Additional Resources For Dementia And Eating Issues
Read and download the NHS helpful Dementia Care Guide Support with eating and drinking . This guide talks about the common problems those living with dementia can have at meal time, and offers some tips to resolve them.
Another great tool that carers can use is The DMAT . The DMAT enables carers to assess, select interventions and generate a person centred care plan to support mealtime eating abilities and meal behaviours in people with advancing dementia. You can learn more about the DMAT and its benefits on their website.
Nonverbal Communication Techniques With Dementia
When speaking can no longer be relied upon as the best form of communication, in the late stages of dementia we can use non-verbal communication to bond and connect. Here is what to remember:
Resources
Dont Talk Down To Them
Caregivers and/or family members should never talk down to the individual with dementia and/or Alzheimer’s, and this especially includes baby talk, which doesn’t work neurologically . The fact that the patient and/or loved one is having problems with language does not mean that talking to them like a four-year-old is going to help. The communication style should still be to a respected, older adult.
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Is Anh A Good Idea
Health professionals and caregivers, who understand that this is a normal part of the disease process may decide against ANH. Inserting tubes is distressing to the person with the disease who may tug or pull on the tubes, sometimes pulling them out. Insertion sites can be sore or become infected. The person living with dementia may not understand why they have to be in the hospital for the procedures and could be distressed by unfamiliar surroundings.
Recent studies, in fact, indicate that giving food and fluids by ANH may actually do more harm than good. Giving food through a tube does not stop coughing or choking. Sometimes fluids may get into the lungs, causing pneumonia. Being confined to bed reduces mobility, furthering weakness and causing the development of dangerous infections such as bed sores. The latest studies show that one-third of people with advanced dementia who have a feeding tube inserted die within one month.
End Of Life Dementia Care And Covid
Older adults and people with serious underlying medical conditions are at higher risk for severe illness from COVID-19. Older adults also have the highest rates of dementia. Given the risks that older adults face from both COVID-19 and dementia, its important to understand how to protect yourself and your loved one. Find more information about dementia and COVID-19 from the CDC.
When a dementia like Alzheimers disease is first diagnosed, if everyone understands that there is no cure, then plans for the end of life can be made before thinking and speaking abilities fail and the person with Alzheimers can no longer legally complete documents like advance directives.
End-of-life care decisions are more complicated for caregivers if the dying person has not expressed the kind of care he or she would prefer. Someone newly diagnosed with Alzheimers disease might not be able to imagine the later stages of the disease.
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Do’s And Don’ts For Communicating With Someone Who Has Dementia
Tags:dementia
Caring for someone with dementia isnt something that any of us expects to do when we are young. Yet, for the adult sons and daughters of more than five million American seniors*, that is their reality. And whether youre caring for your loved one every dayor just occasionally, knowing how to talk to a parent with dementia will help keep the connection you share as strong as possible for as long as possible.
Navigating successful conversations with dementia patients takes trial and error, respect, and practice. It also helps to understand the dos and donts of asking and answering questions. Oh, and did I say patience? Youll need a lot of that.
The 7 Stages Of Dementia
Alzheimers disease and other common forms of dementia including vascular dementia, dementia with Lewy bodies, and frontotemporal dementia are progressive conditions, with symptoms worsening over time as the disease progresses. Learn more about the stages of dementia and what to expect from your loved one as dementia progresses.
Although the two terms are often used interchangeably, Alzheimers disease and dementia are two different terms. Dementia is an umbrella term used to describe several conditions and it includes Alzheimers, as well as other conditions with shared symptoms. More than mere forgetfulness, an individual must have trouble with at least two of the following cognitive areas to be diagnosed with dementia:
- Memory
- Reasoning and judgment
- Visual perception
The assessment tools used to determine which stage of dementia a person is experiencing are meant to be a guide and a rough outline of what caregivers can expect and when they can expect it. Some symptoms may occur later than others, others may appear in a different order than the scale predicts, and some may not appear at all. Some symptoms may appear and then vanish, while others will continue to worsen over time. Because every person is different and dementia manifests itself uniquely, the speed at which dementia progresses varies widely. On average, a person with Alzheimers disease lives 4 to 8 years after a diagnosis, but some have been seen to live as long as 20 years.
