When a loved one is diagnosed with Alzheimer’s disease, some caregivers make the decision to care for them at home. This is a difficult and potentially overwhelming task. Each day brings new challenges as you cope with changing ability levels and new patterns of behavior, like wandering and hallucinations. Simple tasks that were second nature in the past, such as dressing, bathing and eating become increasingly difficult to manage. Having a plan for getting through the day can help you cope.
Many caregivers have devised their own strategies for dealing with difficult behaviors and stressful situations. There is no one-size-fits-all solution for dementia caregivers, so the only way to find out what works for you is through trial and error. Each person with Alzheimer’s will respond differently to different strategies, and their effectiveness is likely to change throughout the stages of dementia.
Devise a Daily Routine
Begin by studying your loved one’s daily routines. Try to detect patterns in behavior and to see if you can alter your routines to make things go more smoothly. For example, if your loved one is less confused or more cooperative in the mornings, adapt your routine to make the most of those moments. Keep in mind that abilities and preferences will fluctuate from day to day, so try to be flexible and adapt your routine as needed. From there, you can incorporate tips and strategies in the categories below to facilitate caring for your loved one.
Communication and Dementia
Communicating with a person who has Alzheimer’s disease can be a challenge. It takes a great deal of practice to achieve mutual understanding, but these suggestions can help:
- Choose simple words and short sentences and use a gentle, calm tone of voice.
- Do not talk to the person with Alzheimer’s like a baby or speak about them as if they weren’t there.
- Minimize distractions and background noise—such as the television or radio—to help the person focus on and process what you are saying.
- Make sure you have their attention before speaking by addressing them by name and making eye contact.
- Allow enough time for them to respond, and be careful not to interrupt.
- If they struggle to find a word or communicate a thought, gently try to provide the word(s) they are looking for.
- Frame questions and instructions in a positive way.
- Be open to the person’s concerns, even if he or she is hard to understand.
- If you can’t understand what they are trying to say, look for clues in their emotions and body language and take their surrounding environment into consideration.
Alzheimer’s Bathing, Dressing and Eating
Activities of daily living present a series of progressing challenges for individuals with Alzheimer’s disease.
For many people with Alzheimer’s disease, bathing is a frightening and confusing experience. Elders may think they have just showered, but in reality their last shower was a week ago. They can become confused by the process or become afraid of the water and a possible fall. Advance planning can help make bath time easier on both of you.
- Plan the bath or shower for a time of day when the person is most calm and agreeable. Be consistent and try to develop a routine.
- Respect the fact that bathing can be scary and uncomfortable. Be gentle, patient and calm.
- Move slowly and tell the person what you are going to do, step by step. Allow him or her to assist in the process as much as possible.
- Make sure you have all the products, towels and assistive devices you need set up before bringing your loved one into the bathroom. Draw the bath ahead of time.
- Be sensitive to the temperature of the water and the air. Warm up the room beforehand if necessary, and keep extra towels and a robe nearby. Test the water temperature before beginning the bath or shower.
- Minimize safety risks by using a hand-held showerhead, a shower bench, grab bars, and nonskid bath mats. Never leave the person alone in the bathtub or shower.
- Bathing may not be necessary every day. A sponge bath can be effective between full showers or baths.
For someone who has Alzheimer’s, getting dressed presents a series of challenges: choosing what to wear, getting some clothes off and other clothes on, and fastening items with buttons and zippers. Minimizing these challenges can make a significant difference.
- Try to have the person get dressed at the same time each day so he or she will come to expect it as part of their daily routine.
- Plan to allow extra time so that they can dress themselves as much as they are able without added pressure or having to rush.
- Allow them to choose what they want to wear from a limited selection of outfits. If he or she has a favorite outfit or clothing item, consider buying multiples or the same style in a few different colors.
- Store some clothes in another room to reduce the number of options they have to choose from. Too many options can be overwhelming when trying to make a decision. Keep only a couple of outfits in their closet or dresser.
- Arrange the clothes in the order they are put on to help guide them through the process.
- Hand them one item at a time or give clear, step-by-step instructions if they need prompting.
- Choose clothing that is comfortable, easy to get on and off, and easy to care for. Elastic waistbands and Velcro enclosures minimize struggles with buttons and zippers.
Some people with Alzheimer’s disease want to eat all the time, while others have to be encouraged. Eating and drinking involve the senses as well as coordinated fine motor functions, all of which can diminish due Alzheimer’s disease. Making some mealtime adjustments can help your loved one get the nutrition they need.
- View mealtimes as opportunities for social interaction. Try to be patient and avoid rushing.
- Aim for a quiet, calm atmosphere by limiting background noise and other distractions.
- Maintain consistent mealtime routines, but adapt to the person’s changing needs.
- Allow the person to choose what they would like to eat, but limit the number of options to choose from. Try to offer appealing foods that vary in taste, texture and color.
- Serve small portions or several small meals throughout the day.
- Make healthy snacks, finger foods, and shakes available. In the earlier stages of dementia, be aware of the possibility of overeating.
- Choose dishes and eating utensils that promote independence. If the person has trouble using utensils, use a bowl instead of a plate, or offer utensils with thicker, easier to grasp handles. Difficulty using utensils can also be addressed by serving finger foods like small sandwiches, chicken fingers, and fruit pieces. Use straws or cups with lids to make drinking easier and minimize messes.
- Encourage them to drink plenty of fluids throughout the day to avoid dehydration.
- Maintain routine dental checkups and daily oral health to keep the mouth healthy.
As the disease progresses, be aware of the increased risk of choking and aspiration due to difficulty chewing and swallowing.
Source: Aging Care