Why The Problem Exists
Firstly, when dealing with issues of incontinence it is important to rule out health reasons that may have little or nothing to do with dementia. Difficulty going to the bathroom can be a sign of a urinary tract infection , dietary or hydration issues , prostate problems in men, or side effects from medication . Consult with your loved ones doctor to be sure none of these are factors, even as you follow the following steps to make toilet use easier.
Alzheimers disease itself, of course, makes using the toilet more difficult. Alzheimers affects brain function, and signals between the brain and parts of the body break down. For this reason, someone with a full bladder may not feel the physical sensation of needing to go.
Mobility becomes a problem for people with Alzheimers, particularly in later stages, meaning the basic act of getting up and walking to the bathroom, taking down your clothes, and cleaning up afterward, are all harder.
Fortunately, there are behavioral steps and around-the-house tips and upgrades that can simplify toileting and cut down on incontinence and accidents.
Tips For Caregivers And Families Of People With Dementia
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A caregiver, sometimes referred to as a caretaker, refers to anyone who provides care for another person. Millions of people living in the United States take care of a friend or family member with Alzheimers disease or a related dementia. Sometimes caregivers live with the person or nearby, other times they live far away. For many families, caring for a person with dementia isnt just one persons job, but the role of many people who share tasks and responsibilities. No matter what kind of caregiver you are, taking care of another person can be overwhelming at times. These tips and suggestions may help with everyday care and tasks.
Coping With Changes In Behavior And Personality
As well as changes in communication during the middle stages of dementia, troubling behavior and personality changes can also occur. These behaviors include aggressiveness, wandering, hallucinations, and eating or sleeping difficulties that can be distressing to witness and make your role as caregiver even more difficult.
Often, these behavioral issues are triggered or exacerbated by your loved ones inability to deal with stress, their frustrated attempts to communicate, or their environment. By making some simple changes, you can help ease your loved ones stress and improve their well-being, along with your own caregiving experience.
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How To Choose Appropriate Activities For Dementia Patients
Along with the social components of caring for someone with dementia, it is important for the caregiver to be intimately aware of a broad range of contributing factors in determining what will be helpful in maintaining an engaged and fulfilling day for a loved one. Here are some guidelines to take into account:
- Abilities and skills. This is a broad topic, however, keeping track of how basic skills and abilities are deteriorating is vital. Is the person able to maintain their personal hygiene? Are they able to go to the grocery store and shop? Can they prepare a simple meal? Set the table? Clean up after a meal? Use a computer or phone? Are they having any trouble with tasks that have for the most part always been taken for granted?
Resources For Alzheimer’s Care
Explore the Alzheimers.gov portal for information and resources on Alzheimers and related dementias caregiving from across the federal government.Phone: 1-800-438-4380
Alzheimer’s AssociationPhone: 1-800-272-3900
The Alzheimer’s Association offers information, a help line, and support services to people with Alzheimer’s and their caregivers. Local chapters across the country offer support groups, including many that help with early-stage Alzheimer’s disease. Call or go online to find out where to get help in your area. The Association also funds Alzheimer’s research.
Alzheimer’s Foundation of AmericaPhone: 1-866-232-8484
The Alzheimer’s Foundation of America provides information about how to care for people with Alzheimer’s, as well as a list of services for people with the disease. It also offers information for caregivers and their families through member organizations. Services include a toll-free hotline, publications, and other educational materials.
Eldercare LocatorPhone: 1-800-677-1116
Caregivers often need information about community resources, such as home care, adult day care, and nursing homes. Contact the Eldercare Locator to find these resources in your area. The Eldercare Locator is a service of the Administration on Aging. The Federal Government funds this service.
Phone: 1-800-222-2225TTY: 1-800-222-4225
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Arrange The Food On The Plate
You may need to experiment with different sizes, textures and flavours of food to see which the person responds to the best. Here are some tips to help you change things up:
- Add variety in the colour of food different colour vegetables help to really brighten up the plate.
- Try less quantities of food and fewer individual items on the plate.
- Think about what types of food they have always enjoyed in the past. Put it on the plate with another food right next to it.
- Cut up the food into small pieces.
- Change the texture of the food potatoes could be mashed, boiled, baked for example.
Preserving Your Loved Ones Independence
Take steps to slow the progression of symptoms. While treatments are available for some symptoms, lifestyle changes can also be effective weapons in slowing down the diseases progression. Exercising, eating and sleeping well, managing stress, and staying mentally and socially active are among the steps that can improve brain health and slow the process of deterioration. Making healthy lifestyle changes alongside your loved one can also help protect your own health and counter the stress of caregiving.
