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Dementia Care Tips & Strategies

12 Dementia Care Tips heart and hand.jpg

1. NEVER argue with someone who has dementia.

Alzheimer’s and dementia causes your older adult’s brain to malfunction. When they say things that don’t make sense or are clearly untrue, they believe what they’re saying because it’s what their brain is telling them. It’s frustrating to hear things that aren’t true and instinctive to try to correct or remind. But that will only lead to both of you arguing or getting upset. And you simply can’t win an argument with someone who can no longer use reason or logic consistently.

2. Ignoring symptoms won’t make them go away.

When you notice your older adult struggling with memory, thinking, or judgement, it’s scary to think that they might have dementia. Because it can be so hard to accept, many people hope that the symptoms will go away on their own or that they’re mistaken. But the situation isn’t going to fix itself. The best thing to do is have them see their doctor for a thorough exam. First, there are many treatable health conditions that cause dementia-like symptoms. Second, even if dementia has no cure, early diagnosis means that treatments will be more effective and could delay progression, reduce symptoms, and improve quality of life.

3. Too many medications can make people feel & act more confused. 

Medications prescribed to relieve symptoms can sometimes make dementia symptoms worse or create new problems, like increasing disorientation or agitation. This can happen because seniors are at higher risk for problems related to medication side effects or drug interactions. Dementia can also change how certain medications affect the brain.

To reduce medication-related problems, call the doctor if you suspect that a new medication is causing a problem and ask them to find alternatives that could work better. It’s also essential to have the doctor regularly review all medications and supplements to make sure every single one is still needed.

4. Use validation therapy or therapeutic fibs to respond kindly.

Dementia care experts recommend joining your older adult in their reality rather than trying to force them back into ours. Trying to get them to understand facts or our reality usually causes confusion, anxiety, fear, and anger.

Someone with dementia may insist that they’re children waiting for their mother to pick them up, they need to get to the office even though they’re retired, or they’re going to visit a relative who passed away long ago. Instead of telling them that they’re wrong, use validation therapy or therapeutic fibs to kindly respond to their version of reality.

Gently ask an open-ended question about the person they’re going to see or activity they want to do. Or join their reality by saying OK, going along with the scenario for a while, then redirecting to a different activity.

Validating their reality and allowing them to express their thoughts helps them feel calmer and happier.

5. It’s never too late to improve brain health.

After finding out that your older adult has dementia, it might seem like improving brain health would be useless. But healthy habits can truly help a brain with dementia. It’s possible to slow the progression of the disease, reduce symptoms, and improve quality of life. Getting regular physical exercise, doing things that are mentally stimulating, and participating in engaging activities all help to improve brain health.

6. Share your challenges and get help.

Caregiving, especially dementia care, can be a lonely and exhausting job. Instead of doing everything alone, talk about your challenges and reach out to people who can help. It can be difficult to seek out or accept help, but caregivers who have gotten help often wish they’d done it sooner – it’s worth a try. Knowing that you’re not the only one going through this or getting a few hours of rest can make a big difference.

That could mean asking family or friends to step up, hiring in-home care, moving to a care community, using respite care, or joining a caregiver support group. If you’re not sure where to start, contact your local Area Agency on Aging to connect with local caregiving resources.

7. Choose one small thing to do for yourself.

When caring for someone, it’s instinctive to focus 100% on them...until you get burned out. But that’s not good for you or your older adult.

It’s not realistic to take long vacations or hours for yourself each day, but you’d be surprised at how effective short breaks can be. Doing something for yourself, whether it’s 30 seconds, 5 minutes, or an hour will help you recharge and reduce the risk of burnout.

8. Choose your priorities and let the rest go.

Because you care so much about your older adult, you want to do as much as you can, as perfectly as you can. But holding yourself to those unrealistic expectations causes frustration, resentment, and exhaustion.

Instead, save your mental and physical health by picking your battles. Choose the top priorities and let the less important things go. Think about how important that thing will be in a week, month, or year.

9. Have the tough conversation about medical decisions and choices.

Taking care of important legal documents like a will, living will, or power of attorney is something that many people want to put off. But talking about end of life choices and getting the paperwork done before a health emergency saves you from making hard choices or running into legal problems in the middle of a crisis.  Plus, many older adults have greater peace of mind when they know their wishes will be honored.

10. Remember that they truly can’t control their behavior. 

Dementia can’t be seen from the outside, so many people assume that the person can actually control their difficult or irritating behavior. It’s natural to think their actions are personally directed toward you.

That’s not true. Dementia physically damages the brain, which can affect personality, behavior, decision-making, and judgment. Knowing that it’s the disease talking can help you take things less personally, reduce the sting of hurtful accusations, or help you stay calm when they’ve asked you the same question for the 37th time.

11. 20 minutes later can feel like a whole new day.

If you’re helping your older adult with an activity of daily living and they get agitated or combative, it can help to stop and take a short break.