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Reasons Why Your Loved One Has Stopped Eating And Drinking
There are many reasons why a person with dementia may lose interest in or turn down, food, and drink.
- Depression: A common sign of depression is a loss of appetite, and depression is common in people with dementia. If your loved one has depression, then their appetite should improve if their depression is treated appropriately.
- Communication: As dementia progresses, people with dementia have difficulty communicating their needs including the need that they are hungry or dont like the food they have been given.
Alternative methods of communication and speech therapy to help your loved one express themselves better is often the solution for poor eating and drinking-related to communication difficulties.
- Pain: Weve all experienced a bad toothache or sore throat. Your loved one may be having problems with their dentures, teeth, or gums. If they have difficulty communicating, then they wont be able to tell you theyre experiencing pain.
Oral hygiene and regular mouth checks are essential to prevent oral pain and discomfort.
- Tiredness: If your loved one is fatigued, then they may stop eating partway through a meal or simply not eat at all. This can also cause concentration and coordination difficulties, so its best for your loved one to eat while theyre most alert.
- Medication: People react to medicine differently, and changes in brand or dose can result in appetite changes. Monitor your loved one carefully and speak to their doctor if you have any concerns.
What Does Sleeping Talking Mean
Sleep talking, formally known as somniloquy, is a sleep disorder defined as talking during sleep without being aware of it. Sleep talking can involve complicated dialogues or monologues, complete gibberish or mumbling. The good news is that for most people it is a rare and short-lived occurrence.
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Stage : Moderately Severe Dementia
When the patient begins to forget the names of their children, spouse, or primary caregivers, they are most likely entering stage 6 of dementia and will need full time care. In the sixth stage, patients are generally unaware of their surroundings, cannot recall recent events, and have skewed memories of their personal past. Caregivers and loved ones should watch for:
- Delusional behavior
Do You Lose Track Of The Time Date Or Season
Once in a while, we all forget what day of the week it is, but we usually remember or figure it out quickly. More troubling: not knowing what day it is, the time of day or how much time is passingand not realizing that youve forgotten. Additionally, unable to remember appointments or even missing them despite putting it on the calendar or having received numerous reminders by family. These may be signs of dementia, according to Johns Hopkins experts.
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Utilizing A Seniors Sense Of Hearing
It can feel awkward at first to try to have a conversation with a loved one who may not comprehend what youre saying or be able to respond. When interactions are so one-sided, it can feel like youre talking at the person, but this connection is still beneficial. Some practice can help you get past the discomfort.
If youre not sure what to talk about, fill your loved one in on what is happening in your life or whats new with extended family members. Talk about familiar things, such as friends or past events they would remember with pleasure. The important thing is to keep the subject matter light and upbeat. Our elders may understand far more than we think they do. Incorporating both touch therapy and pleasant conversation can be very comforting to a senior. Doing so can give you a task to focus on while you chat, such as brushing your loved ones hair, rather than dwelling on trying to fill the silence.
Check Their Advance Care Plan
You should find out if the person has an advance care plan. This document may record their preferences about the care theyd like to receive, including what they want to happen, what they dont want to happen and who they want to speak on their behalf. It may include an advance statement or an advance decision. We have information on planning ahead for patients and their families, which you might find useful.
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Dont Just Talk Loudly
Not every person with dementia has a hearing impairment, and using a loud tone can make them feel like you are yelling at them. Use a clear, normal tone of voice to start a conversation with someone.
If the person doesnt respond or you become aware that they have a hearing problem, you can increase your volume. Speaking in a slightly lower register can also help if someone has a hearing problem.
Things Not To Say To Someone With Dementia
Speaking to an elderly loved one with dementia can be difficult and emotionally draining. Alzheimers and dementia can lead to conversations that dont make sense, are inappropriate or uncomfortable, and may upset a family caregiver. However, over time, its important to adapt to the seniors behavior, and understand that their condition doesnt change who they are.
