Posted 18th May 2021
Dementia can have a significant emotional, psychological, practical and social impact on those living with the condition and their loved ones. Making lifestyle adjustments to these varying impacts and subsequent changes poses various challenges for those with the condition.
Depending on circumstances, it is up to the carer / relative of those with dementia to assess these challenges and make a decision about the type of support they will receive. For many, it is difficult to decide whether the person with dementia should be entrusted into a care home or can continue living independently with the necessary support.
Here at Respectful Care, we care for over 500 people, and employ over 200 carers. For Dementia Action Week (17th -23rd May), team members from each of our branches have provided their top tips to help those looking after people who are in the early stages of dementia and living at home.
See below, our top advice…
Irrespective of age, social support and personal relationships are an integral part of a person’s everyday life. Those living with dementia need to feel valued, supported and understood as they undergo significant life changes. The level of support will vary depending on the individual, but should ultimately focus on their overall wellbeing and making them feel as comfortable and loved as possible.
Having regular interaction with loved ones with dementia can discourage feelings of isolation, uneasiness and discomfort. Be sure to spend quality time with them, whether that be assisting with day-to-day tasks or simply sitting down on the sofa for a catch-up or nostalgic chat.
We recommend that a personalised care plan be established, outlining and addressing the person living with dementia’s full range of needs. This care plan can be delivered by professional caregivers (but could be substituted by a relative or friend) and should aim to facilitate day-to-day activities, chores and tasks (such as showering, preparing meals, and so on), giving reminders and assistance as and when required.
Preserving these routines can enable people with dementia to feel independent and in control whilst simultaneously minimising feelings of anxiety and confusion.
If it is decided that the person with dementia is fit to continue living at home, then a needs assessment must be conducted by the local council. Following the needs assessment, they can then recommend any applicable services to help the person living with dementia, such as a walk-in shower, equipment (e.g. an alarm) or day care/pub access.
This can also be done online via Social Services: www.gov.uk/apply-needs-assessment-social-services
Many people living with dementia struggle to maintain a healthy diet, often becoming overwhelmed by food choices or simply forgetting to eat. Assisting with meal prep or delivering nutritional dishes to their home will help to minimise kitchen-induced accidents and ensure that a healthy, balanced diet is maintained.
If the person living with dementia at home is still able and willing to manage their basic finances, it may be worth setting up direct debits to pay household bills and to make rent/mortgage payments. Alternatively, it may be beneficial to ring up some of the companies they’re registered to and explain that their customer has dementia.
The caregiver can then provide another contact number should a bill payment be missed, thus minimising the risk of the company cutting off electricity/water for the household. This, of course, applies to situations in which the person with dementia is living at their home alone.
Prioritising the safety of those living with dementia is of the utmost importance. Living at home can be hugely beneficial to somebody with dementia as it provides them with a calm, familiar environment that enables them to feel safe and secure. They can also benefit from constant interaction and around-the-clock support, which maximises their wellbeing and overall safety. If and when possible, ensure that they are closely monitored and offered assistance with their movement and day-to-day actions.
This will significantly reduce the risk of incidences, such as injuries, trips and walking with purpose.
Engaging in meaningful activities can be applied to somebody living with dementia at home or in a care home. Fun activities help to enrich their life by providing them with routine and social interaction. These activities can be tailored to each person. For example, if football is something the person previously enjoyed, a walk to the football pitch or watching a local match may boost morale.
Sensory stimulation can also be an excellent way to engage someone living with dementia. This can be achieved via outlets such as music therapy, light therapy, aromatherapy and dance, with many videos on YouTube available for those with dementia: www.youtube.com/watch?v=WcXK5Iw8yAk
The world for those living with dementia is different to the “normal world”, – so our advice to you is this: go along with it! It is common for people living with dementia to talk about a deceased loved one as if they are still with us today, so it may be worth just responding lightly, “yes, he’s doing well!” as opposed to continuously breaking the reality.
In the later stages of dementia, people often prefer a more sensory approach to communication. When interacting with the person living with dementia, you can utilise small physical gestures to create a sense of comfort and intimacy. For example, if you were chatting whilst on the sofa, you could hold/lightly stroke their hand.
This point works in conjunction with the earlier tip regarding safety. Sometimes, those living with dementia can get confused about their surroundings. So, caregivers and loved ones must be aware of the associated risks they can encounter whilst going about their day-to-day lives. Questions worth ruminating on include: “Is it safe for them to cross the road on their own if they want to go out and get a newspaper? Or is it safe enough for them to be in charge of their medication?”.
If the answer is no to one or both of these questions, then it is important to take the necessary steps to minimise any associated risks (e.g. hiding pills, cooking for them, accompanying them to the local newsagent).