Rather than fighting through and making the situation worse, stepping away to give them (and you) time to calm down can make a big difference. Make sure they’re safe on their own and go to another room for 20 minutes. When you come back and approach calmly, they’ll often be more cooperative.

For example, if mom starts yelling and pushing you when you announce that it’s time for a shower, give her some space and come back to it in a little while, perhaps using a different approach. - This won’t always work, but it often does so it’s worth a try.

12. Quality life is still possible.

It isn’t easy to cope with dementia, both for you and your older adult. But finding ways to enjoy life and having good quality of life is still possible.

You don’t have to pretend that the challenges and pain don’t exist. Try to focus on the positives, no matter how small, and adapt activities for the abilities they still have.

Coping with Repetitive Behaviors

If you care for someone living with dementia, chances are you have experienced moments in which they ask repetitive questions or repeat certain behaviors over and over.

Did you know this is rarely due to short term memory loss?  This type of behavior typically signals the expression of an underlying unmet need. Before assuming that memory loss is the reason for the repetition, consider ruling out the following reasons.

  • Are they anxious or agitated?

  • Do they need to use the bathroom?

  • Are they in pain (e.g., mouth pain, stomach pain, muscle or joint pain)?

  • Are they hungry or would a snack help?

  • Are they seeking comfort and security?

Also consider this -  If the repetitive behavior is not a marker of distress and is not causing any harm, why not let them continue? 

For instance, if pacing the room occurs daily during sundowning time, and they are not in immediate danger, perhaps allowing them to pace could be the easiest way for them to extract some nervous energy. Or if they insist on packing their luggage every morning for comfort because they look forward to going home, why not create an environment that is conducive to packing and give them lots of things to fold and pack?  Get creative!​​​​

Tackling Tricky Bathroom Situations

Let's face it. No one likes to talk about those uncomfortable bathroom situations that will become a part of most caregiver's journeys.  Incontinence and bathing are topics that no one teaches us how to handle.  Until now!  Below are some tips and videos to help you think outside the box when trying to find what works for you. 

Keep in mind, what works today may not work tomorrow.  If things aren't working, don't force it!  Walk away and try again later.  Trial and error is the name of the game, and no one knows your loved one like you do.  So don't be afraid to get creative!  After all, what do you have to lose?

Incontinence Tips

  • The Mayo Clinic shares these dietary considerations as potential incontinence triggers:

    • Too little fluids

    • Too much fluids

    • Coffee, tea, and carbonated drinks – with and without caffeine

    • Certain acidic fruits, like oranges, grapefruits, lemons and limes, and acidic fruit juices

    • Spicy foods

    • Alcohol

    • Chocolate

    • Tomatoes and tomato-based products – even ketchup

    • Sugar, honey, and artificial sweeteners

  • Keep a consistent bathroom schedule. Dementia can cause someone to say "no" when they mean "yes" or even take away ones ability to recognize the urge to go.  That's why asking your loved one if they have to use the bathroom will often get a "no" response.  Simply leading them to the bathroom on a regular basis can help. 

  • Use mattress pads and furniture protectors. Leaks and accidents are bound to happen, especially overnight. Clothes can always be washed, but protecting the mattress with matress pads can save a lot of frustration and extra washes.  Simply throw the pads away when they become soiled. 

  • Stop calling them diapers.  Try calling them briefs, panties, underwear - whatever your loved calls their undergarments.  This can help reduce embarrassment or resistance. 

  • Select the right clothes. It helps to have clothese that are easy to pull on and off - like elastic bands and buttons instead of zippers.  You may even consider adaptive clothing specifically designed for easy access. 

  • Use humor to reduce embarrassment.  As uncomfortable as it for you to deal with your loved one's incontinence, it can be especially embarassing or shameful for your loved one. Reassure them everything is okay and make light of the situation to ease tensions.

  • Keep supplies on hand.  Make a kit with all the supplies you'll need for accidents and bathroom trips and keep it on hand.

    • Briefs / pads

    • Wipes / wet wipe warmers

    • Change of clothes and socks

    • Lotion

  • Give step by step instructions.  Be patient!  Narrate each step to your loved one they know what is going on and what to expect next.  Wait until each step is complete before telling them the next step. 

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Above Video:  "Alzheimer's Tip with Erica"  Erica Steiner gets candid in this discussion on everything from getting your loved one to shower to handling bathroom issues like what to do when they have trouble wiping, erasing shame and getting them comfortable wearing diapers and avoiding nighttime accidents. She also describes how to utilize rewards to deal with tantrums and annoyances.

Showering and Bathing Tips

  • Pick a good time for your loved one. Try bathing during a time of day that's best for your loved one. When are they in the best mood?

  • Use a reward system.  Instead of asking your loved one, "Are you ready to go shower?" in which your loved one is sure to say "No!", try saying something like, "Okay, it's time to get washed up so we can ____."  Fill in the blank with things your loved one enjoys like dessert!  Many older adults recall from their childhood bathing for church.  If that was an important part of your loved one's past, try saying, "Okay, it's time to get cleaned up for church tomorrow."  Or maybe there's another place or event your loved one would want to prepare for - get creative!

