How To Care For Someone With Alzheimer’s Or Dementia

What are some common challenges faced by caregivers of people with dementia or Alzheimer's?

“Caring for somebody living with dementia can be very challenging, as many changes happen to the person as the disease progresses. These include a decline in memory and cognition, changes to mood and behaviour (aggression, agitation, apathy and depression can be common), difficulties with communication, and assistance with personal care and safety. As these symptoms develop and the care requirements increase, it can become emotionally and physically exhausting. It can also be socially isolating, as so much time and energy is dedicated to delivering care. There are also financial and legal implications which can add additional complexities and challenges.” – Louise Blezzard, general manager at Loveday Kensington  

“It can often be a lengthy and challenging process for caregivers to connect and forge a trusted relationship with someone living with dementia. To do this successfully, it is vital that there is a thorough assessment process that uses information from family, friends and multi-disciplinary teams. Once a personal history (social and medical) is compiled, caregivers can use this information to plan approaches and write detailed care plans with the aim of achieving realistic outcomes. When supporting a person with dementia, there is often an element of cognitive decline that can be challenging and, as a result, it can take months for a person to accept support and trust new faces.” – Bernadette Mossman, healthcare director at Vida Healthcare

How can caregivers establish a safe and supportive environment for individuals with dementia or Alzheimer's?

“Invest in good footwear – for example, avoid backless slippers that are difficult or dangerous to walk in. Socks with sticky pads on the soles are ideal. Also, remove any potential risks in the home environment – worn or frayed carpets, slippery surfaces, loose rugs, unnecessary clutter, and loose wires or cords. Keep any poisonous or dangerous items out of sight. Handrails and bars are ideal for supporting with additional stability. Night lights are highly recommended for bedrooms and also in hallways, especially for loo visits. Reminder notes and memory aids can be helpful, depending on the person and their requirements. These might also be useful for labelling cupboards to show where items are kept, such as mugs and cutlery, or whiteboards for reminders. Ensure doors and windows are secure. Everyone has a different experience with dementia, so it’s important to find the right support for the individual and be prepared to adapt to their changing needs. Finally, invest in some tech. There are lots of assistive devices out there that can promote better independence in the home e.g. medication organisers, wearable GPS trackers and reminder apps are just a few examples.” – Louise

What are some effective communication strategies to use when interacting with someone with dementia or Alzheimer's?

“The best advice I can give is to live in their reality and see life through their eyes. Read their body language for an insight into their emotions, which they may be struggling to communicate. Keeping calm and patient is difficult, but really important. Sometimes, it’s okay to walk away when we are feeling overwhelmed. We tend to be less patient with someone we love – and occasionally you will need to step away. Don’t correct them, as it makes them feel demeaned. Offer praise and be positive and encouraging. Use simple, clear and concise language with short sentences that are easy to understand. Ask simple questions that don’t require too much thought or interpretation and only give one instruction at a time so it’s easy to process. Provide different solutions by gently orientating people in a way that doesn’t tell them it’s wrong. Finally, reminiscing is a great way to involve and engage, taking them back to a happy place.” – Louise

“People living with dementia or Alzheimer’s can easily lose connections with their community and it is important they have a sense of purpose and feel that they continue contributing to society in some way. Maintaining community involvement is key – it can be as simple as food shopping, attending community groups, visiting the library or going to the hairdressers/barbers.” – Bernadette

How can caregivers promote independence while ensuring the safety of those with dementia or Alzheimer’s?

“Support them to do low-risk things they can do to help promote independence – it gives them a sense of worth and improves confidence. Focus on simple and safe tasks such as setting the table, helping with food prep and buttering toast. Break bigger tasks into manageable steps. This is particularly good when people are in distress – try to help them be in control. Subtly prompt, support and involve them in the decision-making process to make them feel involved and relevant.” – Louise

What are some practical tips for managing behavioural and psychological symptoms of dementia?

“Know when to step away if they are agitated but only if it’s safe to do so. Let them calm down and try to understand their emotions. Do they have an unmet need? Are they feeling something you can’t see? Acknowledge the feeling and listen and respond accordingly. Always offer positive reinforcement and distract and deflect where necessary.” – Louise

How can caregivers create a structured routine that helps patients feel more secure and at ease?

“Routines are very good and reassuring – create a routine that works for them but be prepared for this to change. Continue to do the things they have always loved but, if they lose interest, that’s ok and don’t push too much. Don’t force anything.” – Louise

What are the signs of caregiver burnout, and how can caregivers prevent or address it?