Help with short-term memory loss. In the early stages, your loved one may need prompts or reminders to help them remember appointments, recall words or names, keep track of medications, or manage bills and money, for example. To help your loved one maintain their independence, instead of simply taking over every task yourself, try to work together as a partnership. Let your loved one indicate when they want help remembering a word, for example, or agree to check their calculations before paying bills. Encourage them to use a notebook or smartphone to create reminders to keep on hand.
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Tips To Help Manage Dementia Sleep Problems
There are ways to help your loved on get a better nights sleep, Hashmi says.
Avoid things that disrupt sleep.
- Limit caffeine, alcohol, and sugar near bedtime.
- Avoid over-the-counter sleep aids. Instead, Hashmi suggests you talk to a doctor about whether melatonin might help your loved one sleep.
- Remove electronics from the bedroom.
Create a routine that supports sleep.
- Make sure your loved one gets enough daytime light to help with circadian rhythms.
- Change into comfortable clothing, signaling nighttime.
- Consider warm milk, a hot shower, relaxing music or reading before bed.
- Pick a bedtime not too late and stick with it every night.
Ways To Help When Someone Has Anosognosia In Dementia
1. Dont try to convince them they have dementiaUsing reason and evidence to explain or insist that someone has dementia is not going to help.
It will only upset them and will likely make them even more convinced that theyre right and youre wrongly discrediting them.
A more effective strategy is to discreetly make changes that will help them live safely.
And overall, stay calm and focused on their feelings when expressing your concerns and keep your comments as subtle and positive as possible.
2. Work with their doctors and care teamWhen your older adults dementia symptoms are interfering with their daily lives, its time to start working with their care team including doctors, relatives, friends, in-home caregivers, or assisted living staff.
Explain the problems your older adult is having and help the team understand that they arent aware of their dementia and why it wont help to try to convince them logically.
Work together to creatively provide your older adult the help they need without waiting for them ask for it or forcing them to admit theres a problem.
3. Discreetly make their life as safe as possibleMaking your older adults everyday life simpler and safer can help prevent someone with anosognosia in dementia from hurting themselves or others.
Some people might try to drive, manage money, cook, or do other activities that could be dangerous because of their cognitive impairment.
Finding ways to help that still preserve pride will be most effective.
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Should You Tell The Person They Have Alzheimer’s
Families may frequently ask, Should I tell the person that he/she has Alzheimer’s? Keep in mind that the patient and/or loved one can’t reason. They don’t have enough memory to remember the question, then think it through to form a conclusion. Caregivers and/or family members may often think if they tell the person with memory loss that he/she has Alzheimer’s, then he/she will understand and cooperate. You cant get cooperation by explaining that he/she has the disease and expect him/her to remember and use that information.
Developing A Treatment Plan
Psychologists may work with individuals with dementia and their families independently through a private practice or as part of a health care team. Psychologists will work with the individual and family to develop strategies to improve quality of life and manage emotions related to the dementia diagnosis.
In working with a psychologist, an individual with dementia and those who provide care for them may discuss what is already being done well to manage the dementia and which behaviors may be improved. The psychologist may ask the individual or caregiver to do homework like practicing memory tools. Memory tools can help individuals become more organized to better manage their symptoms of memory loss. These tools might include:
- Using an alarm as a reminder to take medicine.
- Using a calendar, to-do list and journal combo as a memory substitute.
- Establishing routines to identify, plan and carry out pleasant activities that are within the capacity of the care recipient.
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Do Not Keep Correcting The Patient
People with dementia do not like it when someone keeps correcting them every time they say something that may not be right. It makes them feel bad about themselves and can make them drift out of the conversation. Discussions should be humorous and light and one should always speak slowly and clearly using simple and short sentences to capture and keep the interest of the dementia patients.
Dont Counter Aggressive Behavior
People with dementia and/or Alzheimer’s may become aggressive in response to the environment. Bath time is often when the aggressive behavior is displayed. The caregivers and/or family member’s approach may also play a part. Rushing, speaking harshly, or forcing a person may result in an aggressive response. When someone with memory loss displays aggressive behavior, it is a form of communication. It may be the only way a person has left to say, Pay attention to me! I don’t want to take a bath! When someone is communicating vigorously, it is the caregivers and/or family member’s job to respect that communication. Hitting, kicking, or biting are ways of saying, stop. The appropriate response is to stop. That doesnt mean not to try again in five minutes or a half an hour.
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Dementia Books On Prescription
Reading Well Books on Prescription for dementia offers support for people diagnosed with dementia, their relatives and carers, or for people who would just like to find out more about the condition.
GPs and other health professionals can recommend titles from a list of 37 books on dementia. The books are available for anyone to borrow free from their local library.
Read more about the Reading Well Books on Prescription for dementia.
