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How Can You Promote Independence In A Person With Dementia

How To Help People With Dementia Remain Independent

Persuading a person with dementia to accept help

When caring for someone with dementia, it can be challenging to get the right balance between being helpful and supportive and allowing your loved one to retain their independence for as long as possible.

According to Dementia Carers Count, there are currently 700,000 people in the UK who care for someone with dementia, with 40% of these carers looking after their loved one 24 hours a day, 7 days a week.

Unfortunately, there is no manual for carers and most people who look after someone with dementia are simply trying to do their best on any given day.

However, trying to ensure that your loved ones overall wellbeing is looked after while at the same time trying to help them maintain their dignity, confidence and self-esteem can be difficult.

The Future Prevalence Of Dementia: Why Nurses Need To Act Now

The present state of understanding affirms that dementia is incurable and only evidences that particular lifestyle factors attribute to its onset and development . Furthermore, WHO projects that by 2050 there will be 135.5 million cases globally, and that minimising exposure to risk factors which are associated with the onset of dementia , could potentially prevent 50.7% of incidences. Nurses have an inherent obligation as patient advocates to inform society to develop habits that hinder the onset and advancement of dementia, and will have a fundamental role in promoting health and preventing illness through client education. The future global prevalence of dementia heightens the demand for the nurses to be proficient in providing patient-centred care that endorses optimal well-being and improves quality of life.

Staying Independent With Dementia

That being said, with the right support, advice and guidance, carers can ensure that the person they look after is both safe and able to remain independent.

If you are personally struggling to help your loved one with dementia to retain their independence, the below practical steps should ensure that you are able to offer the right support without being overpowering.

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How Can You Promote Independence In A Person With Dementia

Dementia is a difficult disease to deal with. Anyone who has had a family member diagnosed with dementia knows the toll it takes on their loved one and the challenges it brings to both the person and their caregivers.

Here are the top two things you can do to help promote independence in a person with dementia:

  • Promote exercise: Exercise is important as it can help an individual with dementia perform their tasks longer. Going for a walk with the person gets them out in the fresh air stretching exercise helps them maintain flexibility. Studies have shown that exercise may help a person with dementia extend their ability to perform tasks for a longer period of time as their condition progresses.
  • Keep to a routine. Routines and patterns help to aid memory and give a sense of security.
  • Focus on what they can do, even in the later stages of the disorder: There are tasks that an individual with dementia can still perform, despite their condition. For example, they may not be able to cook a meal, but they can wash the vegetables or set the dinner table.
  • Use bulletin boards and wall calendars so the person can see upcoming appointments and activities, which will help their memory.
  • You must remember, though, that some days are going to be much more difficult than others. If the senior struggles with a task of activity one day, it is possible that they can do it another day.

    Safety Inside The Home For People With Dementia

    Every 3.2 minutes someone develops dementia in the UK. You ...
    • Arrange furniture simply and consistently and keep the environment uncluttered.
    • Remove loose rugs and seal carpet edges that may be safety hazards.
    • Install night-lights in the hallways and in the toilet that may be useful to help a person find their way to the bathroom at night.
    • Dispose of, or safely store, all old medications and hazardous materials such as kerosene.
    • Remove electric blankets and hot water bottles that can be a safety hazard for a person with dementia.
    • Install safety switches, which are now recommended, in homes.
    • Use hot water jugs and other appliances with automatic cut-off mechanisms.
    • Replace more dangerous forms of heating, such as bar radiators, with safer heating options, such as column heaters.
    • Check appliances like heaters and toasters to make sure they do not present any safety hazards.
    • Replace long electrical cords on appliances with coiled or retractable cords.
    • Consider thermostats to control the temperature of water that comes out of the hot water taps.
    • Check that smoke detectors are fully functional a person with dementia may need someone else to check the battery and make sure the alarm is loud enough.

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    Medcom Featured Series: Dementia Care

    Caregivers working with residents with dementia have a great responsibility to administer care that supports optimal function, maintains safety, and provides quality of life to those who have lost the ability to determine their own course in life.

    Medcom offers a 7-part series designed to help long term care facility workers provide quality care for residents with dementia. Topics covered include:

    • Alzheimers Care
    • Communicating with Persons with Dementia
    • Dementia Behavior Management
    • Family Issues with Dementia
    • Promoting Independence for Persons with Dementia

    These carefully constructed courses enhance employee engagement, which, in turn, can improve resident satisfaction and outcomes. For more information about our 7-part series on Dementia Care and to set up a free preview, please contact Medcom at 800-541-0253, or email . Dementia Care programs are also available on DVD.

    Client Education And Health Promotion

    Encouraging exercise

    The progression of dementia results in a severe impairment of cognitive capacity, and when coupled with age-related deterioration in physical performance, this can drastically inhibit the ability to coherently perform activities of daily living . There is extensive evidence to substantiate the health benefits associated with regular exercise for people living with dementia, including an improvement in cognitive functioning and overall well-being . Physical exercise preserves strong muscles and joints, maintaining independence levels for longer and reduces the incidence of identified risk factors for the onset and progression of dementia, including cardiovascular disease and hypertension .