“Caregivers can often have an overwhelming sense of guilt surrounding their feelings and thoughts. When a caregiver starts to present with a loss of patience, unkempt appearance, is over emotional and withdrawn, these signs can indicate burnout. Caregivers must be given respite and support to help them in their role and understanding and empathy of their own experience.” – Bernadette 

“Caregiver burnout can include physical exhaustion, emotional fatigue, increased irritability, withdrawal from social activities and relationships, low mood, depression, loss of appetite and weight loss. Persistent and overwhelming feelings of guilt are also very common. It’s important to recognise these symptoms so you know when and how to reach out for further support.” – Louise

How can caregivers support their own emotional wellbeing?

“You have to look after yourself and get support from loved ones, family members and friends, and share your feelings. Enlist the support of loved ones to get some space. It can be all-consuming. Carve time out for yourself to do the things you enjoy. Establish a routine for yourself and seek professional guidance from social workers or therapists for coping strategies. Also, connecting with people going through the same experience is hugely beneficial. Educating yourself as much as possible on the disease is really important so you are prepared. Consider professional counselling if caregiving gets too much.” – Louise

And that of their patient?

“Support should be sensitive to the individual. It's important to focus on what the person still does have, not on what they may have lost. Concentrate on what the person feels, rather than what they remember. The person with dementia may be experiencing a world that is very different to that of the people around them. To understand and support the person, try and see things from their perspective and recognise their coping strategies. Emotional coping strategies might include setting up reminders or prompts, preparing advanced decisions or a lasting power of attorney for the future. You should also try to rely on family help, seek spiritual support and encourage them to join new activity groups where possible. Using humour, focusing on short-term pleasure, or living for the moment are all good strategies too – as are exercising more, adopting a healthier diet and cutting down on alcohol and smoking.” – Bernadette 

What are some strategies for managing wandering behaviour in individuals with dementia or Alzheimer's?

“Technology is a great asset and there are lots of tracking devices that can help. If they are leaving in the middle of the night, there is a problem. If they want to wander, actively take them for a walk in the day and try to engage in lots of active, outdoor activities and create moments where they can feel free to move. Some people may wander because they are anxious or feel they have somewhere to go. Try to understand the reason for wandering so you can best accommodate and address this.” – Louise

How can caregivers involve family members and other support systems in the care of someone with dementia or Alzheimer's?

“Always use open, clear and regular lines of communication to allow family members and friends the opportunity to feel valued and included in their loved one’s care. Take every opportunity to reach out with good news and feedback; share the joy and milestones and always seek to include family in the care planning processes. Professional caregivers are specialists in dementia care, but families are the specialist in their loved ones’ needs, so their knowledge and involvement is a valuable tool.” – Bernadette 

What resources and support services – specifically financial – are available to carers?

“There are many organisations families can reach out to for guidance and support as they navigate the difficult journey of caring for someone with dementia. Local authorities provide social care support, including financial assessment to establish qualification for financial aid; carer resource groups can be contacted via GP services and the local hospital; plus, The Alzheimer’s Society and Dementia Forward are two brilliant organisations worth getting in touch with.” – Bernadette 

“It’s important to reach out for support as early as possible and link up with a service – the better prepared you are the easier it will be to face future challenges and prevent a care crisis. There are lots of options available including Day Clubs, Home Care, Respite and Residential. Remember, having a conversation with an organisation doesn’t tie you in, it’s important to get to know what is available in your local area and understand what the waiting lists are like. Education empowers you to make informed decisions. Signs that it’s time to engage with more professional support include:

• Increasing complex care needs which can be challenging to manage on an ongoing basis. 
• Concerns for the safety of the individual including wandering or safety around the home.
• Changing behavioural and psychological symptoms such as aggression, agitation and anger.
• Declining mental and physical health for both the caregiver and the individual living with dementia

Finally, remember each situation with dementia is unique and the more support you have the better you are prepared.” – Louise

Finally, when should caregivers look at more professional support – be that a residential care facility or an additional healthcare provider in the home?

“It is always a very difficult decision for caregivers to reach out for additional support for their loved one. Some families have feelings of failure when, in fact, reaching out for help means they are advocating for their loved one to receive the very best care, whatever that may be. When caregivers or family members feel the weight of physical or emotional pressure, it might mean their loved one is no longer safe in a home environment. If wandering or forgetting to take medication becomes a problem, this is the time to reach out and begin researching the best possible way to move forward. This could simply begin with a one carer visit per day in the home – this is known as domiciliary care and allows a person to live in their own home safely for a longer period. Domiciliary care can be increased as the person’s needs grow. Alternatively, families may wish to consider long-term care in a care home where they know they can have total peace of mind knowing their loved one is cared for 24 hours a day.” – Bernadette 

For more information and advice, visit LovedayAndCo.com & VidaHealthcare.co.uk.  For more information and support on care options for elderly relatives visit the government website here or Age UK. You can also find more information via the NHS. 

Features published by SheerLuxe are not intended to treat, diagnose, cure or prevent any disease. Always seek the advice of your GP or another qualified healthcare provider for any questions you have regarding a medical condition, and before undertaking any diet, exercise or other health-related programme.