The Behavior We See And Do Not See
Referring back to my point about distress behaviors related to someone with dementia, there are instances that a nurse or caregiver cannot see. What we see are the gestures, body language, words, or tones coming from the person with dementia and may be interpreted as acting out or anxiety, or being out of control. However, what the person with dementia is trying to communicate may be experiences, fears, prejudices, feelings, values, and beliefs that need further assessment. These behaviors are what we cannot see during our interaction with them at that time.
Do not ignore or say OK, you need some Ativan to calm down. There may be an instance where the patient may need Ativan or Xanax but not every time they display a distress behavior. For example, Lucy may come to you saying, Did you know I had a chicken coop? Your response may be to deny that she does. Her response could be a distress behavior to possibly avoid the risk of her flailing her arms everywhere and getting upset. Instead say, Tell me about your chicken coop. This builds trust between you and that individual and will modify the distress behavior producing a positive outcome.
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The Plate Colour Matters
In a study conducted at Boston University, researchers found that patients eating from red plates consumed 25 percent more food than those eating from white plates. This appears to be connected with the way someone living with dementia sees food on a plate. If you cant really see food because its on a white background you are much less likely to eat it.
The use of colour helps to stimulate interest in dementia patents, as often they have trouble distinguishing between colour. If the food is too close to the colour palette of the plate, people with dementia can struggle to distinguish the contrast between the two and realise there is food to be eaten.
A company called Eatwell Tableware have a fantastic selection of innovative tablewear designed for those with dementia or motor impairment.
Sentai – Meal reminders and much more
Using smart technology, Sentai can take care of daily reminders like gently telling someone with dementia that its time to eat. Sentai can help them to retain their independence by giving you piece of mind with live updates and insights as to their wellbeing, without being intrusive. If something doesnt seem right, or they press and emergency button, Sentai will immediately let you know.
Distraction: Singing & Reading
For some people, a distraction can be a good way to get the chore done. Its kind of a different communication style that helps in distressing situations. For example, if a patient and/or loved one likes singing, starting him/her singing could allow the caregiver and/or family member to ease into bathing time with a gesture.
Singing actually can help tremendously with memory loss patients and/or loved ones who can no longer talk, or have trouble finding words to form sentences, because they are usually still able to sing a song. Often, they can remember the lyrics of a song from beginning to end.
Many patients and/or loved ones can still read as well. Singing and reading can give the person great joy and hearing a loved ones voice can very comforting for family members.
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Causes Of Challenging Behaviors In Bathing
When a person is combative or resistive with a bath or a shower, there can be many causes for her behavior. Here are a few possible ones:
- Embarrassment: If a person is concerned about privacy, bathing with someone else present could make him feel very uncomfortable and embarrassed.
- Fear of Water: Some people are afraid of water, whether it’s due to some traumatic incident or just increased anxiety. Others react negatively especially to a shower since they may have always grown up with the routine of a bath.
- Lack of Understanding: A person with middle or later stage dementia might not understand why you’re present, why you’re trying to take her clothes off or why she needs to be in the water and be washed. Understandably, this often causes significant resistance.
Occasionally, the person with dementia may become sexually inappropriate during bathing because he does not understand why you are assisting him. If he misinterprets your help, don’t yell at him. Simply explain: “Mr. Smith, I’m a nurses’ aide and I’m here to help you bathe today. Your wife will be here soon to visit you.”
Dont Answer Questions Of Patient/loved Ones Regarding Bad Memories
People with Alzheimer’s often ask difficult questions, mostly about people who have passed away years ago. Its not helpful to remind the patient and/or loved one that a person theyre asking about has passed away. Rather than avoid the subject, you can say, He/shes not here right now, but tell me about him/her. Often the person with memory loss is looking for the sensation and security that they would have if their loved one was around.
Caregivers and/or family members should be helping patients and/or loved ones comfortable, safe, and protected. Elderly women, for example, who have had children commonly ask, Where are my babies? This question will often come up at meal time, when feeding the children was an important part of motherhood. Find a way to soothe their concern. You could say, The babies are sleeping.
As stated earlier, trying to bring a person with Alzheimer’s the present-day reality is not effective. Caregivers and/or family members should adapt to the patient and/or loved ones reality. Its ok to go anywhere in any time period in order to communicate.
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Paranoia Delusion And Hallucinations
Distortions of reality, such as paranoia, delusions, and hallucinations, can be another result of the disease process in dementia. Not everyone with dementia develops these symptoms, but they can make dementia much more difficult to handle.
Lewy body dementia, in particular, increases the likelihood of delusions and hallucinations, although they can occur in all types of dementia.
Why Is It Important To Keep Dementia Patients Engaged In Daily Activities
A daily routine with healthy activities is important for seniors of any age and especially vital for dementia patients. As dementia worsens over time, the person will find it more difficult to focus and struggle to learn new things. Having a routine in place early on helps give them structure that they find familiar. Additional benefits of having a routine that incorporates engaging activities for a loved one with dementia include:
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