Planning For The Future: Tips For Caregivers
Making health care decisions for someone who is no longer able to do so can be overwhelming. Thats why it is important to plan health care directives in advance. To help plan for the future, you can:
- Start discussions early with your loved one so they can be involved in the decision-making process.
- Get permission in advance to talk to the doctor or lawyer of the person youre caring for, as needed. There may be questions about care, a bill, or a health insurance claim. Without consent, you may not be able to get needed information.
- Consider legal and financial matters, options for in-home care, long-term care, and funeral and burial arrangements.
Learning about your loved ones disease will help you know what to expect as the dementia progresses and what you can do.
Seniors With Dementia Living At Home Have Complex Care Needs
Seniors with dementia who receive care at home may present more challenges than those without dementia because they are more clinically complex. Some of the characteristics of these individuals include the following:
- 1 in 5 have severe cognitive impairment
- 1 in 4 require extensive assistance or are dependent for activities of daily living
- 1 in 4 exhibit any responsive behaviours
- 1 in 4 have signs of depression
Seniors with dementia who live at home score worse on behavioural and cognitive scales compared with other seniors living at home and receiving care. Seniors with dementia exhibit responsive behaviours such as verbal and physical abuse, socially inappropriate behaviour and resisting care more frequently than those without dementia . However, among all seniors with dementia receiving home care, a larger proportion do not exhibit any responsive behaviours than do . Seniors with dementia score the same in health instability and are admitted to hospitals less frequently. The CHESS Scale detects health instability and is designed to identify individuals at risk of serious decline.
What To Do If The Person Disappears When Walking About
If the person with dementia disappears when walking about, try to stay calm. You can try the following:
- If you cant find the person, tell the local police. Keep a recent photograph of the person to help the police identify them.
- Consider taking part in the Herbert Protocol a national scheme that encourages carers to compile useful information that can be used if a vulnerable person later goes missing. The Herbert Protocol is used by about 70% of police services across England and Wales and an online version of the Protocol is being considered. Contact your local police station for more information.
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Outside Approaches To The House
- Keep steps sturdy and textured to prevent falls in wet or icy weather.
- Consider installing a ramp with handrails as an alternative to the steps.
- Eliminate uneven surfaces or walkways, hoses, and other objects that may cause a person to trip.
- Restrict access to a swimming pool by fencing it with a locked gate, covering it, and closely supervising it when in use.
- In the patio area, remove the fuel source and fire starters from any grills when not in use, and supervise use when the person with Alzheimer’s is present.
- Place a small bench or table by the entry door to hold parcels while unlocking the door.
- Make sure outside lighting is adequate. Light sensors that turn on lights automatically as you approach the house may be useful. They also may be used in other parts of the home.
- Prune bushes and foliage well away from walkways and doorways.
- Consider a “NO SOLICITING” sign for the front gate or door.
Handling Sleep Problems And Sundowning
Sundowning is also known as late day confusion. Dementia symptoms may be more prevalent in the afternoon and evening. Due to their confusion and memory loss, they may also be unable to distinguish between daytime and night-time.
- Maintain a routine Keep their day-to-day activities structured, with regular meal, shower, and bedtime.
- Avoid napping in the eye Daytime naps will make it more difficult for your patient to sleep well at night. Instead, keep them engaged in other activities throughout the day.
- Encourage exercise Exercise promotes a healthier lifestyle and keeps the mind active before winding down at night. Consider going to your nearby exercise corner, brisk walking around your neighbourhood, simple stretches, and Qigong.
- Avoid caffeine and sugar Especially from the afternoon onwards.
Adjust the environment In the daytime, ensure that the place is well-lit to make it clearer to the patient that it is daytime. Before bedtime, turn off the lights, reduce ambient noise, and adjust the room to a comfortable temperature to prepare a conducive environment for sleep.
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Caregiving In The Early Stages Of Alzheimers Or Dementia
In the early stages of Alzheimers disease or another type of dementia, your loved one may not need much caregiving assistance. Rather, your role initially may be to help them come to terms with their diagnosis, plan for the future, and stay as active, healthy, and engaged as possible.
Accept the diagnosis. Accepting a dementia diagnosis can be just as difficult for family members as it for the patient. Allow yourself and your loved one time to process the news, transition to the new situation, and grieve your losses. But dont let denial prevent you from seeking early intervention.
