Alzheimer’s and Dementia Care: Help for Family Caregivers
Make a plan
As Alzheimer’s progresses, you may need more caregiving help, so it’s good to start out thinking long term. You can’t anticipate every situation, but being forward-thinking now will help you respond more quickly and effectively in an emergency.
It’s also key to spread caregiving tasks around your team from the get-go. You can’t do it all.
Build your team. Beyond medical professionals, reach out to friends, family and community resources to form a larger network of caregiving helpmates.
Determine tasks. Ask team members what they’re willing to do to contribute to your loved one’s care. Is someone available to travel to medical appointments? Prepare meals a few times a week? Even if team members live far away , they can handle jobs like ordering prescriptions or paying bills. Encourage them to stay connected to your loved one; dementia can be extremely isolating.
Listen to your loved one. To the extent possible, the person you’re caring for should always participate in discussions about needs and plans. Consider the recipient of your care the most important member of your caregiving team.
For many people with Alzheimer’s disease, bathing is a frightening and confusing experience. Elders may think they have showered recently, but in reality their last shower was days or even weeks ago. They can become confused by the process or become afraid of the water and the possibility of falling. Sensitivity to these issues and planning ahead can help make bath time easier on both of you.
Make sure you have all bath 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.
If they need help bathing, 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.
Bathing may not be necessary every day. A sponge bath can be effective between full showers or baths.
Bathing Tips and Techniques for Dementia Caregivers
Getting dressed may not seem very complicated, but Alzheimer’s patients and caregivers face some unique hurdles with this task. Both physical and cognitive decline affect an elder’s ability to recognize when it is time to change soiled clothes, choose appropriate items to wear, and take off/put on clothing and footwear. Minimizing these challenges can make a significant difference in a loved one’s sense of control and independence.
Always set aside extra time before outings and appointments so 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 overwhelm Alzheimer’s patients who are trying to make a decision. Keep only a couple of outfits in their closet or dresser.
Arrange clothing items in the order they are put on to help guide them through the process.
Choose clothing that is comfortable, easy to get on and off, and easy to care for. Dressing aids and adaptive clothing items featuring elastic waistbands and Velcro closures minimize struggles with finicky fasteners like buttons, zippers and shoe laces.
Personal Care and Dressing Products for Seniors
Ensuring that your loved one is eating enough nutritious foods and drinking enough fluids is a challenge. People with dementia literally begin to forget that they need to eat and drink. Complicating the issue may be dental problems or medications that decrease appetite or make food taste “funny.” The consequences of poor nutrition are many, including weight loss, irritability, sleeplessness, bladder or bowel problems, and disorientation.
Make meal and snack times part of the daily routine and schedule them around the same time every day. Instead of three big meals, try five or six smaller ones.
Make mealtimes a special time. Try flowers or soft music. Turn off loud radio programs and the TV.
Eating independently should take precedence over eating neatly or with “proper” table manners. Finger foods support independence. Pre-cut and season the food. Try using a straw or a child’s “sippy cup” if holding a glass has become difficult. Provide assistance only when necessary and allow plenty of time for meals.
Sit down and eat with your loved one. Often they will mimic your actions, and it makes the meal more pleasant to share it with someone.
Prepare foods with your loved one in mind. If they have dentures or trouble chewing or swallowing, use soft foods or cut food into bite-size pieces.
If chewing and swallowing are issues, try gently moving the person’s chin in a chewing motion or lightly stroking their throat to encourage them to swallow.
If loss of weight is a problem, offer nutritious high-calorie snacks between meals. Breakfast foods high in carbohydrates are often preferred. On the other hand, if the problem is weight gain, keep high-calorie foods out of sight. Instead, keep handy fresh fruits, veggie trays, and other healthy low-calorie snacks.
Address safety concerns
You’ll need to consider a range of potential hazards, and they’ll change over time. Is it safe for your loved one to drive? Is the recipient of your care prone to falling, or at risk of wandering and getting lost?
You eventually may need to make home modifications and acquire special equipment such as a hospital bed or lift chair. Useful tools also can help prevent wandering and other safety issues common to dementia patients.
Prevent falls . Some basic, low-cost changes include removing trip hazards such as throw rugs, making sure the home is well lit (use automatic nightlights) and installing safety features such as handrails, grab bars and adjustable shower seats.
Stop them from wandering. Six out of 10 people with dementia wander from home at least once, and many do so repeatedly, according to the Alzheimer’s Association. A predictable routine can help avoid disorientation and subsequent excursions. You might also consider installing remote door locks or alarms, or locks far above or below eye level. The Alzheimer’s Association offers a 24-hour nationwide emergency response system, MedicAlert with Wandering Support , for an annual subscription fee.
Anticipate other risks. Dementia brings with it particular worries about self-injury. To lower the risk, keep medications in a locked drawer or cabinet, disable the stove when not in use and lower the water heater temperature to 120 degrees Fahrenheit or less.
Recognize driving dangers. Impaired driving isn’t only a danger to the driver. It can and does harm others. Discuss your concerns with your loved one. If the person is resistant to giving up the car keys, consider asking a physician to weigh in. Be empathetic about the loss of freedom, a common fear.
Toileting and Incontinence Care
As the disease progresses, many people with Alzheimer’s begin to experience toileting difficulties and reduced bladder and bowel control. Incontinence can be upsetting and embarrassing for a senior and difficult for their caregiver to address and manage. Sometimes incontinence is indicative of a physical illness, such as a urinary tract infection (UTI) , so be sure to discuss changes with their doctor as soon as possible.
Practice timed voiding where you create a bathroom schedule and stick to it as closely as possible. For example, take toileting breaks every three hours during the day, and don’t wait for the person to ask. This includes tracking when accidents happen to help plan ways of avoiding them.
Watch for nonverbal cues that an elder may have to go to the bathroom, such as restlessness or pulling at clothes, and act quickly.
To prevent nighttime accidents, limit fluid intake in the evening hours just before bedtime.
Plan ahead for outings. Look up restroom locations, have the senior wear simple, easy-to-remove clothing, and bring an extra set of clothes and incontinence supplies in case of an accident.
People who have Alzheimer’s disease will require more care as their condition progresses. Caregivers may need assistance in performing physically demanding tasks, such as bathing, moving, or dressing a person.
Caregivers may want to consider seeking professional help if their loved one:
Caregivers who experience adverse health effects, such as chronic stress, fatigue, or depression, may require professional assistance.
Ultimately, it is up to the caregiver and their family to decide when to seek professional help.