  • Make a plan. Before you even attempt to shower or bathe your loved one, get prepared. 

    • Gather supplies. Collect everything you will need beforehand - soap, washcloths, lots of towels, shampoo, robe, clothes, lotion, etc.

    • Make it comfortable. No one wants to get undressed if it's cold!  Turn down the thermostat or use a heater to make the room cozy.  Having soft soothing music ​in the background could also help. It could also be too much stimulation - see what works for your loved one. 

    • Get the water warm.  Make sure the water is neither too hot or too cold, and keep checking it throughout the bathing process. 

    • Use a detached shower head.  This can make moving around your loved one easier.  Consider using one with adjustable water pressure to ensure it's not too hard on your loved one's skin. 

    • Use soft towels.  Our skin gets thinner and more fragile as we age.  Consider purchasing microfiber washcloths and towels to make the bathing experience more pleasant for your loved one.  The towels also absorb moisture more quickly, making the drying process more ideal for both caregiver and care receiver. 

  • Make it safe.  Use grab bars, nonslip pads, shower chairs and benches, etc. to reduce the likelihood of accidents occurring. 

  • Narrate each step.  As always, use short and simple instructions/ steps to let your loved one know exactly what is going on and what to expect. "Lift your leg. Step into the tub. Sit down.", etc. 

  • Try distractions.

    • Water toys.  We know, it sounds crazy, but it just might work!  Try placing something near the shower or tub that your loved one can hold and use as a distraction.  Anything rubber or waterproof is worth trying. 

    • Photos. You might try taping family photos or pictures of places your loved one enjoys on the shower glass or surrounding walls.  These can be easily laminated to make waterproof.   

  • Use shortcuts. Try all-in-one shampoo and conditioners or sew pockets into the washcloths for soap or shower gel. 

  • Don't forget the icky parts!  Even though it's awkward and/or embarrassing, it's important to not neglect cleaning the genital area and under breasts where bacteria can collect and potentially cause infections and skin irritations. 

  • Try giving sponge baths in between bathing. If bathing is a major hassle for you, try spongebaths, nonrinse soaps and wipe clothes for in between days to freshen up.  

  • Get a professional.  There is no shame in asking for help with these difficult caregiving tasks.  Home care companies can provide trained professionals that come to your home and provide this service for you. 

After Shower & Bath Care

  • Check the body for rashes and sores, especially if they are primarily bedridden. 

  • Dry throroughly.  Microfiber towels are soft and help make the drying process quicker. Make sure the nooks and crannies (like between the toes and underneath the breasts) are dry.  Apply powder to prevent moisture buildup. 

  • Moisture the skin. Gently apply lotion to the skin.  Consider using scents that your loved one finds pleasing. 

  • Getting dressed. Have them sit while dressing. It can be less stressful and safer to help your loved one get dress from a seated posture.  Consider garments that are easy to pull on and off. Elastic bands on pants and buttons on shirts are better than zippers. Make sure to narrate with step by step instructions. Try giving them two clothing options to choose from so they have some input without feeling overwhelmed by too many options.  Encourage them to do as much as possible on their own.  

  • Consider perfume or cologne. If your loved one has a favorite scent, use it!  This can make the experience more pleasurable and memorable, because our scense of smell is our strongest.  It elicts the most memories and emotions. 

Washing Hair

  • Use shortcuts. 

    • All-in-One shampoos

    • No-rinse shampoo

    • Dry shampoos / baking soda

  • Use a washcloth.  Washing hair can be messy.  A washcloth can keep water from dripping down your loved one's face and body. 

  • Shampoo on a different day.  It may be easiest to bathe and shampoo on different days of the week to minimize stress and time. 

  • Consider an inflatable basin.  These are great for those who can tilt their head back in a chair. 

​​​​​​​Brushing Teeth

  • Be prepared. Have everything laid out and prepared so you aren't fumbling around for things when you need them.  

  • Select a good toothbrush.  Make sure the bristles are soft and consider a long handle so it's easier to grab. Most older adults aren't familiar with or can be confused by electrical toothbrushes.

  • Try flavored toothpaste. Let's face it, toothpaste is not the most flavorable of things, especially if it has baking soda!  Try a kid's toothpaste that is flavored and has more flouride and nutrients. 

  • Use short step by step instructions. Keep it simple and let them do one thing at time.  

  • Do it with them. Make brushing teeth an activity you do together daily.  Often times, those with dementia will mirror your behavior and do as you do. Be sure to go slow and cover all the regions of the mouth, if possible. 

  • Try music.  Music could make it an enjoyable experience and get your loved one's mouth open. Try playing around with them, use the toothbrush for a mic and start singing and brushing together! 

  • Don't forget to floss. Flossing now can prevent dental pain and concerns later. When flossing becomes more difficult, try the individual hand held flossers or proxabrushes that are available. 

  • Finding the right dentist. Call around and ask for recommendations on dentists in your area with experience of working with those living with dementia. 

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