    Nurses are responsible for implementing and supervising most of the everyday activities for patients within care facilities and play a key role in encouraging involvement . By cultivating a therapeutic relationship with clients, nurses can assist in educating patients to identify realistic exercise goals and encourage participation in regular activity . Physical exercise is not only an appropriate nursing intervention to improve cognitive functioning and well-being, but also offers an opportunity to socialise and decrease seclusion often experienced by people living with dementia .

    Encouraging socialisation

    Encouraging mental stimulation

    Encouraging meaningful activity and cognitive stimulation

    Encouraging people with dementia to maintain independence

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    Determining When Living Alone Is No Longer Safe Or Desirable

    When people with dementia no longer understand their own safety and canât look after themselves, family members and health-care professionals may need to weigh the risks of living alone against the benefits of supporting him to live at home.

    In many families, caregiving falls to one person. Hold a family meeting when he is at an early stage of the disease, so that you can plan what each family member can realistically do to help, now and in the future.

    Adjust To Changing Abilities

    How In-home Care Helps People with Dementia

    As the disease progresses, identify the abilities she still has, break down complex tasks and decisions into more easily managed options, and respect her choices.

    • Reduce the number of options at any one time. For example, ask, “Would you like to have your bath now or later?” rather than, “When do you want a bath?”
    • Give step-by-step guidance by asking about one thing at a time and only going on to the next question after each one is answered. “Would you like to go for a walk now?” Then, “Would you like to wear your blue or red sweater?” And then, “Shall we go to the garden or park?”
    • Learn to recognize and be sensitive to the meaning behind facial expressions, tone of voice and body language. Someone with dementia can communicate meaning to anyone who learns to read the emotional signals conveyed.

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    How To Promote Independence For Care Home Residents

    Firstly, it is important to realise that in the first instance of your endeavours at encouraging independence in the elderly or a new care home resident may be met with some resistance. This is likely for a range of reasons including fear and anxiety. It is vital at this stage that encouragement is gentle and tailored to the individual.

    Promoting independence also isnt the hands-free option of care. Rather it can be very hands-on in terms of support and assistance. This support needs to be accommodating and consistent. At its core should be enabling as much independence as possible with each individuals differences in mind.

    For all care home residents, but perhaps particularly for those who are most distressed at losing independence and therefore themselves resist help, it is vital to keep health and safety concerns at the forefront. Where there is a risk to health and safety, the goals should be to consider how a task can still be achieved independently without preventing the attempt at independence. The aim is to balance the risk of harm against the right to freedom.

    Lets take a look at some practical ways of encouraging independence in the elderly.

    Reasons Why Someone May Have Problems Dressing Or Undressing

    There are a few common reasons as to why a resident with dementia will have difficulty getting dressed. They fall under the following:

    • Physical or medical issues:
    • Dementia creates physical complications, as it affects fine and gross motor skills. A resident may also have impaired vision.
    • Dementia can also cause mental illnesses, such as depression, in which a resident may lose interest in dressing and grooming.
    • Forgetting
    • A person who has dementia may forget how to dress, forget to change their clothes, or suddenly forget they are getting dressed.
    • Environmental issues
    • Room elements such as lighting, noise, clutter and other people can upset a person with dementia.
    • A person with dementia will be particularly sensitive to temperature and/or their senses may be impaired.
    • Privacy concerns
    • The loss of independence will be particularly apparent to a person with dementia who now needs help dressing. They may resist help with dressing if adequate privacy is not provided.
    • Making seemingly small decisions might be difficult for someone with dementia. It is important to encourage them to make their own decisions even if it takes more time. Make the process as easy as possible for them by organising clothes beforehand.
    • Impaired senses
    • People with dementia may have a skewed sense of hot and cold. They might, for example, put on several layers of clothing, despite hot weather.

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    Prepare A Safe Working Area

    People with dementia often have difficulty with visual perception and coordination. Ensure that surfaces are uncluttered with few distractions and noise. Good lighting, without glare, individual seat preferences and correct work heights are all important. If necessary, using plastic containers might help to avoid breakages.

    Living Independently At Home

    Communication can become difficult for a person with ...

    For most older people, independence is largely tied to being able to stay in their own homes. There are many care options available for those who need extra support, such as live-in carers, or regular visits from care support workers, as well as the care and support of family and friends.

    Its also important to ensure the house helps to promote independence as much as possible. Perhaps that means installing a handrail in the shower, adding a chair to the kitchen or installing a chair lift. It may just mean moving items to more accessible cupboards. Read more on home adaptations.

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    Working When You Have Dementia

    If you’ve received a dementia diagnosis, you may be worried about how you’ll cope at work. You should speak to your employer as soon as you feel ready.

    In some jobs, such as the armed forces, you must tell your employer. If you’re unsure, check your employment contract.

    You can also get advice from the disability employment adviser at your local Jobcentre Plus, your trade union or your local Citizens Advice service. If you decide to leave work, seek advice about your pensions and benefits.

