Dementia Care at Home

Do not ask the person “What is wrong?" or "What do you want?" as this may only increase distress if the person cannot elaborate. Instead, ask a few questions that call for short answers. This may calm them. EXAMPLE: “Are you warm enough?” or “Do you need help to get to the bathroom?”. Or “Do you have any pain?” As you leave, reassure that you will see the person soon. Tell them you care about them.

Sit down at eye level, low voice and identify yourself and provide reassurance. Change the subject by offering a cup of tea.

They may simply be expressing a wish. Another possibility is they are thinking about the possibility of dying and thinking about loved ones who have died. Finally, they may have forgotten that their husband has died. At times, the memory of their husband alive may be stronger than the memory that he has died. EXAMPLE: In any event, do not tell them that he is dead and can never visit. This may only cause shock and grief, as if they were hearing the news for the first time. If she asks “Where is my husband”? say “I haven’t seen him” or try “It would be nice to see him” or “How wonderful to have a long, happy marriage” These comments will be more positive and comforting.

If the person has short term memory loss, give frequent cues and reminders, especially as to time and place. Try talking about events from long ago. Some people are most comfortable talking about when they were raising a family or the work they once did. EXAMPLE: Say “We had a nice lunch earlier, and soon it will be time for dinner”. Ask about a place where the person once lived or a job the person held some time ago.

You should always try to find a way that lets them leave the house safely. If there are no neighbours or family members available then you can hire local carers to help them take a walk safely. You can also get help through a local service, group or organisation that helps people with Dementia to take part in activities, including walking.

Refusing meals and lack of appetite is extremely common. If they refuse food, then don’t be afraid to try again later in the day. Try and cook meals that you know they like and choose food that is easily identifiable and use different flavours to stimulate their tastebuds.

In the early stages of Dementia, daily routines help people add a sense of order to their days and provides a sense of security -something that becomes even more important as they lose awareness of time. Establishing a daily routine, creates an environment where routines are more predictable and the person with Dementia is less agitated. Example: Display a weekly planner which includes doctor’s appointments, family visits and even prompts the person to shower, dress and eat.

Ensure lighting in their home is bright and as natural as possible and remove rugs and mats as these could lead to trips and falls. Mirrors can be confusing as they can misinterpret what they are seeing in their reflection, we would advise removing all mirrors and reflective surfaces where possible. Examples of dementia friendly items: • Clocks with large LCD displays showing the day, date and time • Telephones with big buttons • Ensure tables are stable and at a suitable height and have smooth edges.

A person with dementia may experience a disruptive sleep cycle. Therefore, it’s important to ensure they are stimulated during the day and avoid naps as much as possible. Research has found those who participated in 1-2 hours of social activity per day improved their sleep at night. Example: Have a set routine, so they go out for a walk mid morning or play a game in the afternoon. This will provide a familiar routine that helps the person make sense of the time. Ensure an hour before bedtime, they have a set routine, where they use the toilet, wash and brush their teeth, get changed for bed and have a warm caffeine-free drink.

The Alzheimer’s Association tells us that 60% of people who live with Dementia and Alzheimer’s disease will wander about. One of the main triggers is looking for a bathroom and may open the wrong door and end up in the wrong room. Another trigger is poor sleep habits. If they are waking up at odd times during the night, you should examine the daytime routine and try and provide more stimulating activities during the day and avoid any unnecessary napping. They may be too hot or too cold. Adjust the temperature and ensure sleepwear and bedding is season-appropriate. Being hungry is another reason they could be wandering. Ensure their bedtime routine includes a light snack.

Those living with Dementia will still experience emotions and feel embarrassed, therefore it’s important to stop if they become distressed. Encourage them to do as much as they can for themselves as this will help them feel capable and independent. Elderly people may associate washing with a tin bath and a bar of soap so ensure you explore different ways, perhaps washing at the same time to make them feel less self-conscious or even massaging their hands in warm water.

Dementia affects vision, so if they are refusing to use the toilet, it may be simply that they cannot locate it as they can’t differentiate between the white toilet seat and the white floor. Try changing the toilet seat to another colour and always enter the bathroom first, as this will encourage loved ones to follow.

Children want adults to be completely open about a dementia diagnosis, so be honest in an age-appropriate way. Children naturally pick up things quickly and although you may be trying to protect your child from what’s happening to a relative, they may actually worry more. It’s better to be open, and answer their questions as they arise.

First of all, contact your local authority and find out what help and support you’ll need as all care and support assessments are free of charge. Your local Age UK and the Alzheimer’s Society also have a wealth of information about local helplines, groups and services You can also contact local care agencies such as Novus Care who can help give you a break and are able to pop in to help regularly and also provide respite breaks and around the clock live in care.