For senior caregivers, its important to always respond with patience. Here are some things to remember not to say to someone with dementia, and what you can say instead.
1. Youre wrong
For experienced caregivers, this one may seem evident. However, for someone who hasnt dealt with loss of cognitive function before, it can be hard to go along with something a loved one says that clearly isnt true. Theres no benefit to arguing, though, and its best to avoid upsetting a senior with dementia, who is already in a vulnerable emotional state due to confusion.
Instead, change the subject.
Its best to distract, not disagree. If an elderly loved one makes a wrong comment, dont try to fight them on it just change the subject and talk about something else ideally, something pleasant, to change their focus. There are plenty of things not to say to someone with dementia, but if theres one to remember, its anything that sounds like youre wrong.
2. Do you remember?
Instead, say: I remember
3. They passed away.
Instead
4. I told you
Instead, repeat what you said.
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But Is My Loved One Suffering
As a caregiver, the most important concern is that the person with dementia is not suffering. Once we understand that this is a normal part of the disease, it makes it easier to see why the person does not need as much to eat or drink. In most cases, they will not show any sign of being hungry or thirsty, but if they do show interest, have an assessment done and get recommendations on what type of alternatives you can give to keep them comfortable.
Which Dementias Cause Hallucinations
Hallucinations are most common for people with Lewy body dementia, an illness caused by the buildup of proteins called Lewy bodies that disrupt communication between brain cells throughout the brain or kill the cells altogether. Visual hallucinations will often occur in the early stages of the disease, though they eventually stop somewhere in the middle stages and wont recur. People with Lewy body dementia often fluctuate between good days, when theyre thinking normally or at least fairly well, and bad days. In the early stages, those bad days are likely to include visual hallucinations.
Hallucinations will also occur for people with Parkinsons disease with dementia, and for people with Alzheimers. Both those diseases are also associated with a buildup of proteins in the brain. With these dementias, though, hallucinations are more likely to be associated with hearing or feeling. Someone might have conversations with an imaginary person, for example, or think theyre being touched by something that isnt there.
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What Do Elderly People Think About Life And Death
As we get older, death seems to be nearer than when we are younger. In as much as anyone can die regardless of age, for an older person, it seems like it is more likely to happen, especially when dealing with different health conditions that the body does not handle as it used to in the younger years.
For older persons, death does not always spell sorrow and terror, as is the case with younger people. Many of the older people are contented with what the short-term future has for them. You may think that people may get anxious as they become older, but this is not the case. Older people do not have much sadness and anxiety, especially related to death. They are actually more positive about life and death.
As we grow older, our perspective shifts. This is when you realize that things are not as they always seem. Most people fear death because they feel that they will lose the things that they have been working so hard to get over the years. However, for older people, this attachment to things acquired is not really pronounced. This is how some of the fear of death actually melts away.
When you look around you and you realize that there are things that are a part of you that will outlive you actually help in a major way. This could be the legacy we have in children or gardens planted. There are yet others who place value on their country, their religion, or families that live on even after they are gone.
What To Do If They Refuse To Let Go Of The Idea
Sometimes, your older adult will refuse to let go of the idea of going home, no matter how much you try to soothe or redirect.
If that happens, you might need to agree to take them home and then go for a brief car ride.
Experiment with how long it takes before you can take them home without protest. Or, suggest a stop at the ice cream shop, drugstore, or grocery store to distract and redirect.
If its not possible to actually take them out or get into the car, even going through the actions of getting ready to leave can still be soothing. This will shows that you agree with them and are helping to achieve their goal.
Meanwhile, the activities of getting ready give you more chances to distract and redirect to something else.
Keep in mind that not everything you try will work the first time. And even if something works once, it might not work the next time.
Do your best to stay calm, flexible, and creative this technique gets easier with practice.
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Exercise And Outdoor Activities For Dementia
Exercise and outdoor activities can have numerous benefits for people with dementia. They can help improve brain function and thinking skills, regulate their sleep, and can help maintain a positive mood in dementia patients and lower the risk of them developing depression. Physical activities help overall cardiac and breathing health as well.
Exercise and outdoor activities dementia patients can engage in include:
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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