Dementia: Part Two

Last week I wrote an article about dementia. It was my aim to encourage early testing in order to treat or delay the worsening of dementia symptoms. Science is gaining an understanding of this disease and resources are growing to manage or treat dementia symptoms. In this article, I want to provide information on best care practices of a dementia sufferer.

A dementia patient is sensitive to their environment. It is important to maintain consistency of their physical living environment and their helpers. Reduce noise, remove clutter and avoid highly contrasting colors or wall papers. Use clear, soft lighting. Use simple visual reminders to facilitate common tasks. If a patient is moved to a residential facility, bring familiar items with them to their new home.

Outside care givers or facility staff should have a consistent approach. Introduce yourself in a similar fashion at each visit. For example, “good morning Sunshine.” Minimize rigidity, but maintain a daily routine. Avoid trying to reason or argue with them. Remember that behaviors, while frustrating at times, are not intentional. Use simple clear language, and use a caring and positive tone of voice.

Strategies to manage their symptoms include cognitive stimulation. Cognitive circuits can improve. Help them maintain a good diet, exercise and utilize relaxation skills such as meditation. Minimize stress and increase social activity. Skyping, Facetime and voice messages are good tools to increase social contact when you can’t be there. Stimulate memories of positive experiences from the past. Massage and aroma therapy stimulate sensory awareness.

Late stage dementia can be challenging when there are unpleasant behaviors such as agitation, wandering, repetitive questions, yelling, refusal to cooperate, or excessive crying. Sometimes these behaviors can be an indication of an unmet need that they can’t verbalize. They may be in pain, be hungry or thirsty, anxious, lonely or depressed, or they may be incontinent.

Care givers can alter their approaches to unpleasant behaviors. If someone is agitated, they may try to calm, soothe or distract them. They may use music, oils, pets or exercise. If someone is wandering or restless, the care giver can try to engage in a new activity or eliminate the misleading stimuli. Reduce noise, caffeine and clutter. Involve the patient in meaningful activities such as one on one time or group activities. If someone is asking repetitive questions, an intervention is to either distract or reassure. If they are making disruptive noises, music and nature sounds are good interventions. If they are resistant to direction, identify the source of the threat and alter the approach.

If you have dementia symptoms or you are a care giver, you are not alone. Dementia is a growing field of research and resources. I recommend Alzheimer’s Speaks at https://www.alzheimersspeaks.com/ and Alzheimer’s Association at http://www.alz.org/