Dementia - daily care
People who have dementia may have trouble with:
- Language and communication
- Handling their own personal care
Help with memory loss
People who have early memory loss can give themselves reminders to help them function each day. Some of these include:
- Asking the person you are talking with to repeat what they said.
- Repeating what someone said to yourself 1 or 2 times. This will help you remember it better.
- Writing down your appointments and other activities in a planner or on a calendar. Keep your planner or calendar in an obvious place, like beside your bed.
- Posting messages around your home where you will see them, such as the bathroom mirror, next to the coffee pot, or on the phone.
- Keeping a list of important phone numbers next to every phone.
- Having clocks and calendars around the house so you stay aware of the date and what time it is.
- Labeling important items.
- Developing habits and routines that are easy to follow.
- Planning activities that improve your thinking, such as puzzles, games, baking, or indoor gardening. Have someone nearby for any tasks that may have a risk of injury.
Eating and nutrition
Some people who have dementia may refuse food or not eat enough to stay healthy on their own.
- Help the person get enough exercise. Ask them to go outside with you for a walk.
- Have someone the person likes, such as a friend or relative, prepare and serve them food.
- Reduce distractions around the eating area, such as the radio or TV.
- Do not give them foods that are too hot or too cold.
- Give the person finger foods if they have problems using utensils.
- Try different foods. It is common for people who have dementia to have decreased smell and taste. This will affect their enjoyment of food.
In later stages of dementia, the person may have trouble chewing or swallowing. Talk with the person's health care provider about a proper diet. At some point, the person may need a diet of only liquid or soft foods, to prevent choking.
Tips for talking with someone with dementia
Keep distractions and noise down:
- Turn off the radio or TV.
- Close the curtains.
- Move to a quieter room.
To avoid surprising the person, try to make eye contact before touching or speaking to them.
Use simple words and sentences, and speak slowly. Speak in a quiet voice. Talking loudly, as if the person is hard of hearing, will not help. Repeat your words, if needed. Use names and places the person knows. Try not to use pronouns, such as "he," "she," and "them." This can confuse someone with dementia. Tell them when you are going to change the subject.
Talk to people who have dementia as adults. Do not make them feel as if they are children. Do not pretend to understand them if you do not.
Ask questions so they can answer with "yes" or "no." Give the person clear choices, and a visual cue, such as pointing to something, if possible. Do not give them too many options.
When giving instructions:
- Break directions down into small and simple steps.
- Allow time for the person to understand.
- If they get frustrated, consider switching to another activity.
Try to get them talking about something they enjoy. Many people with dementia like to talk about the past, and many can remember the distant past better than recent events. Even if they remember something wrong, do not insist on correcting them.
People with dementia may need help with personal care and grooming.
Their bathroom should be nearby and easy to find. Consider leaving the bathroom door open, so they can see it. Suggest that they visit the bathroom several times a day.
Make sure their bathroom is warm. Get them undergarments made for urine or stool leakage. Make sure they are cleaned well after going to the bathroom. Be gentle when helping. Try to respect their dignity.
Make sure the bathroom is safe. Common safety devices are:
- A tub or shower seat
- Anti-skid mats
Do not let them use razors with blades. Electric razors are best for shaving. Remind the person to brush their teeth at least 2 times a day.
A person with dementia should have clothing that is easy to put on and take off.
- Do not give them too many choices about what to wear.
- Velcro is much easier than buttons and zippers to use. If they still wear clothes with buttons and zippers, they should be in the front.
- Get them pullover clothes and slip on shoes, especially as their dementia gets worse.
Alzheimer's Association. Dementia Care Practice Recommendations for Professionals Working in a Home Setting. 2009. http://www.alz.org/national/documents/phase_4_home_care_recs.pdf. Accessed on May 29, 2014.
Knopman DS. Alzheimer's disease and other dementias. In: Goldman L, Schafer AI, eds. Goldman's Cecil Medicine. 24th ed. Philadelphia, PA: Elsevier Saunders; 2011:chap 409.
Dave J, Hecht M. Dementia. In: Frontera, WR, Silver JK, Rizzo TD Jr, eds. Essentials of Physical Medicine and Rehabilitation. 2nd ed. Philadelphia, PA: Elsevier Saunders; 2008:chap 119.
Joseph V. Campellone, MD, Division of Neurology, Cooper University Hospital, Camden, NJ. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.