Dementia and Alzheimer’s disease have a substantial impact on family caregivers and friends, as well as the person living with it. In the early stages of Alzheimer's and dementia, many people are still very independent at home, and enjoy their usual activities. It’s important to respect their choices to remain independent. However, there will be changes ahead in their ability to handle daily tasks, and a safe home environment will become increasingly critical.
It’s important to respect their choices to remain independent. However, there will be changes ahead in their ability to handle daily tasks.
If you need to speak to someone who can help, call Elizz at 1-855-Ask-Eliz (275-3549). Also, consider these Alzheimer’s and dementia care tips and guidelines compiled by Elizz, the place to go for all things caregiving including caregiver support services and home care services.
1. Stick to daily routines
Daily routines are a necessity when caring for individuals with dementia. Change is difficult, and a routine will help people maintain their abilities while also relieving caregiver stress. Here are some care tips for maintaining a routine:
- Involve the individual in daily tasks to maintain self-esteem and reduce chances that he or she will forget how to do tasks themselves (e.g., dressing).
- Establish a routine to make each day more predictable and less confusing. Schedule the most difficult tasks, such as bathing or medical appointments, for the time of day when your family member tends to be most calm and agreeable.
- Over time, if your family member experiences behavioural changes or frustration in the evening, or “sundowning”, you may need to switch some routines like bathing to the morning.
- Be consistent. When you say that you are going to do something, follow through with it.
- Maintain social connections as this is still very important. You may find that one-on-one or small group settings are easier.
2. Create a safe home environment
It's important for dementia caregivers to focus on what the person in their care can do, and to develop strategies for successfully doing the activities that may be harder – or where declining judgment increases the risk of injury. Proper dementia and Alzheimer’s care at home requires a safe home environment:
- Prevent falls by removing throw rugs, extension cords and any clutter that could cause your loved one to trip or fall. Install handrails or grab bars in critical areas.
- Encourage walking for exercise to maintain strength and balance.
- Install locks on cabinets that contain anything potentially dangerous, such as medications, sharp utensils, chemical cleaners or any other potential hazards.
- Use electrical appliances that shut off on their own.
- Install smoke and carbon monoxide detectors and check the batteries regularly.
- Leave written reminders like "turn off the stove" or "unplug the iron." Place them where they will be seen frequently and easily.
- Have the person keep a map of where his or her home is.
- Have medications organized in a weekly blister pack or dosette and delivered on a regular schedule.
3. Get organized
There are many simple things that can help a person with dementia manage daily tasks. For example, designate an obvious place to keep keys, such as a large bowl in the hall, and leave an extra set with a trusted neighbour. Use electronic aids such as cell phones, alarm clocks and timers to help manage the changes that are happening in day-to-day life.
More organization tips for Alzheimer’s and dementia care at home:
- Create a list of phone numbers of people who currently help with care: what tasks they help with, when they visit, and how to get in touch with them. Post this list near his or her phone.
- Label cupboards with words or pictures that describe what is inside. For instance, dishes, knives and forks, cereal.
- Clean out closets and dresser drawers to only include necessary items. This will make it easier to find items and make daily decisions, such as what to wear.
- Write emergency contact information and important telephone numbers in large print and post them by the phone. Also program these names and numbers into his or her phone.
- Keep a pad of paper handy at all times to write down important "Things to Remember."
- Have a daily newspaper delivered to remind the person of the date.
4. Reduce frustrations
A person who has Alzheimer's might become agitated when once-simple tasks become difficult or impossible. They also often feel like they are always being told what to do by their caregiver or family members. Boredom and loneliness are reduced through activities that embrace roles, establish routines, and improve self-esteem. Dementia care activities to try:
- Limiting choices and breaking tasks into smaller steps can be helpful. If your family member shows signs of getting easily overstimulated, has difficulty following conversations, or has a limited attention span, help them to pick activities they can manage.
- Use visual cues. For example, write out instructions for routines like brushing teeth. Place picture signs on bathrooms, the fridge, and other places of importance or danger. Use photo albums as visual cues for storytelling, stimulating memory and creating positive feelings.
- Involve your family member in meaningful daily activities. Start folding and sorting laundry; give clothes to the individual and ask for their help. Wash dishes together; give him/her a towel and gently encourage them to dry the dishes. Repeat by asking for help.
- Use a calendar or date book to show the day’s activities instead of repeating or reminding the person of what is happening. Eventually the person may go to the calendar without prompting.
5. Be patient and flexible
It may be scary and unsettling as you see your family member’s abilities to function and cope decline. Sometimes the changes are day to day. For example, he or she may repeat the same task several times, or suddenly refuse what was once a favourite food or activity. As the caregiver, you may go along with the change, adjust the meal plan, or gently redirect them to another activity. If bathing is upsetting, you may try switching from the evening to morning, or doing it every second day instead of daily.
- Expect to need extra time to do things. Allow for more time than you used to, so that you don’t need to rush your family member in doing things.
- Encourage independence. Allow them to do as much as possible on their own. For example, maybe he or she can get dressed alone if you lay out clothes in the order they go on; or, sort closets and eliminate clutter so that only a few appropriate seasonal outfits are hung up together.
- Reduce distractions. Turn off the TV and minimize other distractions at mealtime and during conversations so that your loved one can better focus on the task at hand.
6. Focus on individualized care
Remember the person, not the disease. Each person with dementia or Alzheimer's will experience symptoms and progression differently. It’s important to focus on an individualized dementia care plan that includes his or her history, family, interests, abilities, and favourite activities. Find activities with meaning and purpose, based on their needs, interests, skills, and abilities.
- Ask the person to tell you stories from their childhood. Write them down and then ask the client to read the stories to a grandchild. This activity is meaningful in creating a family history and helping the person feel needed by his/her family.
- Play sorting games with pictures of the person’s hobbies. If the person enjoyed gardening, sort flower pictures by colour. Provide a cue to help the person remember where each item will be placed by putting one red flower in front of the person and one yellow flower beside it.
- Consider arranging Companion Care services to help with tasks around the house like housekeeping, meal preparation or transportation, and plan ahead for how these needs will increase. Speak to a local community support organization, home health care organization or health care authority.
As dementia progresses you will likely need to connect with local support resources and explore your dementia care options. Talking with other caregivers can be an excellent way to manage your own well-being and find peer support.
For more information about Alzheimer’s visit the Alzheimer Society Canada website. You can also speak to someone at Elizz directly by calling 1-855-Ask-Eliz (275-3549) or contact us online.