Coping with dementia

For caregivers, dealing with dementia can be difficult. Here are four strategies that might help.

Dementia can be one of the most difficult aspects of caregiving. Watching a loved one succumb to confusion, forgetfulness, agitation, suspicion, and sleep disturbances is wearying and trying to mitigate its effects – sometimes annoying, and sometimes dangerous – seems an impossible task. Here are four strategies to apply to your particular caregiving situation.

Use routine to structure day
Going through the same routine for daily or weekly activities can help in a number of ways. For the caregiver, it gives a sense of control and order to the day (at least, most days). And for the person receiving the care it helps to keep them better oriented to time, fosters independence on some tasks, and helps to decrease frustration. Some tips for developing a routine include:

• Use past routines to help develop yours. If your parent or partner always showered in the morning, consider bathing in the morning.

• Allow sufficient time for tasks.

• Use “good times” of the day for more complicated tasks. If the person suffering from dementia is clearer-headed in the morning, for example, this may be a better time for a larger meal or for visitors to come by.

• Simplify routines as much as possible, breaking them down into the same small steps each day. Giving one instruction at a time can help to keep things running smoothly.

• Use external cues to help emphasize the routine. Lay the toothbrush out on the counter each morning. Play the same music during meals, or before going to bed. Sit in the same chair before putting on shoes to go out. You can also use pictures to label things if reading is becoming difficult.

Let go of logic
Often we maintain expectations of our loved ones beyond their ability to meet them – the idea, for example, that if we explain something logically they will be able to understand why they must do a certain thing, or stop doing something else. The difficult reality is that someone who is suffering from dementia is losing or has lost his or her capacity to apply logic at all times. Instead of explaining, it can help to stick to simple sentences about what is going to happen or what must be done next.

Another trap is the agreement, when we ask someone in the early stages of dementia to agree not to repeat behaviour such as wandering or using the stove unsafely. Just as with a very young child, the individual may agree with you but be unable to control his or her impulses – or even remember the promise. It’s best to restructure the environment to remove as many dangers as possible.

You can also reduce stress if you let go of the idea that it is your responsibility to educate your loved one if he or she is mistaken – for example, if he or she believes his or her mother is alive, it’s not necessarily important to correct the confusion. It may be worth letting some of these things go, even if it is emotionally trying to see such evidence of their own decline.

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