Deal with conflicting emotions. Feelings of anger, frustration, disbelief, grief, denial, and fear are common in the early stages of Alzheimers or dementiafor both the patient and you, the caregiver. Let your loved one express what theyre feeling and encourage them to continue pursuing activities that add meaning and purpose to their life. To deal with your own fears, doubts, and sadness, find others you can confide in.
Make use of available resources. There are a wealth of community and online resources to help you provide effective care on this journey. Start by finding the Alzheimers Association in your country . These organizations offer practical support, helplines, advice, and training for caregivers and their families. They can also put you in touch with local support groups.
What Can You Do To Help Dementia Patients Sleep Better At Night
Sleep disturbances are common in dementia patients. Some studies report that as much as 20 percent of Alzheimers patients start getting agitated, anxious, and confused at nightfall. Others may become restless or have changes in sleep patterns. Below are some suggestions to help agitated dementia patients have an easier time getting restful sleep.
- Speak to a doctor: Health care physicians should always be your first stop when you have questions regarding medical conditions or are looking for credible, science-backed information. Theyll let you know about helpful prescriptions and over the counter remedies, as well as other things to do at home.
- Keep the lights on: A well-lit home in the evening can make loved ones feel less agitated because they can see and recognize their surroundings.
- Develop a nightly routine: Having a predictable nightly routine cues dementia patients that bedtime is coming. Their body can then prepare as well by lowering cortisol levels and ramping up melatonin production. An equally important part of winding down is avoiding stimulants and stimulating activities after sunset. If your loved one is sensitive to caffeine, consider restricting coffee morning hours.
- Tire them out: People who spend most of the day resting wont feel tired at night. This can make it difficult to fall and stay asleep. Encouraging more physical activity and discouraging napping can ensure dementia patients are ready for sleep at bedtime.
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Caregiver Tips For Home Safety
Maintaining a Safe Temperature in the Home
Older people are more susceptible to cold temperatures. Potentially dangerous drops in body temperature, known as hypothermia, may occur if its not warm enough. People with Alzheimers may not know how cold they are and wont take appropriate steps to stay warm.Chilly room temperature can cause a drop in strength and energy after only 45 minutes, and hypothermia can happen even when the temperature is not freezing, so the temperature in the home of your loved one with dementia should be set around 70 degrees.
Tips: Drawing curtains or blinds at the right time of day can help keep a room warm. Weatherization and minor repairs can help a home hold its warm temperature. Programs to help seniors afford that cost of installing insulation or taking other steps to weatherize include the Department of Health and Human Services Home Energy Assistance Program .
Moving About the Home
Tips: Make sure there are clear paths through rooms and hallways by getting furniture, cords, or clutter out of the way. This includes floor rugs that can be a tripping hazard. Make sure that rooms and hallways have non-slip walking surfaces and sufficient lighting. Consider placing nightlights in the bedroom, bathroom, and hallways if your loved one walks around at night. If there are stairs in the home, consider installing handrails, as well as safety strips on the steps.
Bathroom Safety Measures
Did You Know?
Preventing Accidents
How To Keep A Wanderer Safe And Indoors
When it comes to keeping someone from wandering outside , you can lock the doors to the house as long as you are home in the event of an emergency. It is not cruel to lock the doors. You are also saving the neighbors and police some worry. If the police are summoned frequently, they may insist that you find some way to keep your loved one inside and supervised so they will be safe. JessieBelle
Get deadbolt door locks, take the keys out of them at night, and keep the keys on a chain around your neck, that way if your loved one is wandering at night, they cannot get out of the house. If there is a fire, you do not have to look for the keys in the middle of a crisis, because they are right there around your neck. If all the deadbolts are keyed the same, you only need to wear one key. LyricaLady
Child locks and alarms work well and are reasonably priced. Also, try installing a lock at the bottom of the door or at the top. Your loved one may not think to look in those places to unlock the door. jycaregiver
I finally secured the doors to the point that my mom could not open them on her own. I covered our doorknobs with plastic covers designed to keep toddlers from opening doors. Eventually, I had to secure those with duct tape wrapped around and around, as she could get the knob covers off when she was really intent on leaving. I also had to add internal hardware, like sliding locks and chained door guards, and these had to be installed above her reach. Catjohn22
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My Mum Suffers From Dementia And Excessive Sleep She Sleeps During The Day And Sleeps Very Little At Night Is It Ok To Let Her Sleep All Day
If possible we recommend encouraging her to take fewer and shorter day time naps, at the same time and place if possible . Keeping to a routine full of activities can help keep her awake during the day, and work some way towards night-time sleep problems. Try regularly getting her up for short walks and maximise daylight in rooms. Sensitively wake her up if she does fall asleep outside of a routine nap time.
