Guidance From Experts in Alzheimer’s and Dementia Care
A Practical Guide For Managing Alzheimer’s and Dementia Behaviors
Few people thrust into the role of caregiver have received any formal training on the confusing symptoms that can attend the onset of memory loss. Relying on experts in the field, our guide is a short yet comprehensive primer in managing behaviors associated with Alzheimer’s disease and dementia.
A Trusted Resource
Sonata Senior Living is a resource for caregivers. We offer services, information and understanding to caregivers managing the day-to-day situations and behaviors associated with Alzheimer’s and dementia.
Relying on experts in the field, we’ve compiled a short yet comprehensive primer in managing Alzheimer’s and dementia symptoms and behaviors.
Using general guidelines, we offer practical strategies used by our certified dementia care experts to manage the daily challenges that accompany dementia caregiving.
Common Alzheimer’s and Dementia Behaviors
- Agitation
- Cognitive Decline
- Confusion
- Depression
- Dressing
- Falls
- Paranoia and Hiding
- Weight Loss
- Poor Sleep
- Wandering
Agitation Caused By Dementia
Agitation, one of the most common symptoms of dementia, is particularly noticeable as the day winds down. A time of day coined by healthcare professionals as “sundowning,” late afternoon changes often cause people with dementia to become restless and agitated.
Feelings
Do not underestimate the importance of feelings and human touch. Preserve your loved one’s dignity by validating their feelings of frustration using a gentle tone of voice or understanding touch.
Activities
Distracting or redirecting the person in your care to a different activity can alleviate agitation. Suggest a walk, new activity or favorite snack. Or, provide a comfy blanket and box of familiar objects such as family photos or collectibles. Helping to change the dementia person’s perspective with an activity will diminish agitation.
Environment
Creating a comfortable ambiance has been proven to play a role in alleviating symptoms of agitation in Alzheimer’s disease. Reduce stimulation and minimize distractions in the room by turning off the television and playing soft, relaxing music.
Treatment
Some research suggests that agitation can be treated with antidepressants. If continued agitation is severely interfering with your loved one’s quality of life, ask your doctor for more information.
Depression Caused By Dementia
Alzheimer’s disease interferes with neurotransmitters in the brain that impact mood. Depression is very common among people with dementia, particularly in the early and middle stages. It is important to make the doctor aware of any signs of depression so that proper treatment can be prescribed.
Medical Evaluation
Ask for a referral and make an appointment to see a geriatric psychiatrist who specializes in treating depression in older adults. In some cases, the doctor may prescribe therapy or an antidepressant to treat the symptoms of depression.
Social Isolation
Social isolation contributes to depression in people with dementia. To combat this risk factor, experts recommend introducing more socialization opportunities, such as scheduled outings. Taking your loved one to a favorite park or restaurant can provide a much-needed respite. Or simply ask a good friend to stop by for a visit.
Tasks
Cognitive disabilities associated with Alzheimer’s cause confusion which can create feelings of failure and hopelessness. Plan more opportunities for the person with dementia to achieve something small every day such as setting the table to help boost self-esteem.
Confusion Caused by Dementia
Confusion is the natural result of memory loss. When a person with memory impairment cannot remember words to communicate or how to conduct activities that used to be accomplished with ease, it becomes a struggle to fill the gaps caused by forgetting ordinary tasks. Specialized memory care communities encourage people with dementia to use their retained abilities, maximizing feelings of freedom and control, while reducing opportunities for failure and feeling of confinement.
Visual Clues
Memory loss causes one to feel disoriented in the world, especially with regard to time and space. Use of visual aids such as clocks, watches or signs can help reorient the person and minimize confusion.
Communication
Modifying the way you communicate with the person in your care can alleviate or even prevent confusion. Avoid talking in long sentences or giving lengthy instructions, which are more difficult to understand for people with dementia. For greater success, only give one instruction at a time or break tasks down into small steps.
Activities
Activities are a fundamental aspect of purpose-built memory care communities since they help residents retain their independence and sense of self for as long as possible. Replacing the confusion with functional activities like folding towels can provide a distraction and help a person with dementia reorient themselves in the moment. Avoid attempting later in the day any complicated tasks which are better suited for the morning, such as bathing and running errands.