    If you want to continue to work, speak to your employer about what adjustments can be made to help you, such as:

    • changes to your working hours
    • scheduling meetings at different times
    • changing to a different role that may be less demanding

    Under the Equality Act 2010, your employer has to make “reasonable adjustments” in the workplace to help you do your job.

    Find out more about working and dementia from Alzheimers Society

    Advance Directive Living Will Enduring Or Durable Power Of Attorney

    You can write down the person’s values and wishes in an advance directive, a document that records her wishes about the preferred type of future care. If she can no longer make decisions, the advance directive will provide direction.Other terms used for an advance directive in Canada include living will, or enduring or durable power of attorney for health care. Laws about advance directives vary in different provinces and territories. Contact your local Alzheimer Society for more information.

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    Tips For Caregivers: Helping People With Dementia Maintain Their Independence

    Its not uncommon for caregivers to get into the habit of assuming most of the day-to-day tasks of daily living for a person with dementia. In doing so, however, caregivers can unintentionally undermine the independence of those they care for.

    Research supports this claim. A study conducted by psychologists at the University of Alberta in Canada showed that dementia patients who were too dependent on their caregivers were less likely to contribute to daily activities, which diminished their sense of self-worth.3

    Here are things caregivers can do to help promote independence in the person with dementia:

    Caregivers have the unique opportunity to change how people with dementia and their family members experience the disease. By encouraging participation in suitable daily activities, caregivers can help the person with dementia maintain a sense of autonomy and control and reduce challenging behaviors associated with the condition. Ultimately, caregivers can help improve quality of life and, possibly, even slow the progression of the disease for those living with dementia.

    Appropriate caregiver training is vital in long term care facilities serving patients with dementia. Medcom provides comprehensive DVD and online streaming courses that can be seamlessly incorporated into long term care staff development programs. Learn more below.

    Ways To Encourage Independence In Aging Adults Who Have Dementia

    Bridging the Dementia Divide: Supporting People Living with Dementia
    By Kristy Butler 9 am on January 13, 2020

    When seniors with dementia take on more tasks, it can increase their confidence and make daily life less challenging for their caregivers. Regardless of your elderly parents limitations, theres almost always a safe way to promote independence and keep him or her actively involved in everyday tasks. Continue reading to find techniques you can use to encourage your loved one with dementia to remain independent as the condition progresses.

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    Promoting Functional Independence In Dementia

    Sommerlad, A Rapaport, P Promoting Functional Independence in Dementia. In: Frederiksen, K and Waldemar, G, Management of Patients with Dementia: The Role of the Physician. . Springer: Cham, Switzerland.

    TextSommerlad Rapaport – Chapter 14 – FINAL.pdf – Accepted versionAccess restricted to UCL open access staff until 24 July 2023.

    Strategies For Promoting Independence In Adls

    Even with proper training and mentoring, its nearly impossible to be a great caregiver all of the time. Its no fun getting up in the middle of the night to clean up after an incontinent family member. Its almost impossible to be patient when your mom swears at you, screams, hits, bites, collapses during a transfer, or refuses to eat. But the training I found online and the support from hospice helped a lotit gave me strategies and techniques to use when all seemed lost and when nothing was working.

    Family Caregiver, California

    Good Communication Is the Basis for Success

    Good communication starts with patience and thoughtfulness. Good communication builds trust, encourages independence, and leads to better outcomes. Caregivers must learn and believe that consistently trying to understand the needs of the person they are caring for will make their job easier. Good communication takes into account a persons ability to comprehend, their sensory abilities, and their culture.

    In the home setting, communication may be easier because the environment is familiar with fewer distractions although caregivers are often alone and cannot turn to a co-worker for help. No matter what setting, a calm tone, short direct sentences, a slow rate of speech, and patience encourages independence in people with dementia.


    ADL Skill Training

    Planning Activities

    Assistive Technologies

    Assistive technologies:

    Examples of assistive technologies include:

    Adaptive Aids

    Adaptive aids include:

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    Independence Aids For The Person With Dementia

    • hand-held shower hoses that allow a person to direct the flow of water as desired
    • a shower chair or bath seat that allows a person to be seated while bathing and eliminates the need to lower oneself into the bath
    • handrails near the bath, shower and toilet to provide support and balance
    • easy-to-read clocks and large calendars to help orient to date and time
    • heat sensors or alarms in case of emergency
    • a list of contact names and numbers in large print placed by the telephone allows the person to stay connected more easily.

    Why Is Independence So Important

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    Retaining independence benefits older people in many ways. It can help their physical and mental health, boost their confidence and self-esteem, and improve their sense of purpose and quality of life. It can help them feel useful, which is especially important if they tend to fear theyre a burden on loved ones.

    Giving someone the independence to do one thing can boost their confidence and radiate into other areas of life. For example, instilling in them the confidence to go to the hairdressers alone could make them more aware of their own abilities, and mean they want to start doing other things independently, too.

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