Cope With Changes In Communication
As your loved ones Alzheimers or dementia progresses, youll notice changes in how they communicate. They may have trouble finding words, substitute one word for another, repeat the same things over and over, or become easily confused. Increased hand gestures, losing their train of thought, and even inappropriate outbursts are all common as well.
Even if your loved one has trouble maintaining a conversationor less interest in starting oneits important to encourage social interaction. Making them feel safe rather than stressed will make communication easier, so try to manage your own frustration levels.
Be patient. If your loved one has difficulty recalling a word, for example, allow them time. Getting anxious or impatient will only inhibit their recall. Gently supply the word or tell the person that you can come back to it later.
Be aware of your body language. Your loved one responds to your facial expression, tone of voice, and nonverbal cues as much as the words you choose. Make eye contact, stay calm, and keep a relaxed, open posture.
Speak slowly and clearly. Give one direction or ask one question at a time, use short sentences, and give your loved one more time to process whats being said. Find a simpler way to say the same thing if it wasnt understood the first time.
Maintain respect. Dont use patronizing language, baby talk, or sarcasm. It can cause hurt or confusion.
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Music And Art Activities
Restless Leg Syndrome And Related Conditions
According to the National Institute of Neurological Disorders and Stroke, about 10 percent of the United States population could have restless leg syndrome with or without a dementia diagnosis.
Its more common in women but happens in men, as well. For example, my husband suffers from a related condition called periodic limb movement disorder, which makes his muscles twitch while he is sleeping and this affects his sleep quality.
Restless leg syndrome causes pain and discomfort in the legs unless moving them. They might feel burning or tingling and even charley horses.
Thus, even if older adults with dementia wanted to sleep, their restless leg syndrome or similar condition would force them into another sleepless night.
They might decide to get out of bed to relieve the discomfort in their legs and then lose track of what theyre doing. Then you wake up and find them rummaging through the house in the middle of the night.
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Hide Car Keys And House Keys
In addition to wandering on foot, people with Alzheimers might attempt to drive. Getting lost while driving not only endangers the dementia patient but also the public. Be sure to store keys to all vehicles and exterior doors in a secure place. Coats and shoes may trigger a dementia patients desire to go out or resume deeply engrained routines like running errands, picking up kids from school or driving to work. Keeping these items out of sight may help deter them.
Most Seniors With Dementia In Canada Live At Home
About 61% of seniors with dementia in Canada live at home and they require support while staying there.
There are approximately 5.8 million seniors in Canada and about 5.5 million live at home. CIHI analysis finds that of the estimated 431,000 seniors living with dementia in 20152016, more than 261,000 were estimated to reside outside of publicly funded long-term care or nursing homes.
Canadians living with dementia want to maintain their independence they want to live at home and engage with their community, said Pauline Tardif, CEO of the Alzheimer Society of Canada. Comprehensive home and community care is an essential part of this equation. It helps maintain quality of life for people with dementia while also providing needed support for caregivers.
Seniors living with dementia who receive their initial assessment to determine eligibility for long-term care in a hospital are 6 times more likely to enter residential care than those assessed elsewhere
Seniors with dementia and their caregivers can follow 7 key strategies to help them remain in the community longer
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They Wake Up A Lot During The Night To Use The Loo And I’m Worried They May Get Lost Or Confused Should I Wake Up Too To Help Them
It is normal that older people will need to use the loo more often during the night. This can be difficult if a person also has dementia as they might forget why they’re up, where the toilet is or that they should go back to bed. Start by looking at your parents drinking and eating habits. If they are eating and drinking large amounts in the evening this will increase the need for them to visit the toilet. Limit their intake from late afternoon and enjoy a main meal at lunch. Next make the route to and from the toilet as clear as possible by using signs and plug-in nightlights. Try using pictures if it helps. It might also help to make the lights in the bathroom motion activated for when they get there. If you are still worried or you find they still get lost, it may be that you will have to help them. A monitor or bed-exit sensor will help you to wake up when you need to.