Understanding the Needs of Elderly Parents with Dementia

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Understanding the needs of your elderly parents with dementia can be challenging. It is best to approach your situation with a realistic positive attitude, it is equally beneficial to be empathetic of your parents’ needs. The confusion they experience can be frustrating and they will need you for compassion and guidance. Educating yourself about Dementia Care as well as the resources and help available to you is crucial in understanding how best to deal with this progressive disease.

How do you care for an elderly person with dementia?

Stick to a Daily Routine

Keeping a sense of structure and familiarity will help you and your elderly parent cope with the unexpectedness of dementia. Being consistent with daily activities such as bathing, dressing, mealtimes and even receiving visitors can help with orienting your parent. As daily routines are developed, it is important to include socialization with family members and friends but not to the point where your parent is stressed or anxious. Make sure to involve your parents in their daily personal tasks as they are able to perform them. For example, dressing, placing clothes in the hamper, tidying up their bedroom. Sticking to a general daily routing allows for dementia care to run more smoothly.

Eating

Proper nutrition is important to keep the body strong and healthy even more so when there is a diagnosis of dementia, the most common form of Alzheimer’s disease. Offer your parent a balance of vegetables, fruits and lean protein foods depending on their dietary tolerance. Keep in mind not to overwhelm them with choices but rather offer two at a time. Offering small cups of water or other fluids low in sugar during the day is important for hydration.

  • Eliminating distractions such as having the TV on too loud or other noise can limit confusion and will keep your parent focused on eating their meal and will ensure proper nutrition.
  • When setting the table use only utensils needed for the meal.
  • Try to use white plates as opposed to patterned ones, this can help with distinguishing food from the plates and/or place mats.
  • Allow your elderly parent to be as independent as possible during meals. Offer help only when needed.
  • Serving one to two dishes at a time may seem less overwhelming and less confusing for example, mashed potatoes, then chicken breast and broccoli.
  • Give your parent plenty of time to eat, never rush them as this can cause agitation.

Make it a social event by keeping your parent company during mealtimes! Remember that keeping mealtimes enjoyable and simplifying them will help your parent feel more at ease and they will look forward to the activity. When dementia is more advanced, your parent may not remember what they ate or even if they ate. They will however let you know in most cases that they are hungry or thirsty.

Dressing

The personal task of dressing can become less stressful for your parent with dementia if you take the time to organize the process. There are several ways to help your parent if you plan ahead:

  • You can lay out clothing in the order that each item should be put on.
  • Choose comfortable, simple clothing made out of fabrics that are soft and stretchable.
  • Keep choices simple and closets clutter free.
  • Remember to be flexible, your parent may insist on wearing the same article of clothing every day, buy duplicate items or keep similar ones available for them.
  • Shoes should be easy to put on, no laces or complicated fasteners. They should also be comfortable and non-slip.

It is okay if your parent wants to layer their clothing as long as they are comfortable and do not overheat or under dress in colder weather.

Bathing

Bathing can be the most difficult task when providing dementia care. Allow your elderly parent to be as involved as possible as this gives them a sense of independence and they feel less vulnerable. Always be sure to prepare the bathroom before bathing by gathering bathing supplies and making the room comfortable before you let your parent know that it is time to bathe. Be sure to place soap, shampoo and other supplies within reach, always supervise. Having larger towels will aide in maintaining your parent’s privacy and make them more comfortable.

It is especially important to keep the bathroom safe by installing grab bars, non-skid mats and bath chairs. Never leave your parent with dementia alone and be sure to use products that are non-breakable. Remove scissors and tweezers from the bathroom or keep them out of reach.

Leisure Activities

Depending on what your parent enjoys, leisure activities can help them feel connected to memories of their younger days. If you are not familiar with what your parents enjoyed when they were younger, speak with family members about interests they used to have. Sharing a leisure activity with your parent is beneficial to you both and makes for a great bonding experience. If your parent enjoys music, identify music that is enjoyable and uninterrupted by commercials as this may cause confusion. If possible, let your parent choose the music. Music can also help create a calm environment.

Planning outdoor leisure activities can be healing and relaxing. Activities such as walking, going for a drive, or going to a park can be soothing.

If your parent enjoys being around others, signing them up with an adult day care center designed for those with dementia can be a good option. Having visitors is also considered a leisurely activity, be sure to plan visits ahead and choose a time of day that your parent is best to handle them. Avoid visits that will overwhelm them and plan for one visit at a time. If taking a parent to a social event, choose events that are not high stimulative or have excessive activities.

The goal to including leisure activities is to stimulate all the senses. Keep in mind not to overdo it as you do not want to turn your parent off from experiencing leisure activities.

Sleep

A sleep routine is essential when providing dementia care. Sleeplessness is common with dementia as your parent may feel disoriented toward the end of the day, this is called sundowning. Sundowning behaviors are common with dementia. To prevent sleeplessness experts recommend increasing daytime activities, limit sugar intake as well as caffeine and certain junk foods.

  • During late afternoon and evening hours it may help to minimize over stimulated activities.
  • Calm, soothing activities are recommended such as reading, watching a movie and listening to soft music.
  • Keep a nightlight in the bedroom, bathroom and hallway so that your parent is aware of their surroundings.

