By Kelly Prevost, Director of Care, Qualicare
Taking care of a loved one with dementia is equally challenging and heartbreaking. During the later stages of dementia, challenges like behaviour problems start to become an issue for the caregiver. The good news is there is always a way to make the job of the caregiver easier and to reduce anxiety of the patient. The following are some tips on the most common areas we find difficult for patients suffering from dementia. The general principle is to enter the patient’s reality, let them set the pace, and to treat them with respect and dignity.
If a dementia patient is confused and anxious about what time it is or where they are, it does no good to give long explanations to re-orientate the patient back to time and place, especially if the patient in the past has had a negative reaction. For example, if the patient is asking where her small children are, reassure her that they are being taken care of maybe at school or at a friend’s house and will be back later. Continue to talk to the patient about the child and ask simple questions like name and age, talk about school and how she made lunches for her children and baked cookies. Distract to another topic this way with reassurance the child is safe. For example, redirect the conversation by encouraging the patient to talk about being a wonderful mother.
Meal times can be very stressful for someone with dementia. There is generally a lot of stimulation and can easily become overwhelming. The patient may not understand what is expected of her and require more reassurance at this time. It is important to sit with the patient and reassure that everything is taken care of. The caregiver may need to load up the spoon or fork and hand it to the patient to get them going and offer reassurance, cueing and reminding of what to do next frequently. Difficulty chewing and swallowing is a common concern. If you notice the patient chewing food longer or keeping food in the side of the mouth (pocketing), a decreased appetite, or frequent coughing during meals, it is important to have a swallowing assessment done by a professional speech therapist. A nurse can also assist you to make appropriate meals, how to change consistency of food and show feeding techniques.
Bathing is one of the most difficult tasks to perform with a dementia patient. For anyone of sound mind, showering is simple and we do it every day. Try to think of all the little things that we do to prepare for our shower, prepare clothing, prepare toiletries, walk to bathroom, close door for privacy, open shower, turn on tap, adjust temperature, disrobe clothing step into shower… all of these steps we do without thinking and that’s just to prepare for the shower not doing the task itself.
With someone with dementia all these steps are overwhelming and confusing and will cause anxiety. Having assistance is not always wanted as it’s a loss of dignity and control to be in such a vulnerable state. Forcing a dementia patient to shower will result in anxiety, agitation, and aggressive outbursts. It is best to have a calm and relaxed approach to this and know that the patient may refuse, but that it is okay and try again tomorrow.
Prepare the bathroom prior to shower, turn taps on, and make the room warm. Ensure that all toiletries are prepared and within hands’ reach. Ensure you use products of their choice. Prepare the client outside the bathroom and cover with a robe. Assist into the warm and inviting space and disrobe patient. You may also try giving the patient a towel to cover personal areas. Encourage the patient to participate and talk to the patient during the entire process with a reassuring voice. At any time if the patient becomes anxious reassure the patient and assist them out of the shower as soon as possible. Cover the patient, keep warm, and try to distract.
Dealing with Aggressive Behaviors
This is an important topic and merits its own topic. Please watch this space for our next entry. However, if you would like to find out more sooner, please email us at Ottawa@Qualicare.com and we’d be glad to send you advance information about dealing with Aggressive Behaviors caused by Dementia.
All personal dementia care is difficult but in most cases it can be done. Talk to a nurse for more advice. For more information on learning about or getting dementia care for your loved one, give Qualicare Family Homecare a call any time