If you care for someone with dementia, you have probably researched all you can about it. Day to day tasks can be very difficult especially if the person you care for is experiencing physical decline along with cognitive decline. Despite all your efforts to learn about caring for a client or loved one, you probably still feel tired and overwhelmed. It can be physically and emotionally taxing to be a caregiver. I wanted to share a review of the strategies that we find most helpful when working with clients who have dementia.
#1: Be patient
While this is easier said than done, it is important to remember that dementia can cause a delay between the time that the individual hears your words, and the time it takes for him/her to formulate a response. For example, if you ask your loved one to lift her arms so you can remove her shirt, and she doesn’t immediately respond, try to be patient and encourage her to do the task in her own time. You may be surprised to find that given the extra time, she can do more than you thought. We tend to assume that if she doesn’t respond, that she can no longer perform that movement, or respond to simple requests. Often times it is related to response time, and not physical or cognitive decline.
#2: Break complex tasks into simple steps
Dementia may affect your loved one’s ability to process complex ideas/tasks/movements/conversations. It may help to break them up into simple steps. For example, rather than saying “Ok Dad, I need you to scoot forward in your chair so we can stand up and move into the kitchen.” You may need to say, “Ok Dad, can you please scoot forward in your chair?” “Great, now I’m going to help you stand up.” “There we go." “Now can you turn toward me?” “Perfect.” “Let’s walk together to the kitchen.” It is much easier for him to process one thing at a time, and he is more likely to actively participate without confusion or miscommunication. Don’t forget patience! Each step may need to be slow and deliberate.
#3: Use consistent verbal and tactile cues
Cues are things that you do to prompt a response. A verbal cue may be “please scoot forward in your chair.” A tactile cue would be to place one hand under his knee, and one hand behind his hip, and help guide him to scoot forward in his chair. Typically, it helps to use verbal and tactile cues in unison. Consistency is key. It is helpful to use the exact same wording and hand placement every single time. For example, changing “please scoot forward in your chair” To “please scoot up” can be very confusing to someone with dementia. They may no longer understand what you are asking. Find a phrase that works for him/her, and stick to it.
#4: Use visual demonstration
Sometimes words are misunderstood. Even after you patiently explain a task, step by step, using consistent cues, you may still find that there is a misunderstanding. Visual demonstration is very powerful. Between hearing loss, short term memory loss, and confusion, verbal cues can be ineffective. Try demonstrating each step clearly. Tell him the first step, demonstrate it clearly, and give him time to try. When that is complete, explain and demonstrate the next task, and so on.
#5: Take the path of least resistance
Dementia is a frustrating disease, not only for the one who suffers from it, but for those for care for him/her. Depression, anxiety, hostility, and despair are all common. The above mentioned strategies will help to smooth out day to day tasks, but they cannot eliminate the inevitabilities and emotions surrounding dementia. Sometimes the best strategy is to take a break. If your loved one is frustrated, angry, or upset, it may be best to leave that task and come back to it when everyone calms down. For example, if your Mother frequently gets agitated about showering, try to leave extra time and patience for that task. You may want to try setting days of the week in advance, so she knows what to expect. Choose a time of day when she has the most energy. Ask her what would make her shower more comfortable or enjoyable. If all else fails, take a break from that subject and return after she gets some rest.
We hope that these strategies help you provide the best care for your loved ones, and reduce the physical and emotional stress associated with care giving.
Reneu Health, inc.
Director of Education
We are a team of experienced clinical kinesiologists who specialize in preventive and rehabilitative exercise for seniors. We believe that aging is part of a beautiful journey and everyone deserves to live their best life. We understand that as our bodies get older, it doesn’t function the same. As some see this as a limitation, we see it as an opportunity. With the right mindset, knowledge, tools and support we help improve quality of life, slow the progression of certain conditions and help you take control of your health.
Call us today for a free consultation. San Diego 619.263.0329 or Orange County 949.245.6239.