Cognitive Decline Caused By Dementia
According to the 2018 update to the American Academy of Neurology (AAN) Guidelines on Mild Cognitive Impairment (MCI), there are no FDA-approved medications for the treatment of MCI. Instead, most medical interventions focus on physical exercise, nutrition and brain health.
Physical Exercise
Physical fitness and cognitive function have been consistently linked in research. Studies also show that exercise reduces agitation and promotes sleep. Start with a gentle exercise program that includes walking and gradually add activities such as dancing if they are well received.
Brain Health
New experiences, longer sleep cycles, music, reading and even video games and social networking have been found to have a positive impact on brain health and cognition. In recent years, research has been focused on ways to maintain and even regenerate new brain cells and neural connections. In specialized memory care communities, brain training – or neurobic exercise – is often used as a technique to boost cognition.
Legal Documents
If and when cognitive decline progresses to dementia, it is important to get legal documents in order. Gather and organize documents such as insurance policies, birth and marriage certificates, deeds and mortgages, and a living will. It’s also a good time to assign a durable power of attorney for healthcare (DPAHC).
Memoirs
Collecting and capturing memories in the early stages of cognitive decline will help you stay connected to your loved one. Explore popular online applications that help capture and preserve memories such as My Life Story and StoryCorps. Or, simply grab a video camera and make your own video.
Weight Loss Caused by Dementia
Swallowing is a learned reflex and people with memory impairment often “forget” how to swallow. People with dementia may be hungry, but often lose the ability to comprehend that hunger is the body’s way of signaling that one should eat.
Aroma
Memory challenges begin early in the disease, while the sensory memory of favorite foods will linger. Smells associated with familiar foods are known to trigger the brain, so serving food “family style” is a good way to stimulate appetite. Get out the bread machine or use a slow cooker and fill the home with appetizing aromas!
Snacks
Nutritious foods can improve the health and quality of life of those with Alzheimer’s disease. Providing lots of snacks and easy access to fruit, crackers and vegetables can stave off weight loss. The goal is to maximize opportunities for your loved one to make the connection between food and eating by availing it frequently throughout the day.
Vision
Changes in vision can prevent people with dementia from perceiving food on a table, because it typically sits below eye level. Experts recommend use of high contrasting colors to draw attention to plated foods. Serving mashed potatoes on a blue plate or brightly colored Fiesta® dinnerware, for example, is a popular strategy.
Plating
The amount of food on a plate can be overwhelming for people with dementia. Finger foods and single-serve items can boost the desire to eat. Experts recommend serving food in a mug or on a piece of bread or tortilla to encourage eating while providing necessary nutrition.
Falls Caused by Dementia
Safety is a common concern among caregivers, and for good reason. People with dementia are up to five times more likely to fall and become injured than those without memory impairment. Fortunately there are protective measures you can take to prevent falls before they happen.
Adaptive Equipment
Preventing falls in the bathroom is paramount. Install grab bars, purchase a bath chair or bench, and install a hand-help shower and raised toilet seat. All of these home improvements will not only make your home safer, but make your life easier, too.
Contrast
High contrasting colors are simply easier to see. Experts suggest applying contrasting-colored tape and paint to serve as a visual guide. For example, black tape on the edge of a white tub enhances contour and is easy to see.
Surfaces
Hard wood floors can be slippery. Experts recommend use of rubber-soled shoes coupled with non-slip stair treads to prevent falls. Avoid waxing the floor and clean up spills right away.
Lighting
Falls are less likely to happen in a well-lit home. Install lights in dark hallways and place nightlights at eye level to help your loved one navigate to the bathroom during the night.
Clear walkways
Move furniture against the wall and remove all clutter, including throw rugs, mats, and extension cords, to ensure all pathways in the home are free and clear.
Poor Sleep Caused by Dementia
Trouble with sleeping is one of the more challenging aspects of dementia. People with dementia often get days and nights mixed up. Due to changes in the brain, the circadian rhythm is interrupted, and deep sleep, which the human body needs, is difficult to achieve.
Daylight
Exposure to natural light will assist with the body’s natural rhythm to wake and sleep! Open the drapes and make sure the lights are on during the daytime to promote wakefulness.