Make sure you are getting enough sleep yourself as the caregiver. Ask for help if you are not getting proper rest. If sleeplessness becomes a significant issue speak with the Dr. regarding medication as a last resort.

Simplify Your Communication

Communication in dementia care requires patience and understanding. It is important to speak slowly and clearly as speaking rapidly will confuse your elderly parent and may result in frustration. Offer reassurance so that they can be encouraged to express their thoughts. Asking yes or no questions will lessen the confusion. Keep instructions simple and one at a time.

Use Smaller Words

Simple, small words work best when providing instruction. Lengthy description of tasks may become overwhelming and discourage your parent from performing the task. Use short simple sentences and allow time for your parent to process the information and respond if a question is asked. Although this may seem like an awkward pause to you, it is important that they understand what you are saying.

If your parent is having a difficult time understanding, try to break down what you are saying in smaller portions so that it is more manageable. Try rephrasing rather than repeating. If they did not understand the first few times, chances are you will need to use different words so that they are able to process the information.

Limit the Number of Options

Sticking with one idea at a time will less likely confuse and frustrate your parent. Giving them a choice is important but too many choices is overwhelming. Yes or no questions are easier to understand rather than open ended questions and can provide less confusion. For example, “Would you like some coffee” instead of “What would you like to drink?”. It is also beneficial to show them the options, white shirt or blue shirt? Your parent may become withdrawn if they cannot find the answers to your questions or if they are not able to make a decision about the options you are providing. Limiting the number of unnecessary options keeps the interaction focused on the task at hand.

Be Positive and Assertive

Make sure you have your parent’s full attention prior to having a conversation. Speak clearly and calmly. Body language is important as sometimes feelings are communicated through this form of expression more strongly than words.

It is also okay to joke and laugh, it may lighten the mood and make communication easier. Speaking directly to your parent and engaging in eye contact will leave less room for confusion. Refrain from raising your voice as this can be mistaken for chastisement. Always try to have a positive tone but remain assertive.

Safety

Improving safety can prevent injuries and help your parent with dementia feel more relaxed and maintain his or her independence longer. It is important to evaluate your home environment, avoid safety hazards and be prepared for emergencies. Try to keep the home unrestrictive by installing locks out of sight for example. The home should still create independence and comfort for your parent.

Delusions and Confusion

When your parent becomes delusional or confused, remember that these feelings are very real to them. It is best not to argue or disagree with them but to try and understand what they are expressing. Fear and anxiety may prevent them from communicating clearly, therefore it is important to remain calm and supportive. If they are looking for a missing object help them look for the object, then try to distract them into engaging in another activity. Your words and actions have the power to ease or deescalate an exceedingly difficult situation of paranoia and confusion.

Wandering

Wandering is a common behavior in dementia. Even in the early stages of dementia a person can become disoriented for a period of time. Some of the warning signs include taking longer than usual returning from walks, talking about getting to places they no longer go to such as work and forgetting how to get to familiar places.

When your parent exhibits wandering behaviors, it will help to identify the time when they are expressing this behavior and conducting an activity to aid with restlessness and confusion. Having a routine will provide structure and will lessen disorientation. If your parent insists on “going home or to work” do not argue with them, rather reassure them that you can take them home in the morning after a good night’s rest and that they are ok here with you for now. Never leave your parent unsupervised even in a locked home. If wandering does occur, make sure you keep a list of past places your parent may have wandered to.

Safety Proofing the House

Living with dementia can make a person vulnerable and pose safety hazards around the home. Look out for exposed chemicals, tools, cleaning supplies that are generally found in kitchens, garages, bathrooms and basements. Make sure stairs are safely gated as balance is sometimes affected and can contribute to falls. Keeping walkways well-lit is essential in preventing accidents and disorientation. Use night lights as needed in bedrooms and bathrooms. Make sure smoke detectors and carbon monoxide detectors are in working order. Remember to install locks out of sight to prevent wandering outside of the home. It is possible to adapt the home environment to support dementia changes using creativity!

Medical Needs

Speaking with the doctor regarding a plan of care and treatment options is the first step in ensuring your parents medical needs are met. As dementia progresses, the treatment plan will change. Be sure to keep communication transparent with the doctor.

Once a plan of care is established, be sure to allow for flexibility as your parent’s medical needs may vary daily. Looking into in-home care may be an excellent option as the caregiver is specialized in dementia care and may allow you to focus on maintain the parent/child relationship.

In-Home Care

When exploring in-home care options, be sure to make a list of care needs first as well as your expectations for meeting the care needs. Call in home care providers and suggest an interview in your home. Learn about the specialized care they provide and determine if the care aligns with your parent’s care needs. Giving the care agency as much information as possible will allow them to provide better care.

Caregiver Respite Services

We all need a break! Respite care provides a temporary break from caregiving while your parent continues to receive care in their safe environment. It is an essential way for you to take some time off and maybe even spend time with friends and family. Respite care can be a short period of time to run errands, go to the gym or get some shopping done. You will experience comfort knowing that your parent is being taken care of by another caring individual.

Consult with the Professionals

For more information about finding the best fit for your care needs please contact Senior Nannies. We are available to answer any and all your questions about caring for an elderly parent with dementia. We are here to offer guidance as we understand that dealing with dementia care can be challenging.