If you are caring for someone with dementia, your role in managing daily tasks will increase as their disease progresses. Educating yourself about dementia and maintaining a positive but realistic attitude allows you to maintain an element of control as a caregiver. It can help you plan for future challenges and also improve the care that you provide. Here's how to manage some common behavioral changes that you might notice:
1. Neglecting personal care
Many people with middle-stage dementia stop caring about they way they look. They may forget to brush their teeth, change their clothes, bathe or brush their hair. One way to help maintain personal hygiene is by establishing a routine and setting up reminders. It may also help to demonstrate a particular action, and even initiate it.
2. Changes in eating habits
People with dementia sometimes forget to eat. They also lose the ability to make good decisions, and end up making poor dietary choices. Many people tend to lose a lot of weight owing to dementia related changes in eating habits. If you notice weight loss, try to help by providing meals or going grocery shopping, and also try to ensure the food is consumed.
If your loved one has early-stage dementia, they may have trouble finding words to describe their feelings, or they may forget new information. Confusion tends to worsen as the dementia progresses. The affected person may have hallucinations or delusions about where they are, and who they are. They get confused about time and place. To keep them oriented in time and place, keep their living space bright and devoid of clutter. Keep a wall calendar on a prominent wall, place a large digital clock on a table. Have lots of pictures of friends and family and major life events displayed around the house. This will help manage the confusion of time and place to a certain extent.
Such confusion often gives rise to anxiety. The combination of the two feelings is hard to manage. When you notice confusion, trying to convince them of their mistake may upset them even more. Instead, try connecting on an emotional level. Keep things simple and be patient. Answer their questions, and try to comfort them.
Once someone with dementia starts wandering outside, full-time monitoring may be needed. But if you notice that your loved one wanders inside when they’re bored, engaging them may help. Home security systems and webcams can help keep them safe.
People with dementia often lash out at family members, accusing them of lying or withholding information. Remember that it isn’t a personal attack. Instead of arguing, shift the conversation. Redirection is a technique that has been used successfully repeatedly. It is not helpful to argue whether they are telling the truth or not. Don’t bring up past events to prove or disprove statements. Don’t accuse them of lying or manipulation.
Lengthy explanations or reasons are not the way to go. You can’t reason with someone who has dementia. Doing that might just trigger the response that you are getting because of the questions you are asking.
Sundowning is also known as "late-day confusion". If someone you care for has dementia, their confusion and agitation may get worse in the late afternoon and evening. It is not uncommon for a dementia patient to engage in aggressive and sometimes violent actions toward another person. It is important to be aware of this type of behavior to mitigate the risk to yourself and others. If your loved one gets agitated in the evening, schedule stressful activities earlier in the day, and offer relaxing activities instead. Keep the person engaged in things you know they enjoy.
These are only a few of the many different behaviors seen in people with dementia, here are some excellent resources for information related to dementia:
Dementia resource materials https://alz.to/dementia-resource-materials/
Dementia: A guide for caregivers https://tevacaregivers.com/files/Dementia_Conditions_Brochure_ENG.pdf
We know how challenging it can be for those of you who are caregivers to loved ones with dementia. At in4MED, we can make this stressful time easier by connecting you to local support systems and being there for you as your trusted health advocates. As always, feel free to connect with me or leave a comment.
Healthcare Consultant, in4MED
The author of this blog post is a Physician with over 10 years of experience working in the healthcare system as a clinician, researcher and educator. She is passionate about healthcare for older adults and strives to be a resourceful inspiration to caregivers.
*No content on this site, regardless of date, should ever be used as a substitute for direct medical advice from your doctor or other qualified healthcare professional.