Not every person living with dementia will go through the same experiences. Although complex decisions may prove difficult, many are still able to make simple decisions. For example, some may still want to decide what they want to have for dinner that evening, and others may want to choose the green blazer over the yellow coat.
In direct correlation with the previous ‘don’t assume’ point, it’s important to recognise that we mustn’t assume that just because they have dementia, they don’t have the mental capacity to be involved in decision-making processes. Please ask them about their preferences, and engage them in discussion whenever possible.
If the person living with dementia is still capable of undertaking day-to-day activities and household tasks, this is worth encouraging. A good example of this would be if they have always liked going out to get a newspaper, you can accompany them to the newsagents (so they can both go for a nice stroll and receive a reward for their efforts!). Or, if they love cooking but a risk assessment has been conducted and it’s unsafe for them to cook alone, perhaps they could assist with prepping the ingredients for the meal.
This helps those living with dementia to retain a sense of normalcy and routine whilst asserting their independence.
In the later stages of dementia, it can be difficult for the person to recall short-term memories or recent events. To engage them in conversation, it may be beneficial to introduce life history or memory books containing a collection of photographs, pictures and descriptions so that they can talk about their life experiences and loved ones.
Although nobody likes a noisy house, people with dementia and hearing problems may be more impacted by everyday background noises. If a person with dementia wears a hearing aid, for example, sounds will be magnified, which can cause distress and discomfort. Be sure to turn off radios, TVs and other noisy appliances if nobody is engaging with them.
As mentioned in a previous point, it is important to promote the independence of somebody living with dementia as much as possible. If they are still able and willing to make decisions, sort finances, cook, dress and so on, then please both allow and encourage them to do so.
In the very early stages of dementia, it is good to try and talk openly with a person who has just been diagnosed to get them to talk about their frustrations of dealing with the illness. Sit and listen whilst they vent. Lending an empathetic ear and being understanding will allow them to feel heard, loved and supported.
Sometimes, the situation can be difficult for both those living with dementia and their loved ones. It can be frustrating for all parties when somebody is unable to recall a significant life memory or a loved one’s name. In these moments, caregivers/relatives must remain kind and patient, as opposed to giving into any feelings of impatience (although it is important to recognise that we are all human, and these internal feelings are valid).
Memory aids can be extremely useful to those living with dementia at home. These can be in the form of labels and signs, which can be placed on cupboards, drawers and containers such as salt, sugar and tea bags. Memory aids are a great way to help somebody with dementia remember where things are.
People with dementia, and elderly people in general, benefit from good lighting in the home as it significantly reduces the risk of falls. Natural light is recommended, which can be improved upon by opening curtains, cutting back overgrown shrubbery blocking light and minimising nets and blinds. At night time, consider leaving lights on so that the person can access the toilet more easily.
When caring for a person living with dementia at home, be particularly mindful of potential hazards such as decorative rugs or mats on the floor. Some people with dementia may become confused and think that the rug or mat is an object they need to climb over, which can result in trips or falls. If possible, avoid shiny and reflective flooring and instead opt for a matte colour that contrasts with the walls.
Some people living with dementia may find mirrors and reflective panels (such as glass windows where a reflection can be seen at night) distressing - particularly if they are having trouble recognising themselves. To combat this, it may be worth hiding/covering mirrors and making sure to close curtains at night.
People of all ages benefit from getting fresh air, exercise, and a bit of Vitamin D. Those living with dementia are no exception. Therefore, it is good to encourage outdoor activities whenever possible. This can be simply a stroll to the shop, a walk down a nature reserve or a trip to the beach.
Following on from our previous point, it may be worth conducting a risk assessment on the garden of somebody living with dementia to ensure that it is secure and minimises walking with purpose. If possible, ensure that walking spaces are flat (with no broken pavement slabs on pathways, for example) and the lighting is adequate to minimise trips or falls. Furthermore, it may be beneficial to keep flower beds or grow vegetables.
This provides a fun hobby to the person living with dementia and enables them to assist with garden maintenance.
Finally, and equally important, is for the carer/relative of the person with dementia to take care of their wellbeing. If that’s you, ask yourself: When was the last time I took a nice, hot bubble bath or treated myself to a new haircut? What about the last time I danced around the kitchen to my favourite song or sat down and savoured a delicious, warm dinner? Supporting somebody living with dementia at home can be physically, emotionally and psychologically draining.
Be sure to take care of yourselves in the same way that you superheroes are taking care of your loved one!
If you would like to talk to one of the team here at Respectful Care for further advice, please do get in touch. We are here to help. Just complete the enquiry form on our contact us page.