, or unmet needs can lead to aggression.
- Strategies:
- Avoid triggers: Identify and eliminate potential causes of distress. This may include loud noises or unfamiliar environments.
- Stay calm: Use a soothing voice and gentle touch. Avoid arguing.
- Distraction: Engage them in a different activity or change the environment.
- Sleep Disturbances:
- Reasons: Changes in the brain may affect the sleep-wake cycle.
- Strategies:
- Routine: Establish a regular bedtime routine and keep it consistent.
- Bedroom environment: Ensure the bedroom is quiet, dark, and cool. Use night-lights to prevent disorientation.
- Limit naps: Discourage sleeping too much during the day to ensure better sleep at night.
- Hallucinations and Delusions:
- Reasons: Misinterpretations of the world around them can result in false beliefs or visions.
- Strategies:
- Don’t argue: If the hallucination isn’t causing harm, it might be best to go along with it rather than refute it.
- Reassure: Gently acknowledge their feelings and assure them they are safe.
- Distract: Shift their focus to another topic or activity.
- Repetitive Speech or Actions:
- Reasons: They might be trying to communicate an unmet need, or it may just be a comforting action.
- Strategies:
- Stay patient: Avoid showing frustration or correcting them.
- Distract: Engage them in a different activity.
- Check for unmet needs: Ensure they aren’t hungry, thirsty, or in discomfort.
- Wandering:
- Reasons: They may be looking for something, feel restless, or want to escape an overwhelming situation.
- Strategies:
- Safety precautions: Use locks and alarms to prevent them from wandering into unsafe areas.
- Routine: Establish and maintain a daily routine to provide a sense of structure.
- Identification: Ensure they have an ID or a GPS tracker on them.
- Mood Swings and Depression:
- Reasons: Physical discomfort, changes in the brain, or feelings of loss or confusion.
- Strategies:
- Seek medical advice: Consult a doctor about potential treatments or therapies.
- Engage: Keep them involved in social activities and hobbies.
- Reassure: Remind them that they are loved and valued.