Routines
Adhere to daily schedules, since these may contribute to promoting sleep. Serve meals and shower at the same time every day to help establish routines that may ease transitions.
Stimulants
Avoid or limit caffeine, a nervous system stimulant that interferes with the body’s natural adenosine level and blocks the brain’s normal sleep signals. Alcohol, a diuretic, also prevents REM sleep and leads to more bathroom trips.
Flexibility
Allow sleep where and whenever it happens – in a recliner, sofa or bed. Like food, it’s important to let people with dementia sleep when they can and reset the body’s internal clock.
Wandering Caused by Dementia
Wandering – or the urge to pace or walk around – is a natural and common behavior associated with Alzheimer’s and dementia. Preventing wandering may actually increase negative behaviors such as agitation, so the key is to allow wandering in a safe and manageable way.
Unmet Need
Restlessness may be caused by an unmet need that the person with dementia is unable to identify or articulate. Offer food or beverage and a trip to the bathroom. Adjust the thermostat if it’s cold or hot.
Safety Products
When wandering causes someone to become lost outside, particularly in the Florida heat, it can lead to a serious accident or even death. Allow safe wandering in the house, but prevent someone from venturing alone outside by using child-proof locks or doorknobs. At a minimum, install alarms that alert you when an exterior door is opened.
Register
Register with the Alzheimer’s Association Safe Return®program at www.medicalert.org/safereturn. The program includes a MedicAlert® ID bracelet or pendant, personalized wallet card, a personal health record, and 24-hour emergency response service, so that in the event your loved one were to get lost, a community support network consisting of law enforcement and medical professionals would be alerted to assist.
Neighbors
As a precaution, notify neighbors that you have someone living at home with dementia, so if the person in your care were to wander outside and become lost, neighbors are able to assist.
Paranoia Caused by Dementia
Dementia can exaggerate suspiciousness, which can result from memory loss. Rather than becoming defensive or upset, the best way to handle paranoia is to be patient and reassuring.
Empathy
Think about how you feel when you lose something important to you and reassure the person in your care. Tell them you are sorry the item was lost, but that you know how frustrating it is to lose something meaningful. If appropriate, offer a hug.
Distract
Agree with the person in distress, listen, and redirect their attention, but do not argue or attempt to reason with them into believing something different, as this only leads to more unwanted behavior.
Hiding
Paranoia may cause a person with dementia to hide items, but also forget the location of the hiding place. Store valuables such as wedding rings safely away and out of plain sight. Avoid clothing with pockets and identify favorite hiding places in order to locate missing items.
Dressing Issues Caused by Dementia
What once was an easy task can become a daily challenge for people living with Alzheimer’s and dementia. People lose the ability to manage buttons, laces and zippers, so making smart clothing selections will ease frustration.
Clothing
People with dementia don’t always complete tasks, such as getting dressed, in a natural sequence. In general, the fewer steps required to get dressed, the more independent the person in your care will be. Pull-on pants or trousers with elastic waists and tops – think sweat suits – are a practical choice for both men and women.
Toileting
Due to cognitive impairment, people with dementia cannot always react quickly to the sensation of needing to use the toilet. Specially designed clothing called adaptive wear can be purchased online and features easy fasteners such as Velcro tabs to help prevent accidents.
Get The Help You May Need
Remember that dementia is a disease that causes damage to the brain. Brain impairment creates confusion which triggers a litany of other behaviors that can be distressing to both the person responsible for caregiving and the person in their care.
If you need help, do not wait until you are exhausted or sick. Build a support system early on to establish familiarity with other caregivers. Or, consider a day stay at a memory care community to give yourself a break from the demanding role of caregiving. A memory care community will help your loved one feel connected and engaged with life while you take a needed break to preserve your health.
Alzheimer’s is a progressive disease. It is important to recognize that your loved one may eventually require care beyond what you can provide on your own. Serenades Memory Care communities provide assistance, resources and the highest level of certified dementia care if and when you need it.
Information featured on this page is for informational and educational purposes only. The information provided should not be considered a substitute for individualized medical assessment, diagnosis or treatment by your medical provider or physician. If you or someone in your care has a medical problem, contact your medical provider or mental health provider.
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