10 Realistic Strategies For Dementia Care

Oftentimes caregivers rely on intuition to guide them. No one ever gave us lessons on how to relate to someone with memoryloss. Unfortunately, when it comes to Alzheimer’s disease and other dementias, often the right thing to do is exactly opposite of what seems logical. Here is some practical advice:

1. Being reasonable, rational and logical can be counter intuitive.
When someone is acting in ways that don’t make sense, we tend to carefully explain the situation, calling on his or her sense of appropriateness to get compliance. However, the person with dementia doesn’t have a “boss” in his brain any longer, so he does not respond to our arguments, no matter how logical. Straightforward, simple sentences about what is going to happen are usually best.

2. People with Dementia don't need to be grounded in reality.
When someone has memory loss, he often forgets important things, e.g., that his mother is deceased. When we remind him of this loss, we remind him about the pain of that loss also. When someone wants to go home, reassuring him that he is at home often leads to an argument. Redirecting and asking someone to tell you about the person he has asked about or about his home is a better way to calm a person with dementia.

3. Stop trying to be the perfect caregiver.
Just as there is no such thing as a perfect parent, there is no such thing as a perfect caregiver. You have the right to the full range of human emotions, and sometimes you are going to be impatient or frustrated. Learning to forgive your loved one as well as yourself is essential in the caregiving journey.

4. Therapeutic lying can reduce stress.
Most people strive for honesty as the best policy. However, when someone has dementia, honesty can lead to distress both for them and us. Does it really matter that your loved one thinks she is the volunteer at the day care center? Is it okay to tell your loved one the two of you are going out to lunch and then “coincidentally” stop by the doctor’s office on the way home to pick something up as a way to get her to the doctor.

5. Making agreements doesn’t work.
If you ask your loved one to not do something, or to remember to do something, it will soon be forgotten. For people in early stage dementia leaving reminder notes can sometimes help, but as the disease progresses this won't work. Taking action, rearranging the environment rather than talking and discussing is usually a more successful approach. For example, getting a teakettle with an automatic “off” switch is better than warning someone of the dangers of leaving the stove on.

6. Sometimes, even your doctor needs educating.
Telling the doctor what you see at home is crucial. The doctor can’t tell during an examination that your loved one has been up all night pacing. Sometimes doctors need to deal with therapeutic lying; e.g., telling the patient that an antidepressant is for memory rather than depression.

7. You can’t do it all.
It is harder to ask for help than to accept it when it is offered, so don’t wait until you “really need it” to get support. If someone offers to help, your answer should automatically be “YES.” Have a list of things people can do to help, whether it is bringing a meal, picking up a prescription, or staying with your loved one while you run an errand. This will reinforce offers of help. It’s OK to ask for help before you get desperate.

8. Beware of misjudging what your loved one can or cannot do.
It is often easier to do something for our loved ones than to let them do it for themselves. However, if we do it for them, they will lose the ability to be independent more quickly. On the other hand, if we insist individuals do something for themselves and they get frustrated we just make our loved one’s agitated and probably haven’t increased their abilities to perform tasks. Not only is it a constant juggle to find the balance, but be aware that the balance may shift from day to day.

9. Tell, don’t ask.
Asking “What would you like for dinner?” may have been a perfectly normal question at before. But now we're asking our loved one to come up with an answer when he or she may be incapeable of expressing what they want. Even if they can answer, they might not want the food when it's served after all. Saying “We're going to eat now” encourages without put them in the position of having failed to respond.

10. It's perfectly normal to question the diagnosis when someone has moments of lucidity.
One of the hardest things to do is to remember we're responding to a disease, not the person who once was. Everyone with dementia has times when they make perfect sense and can respond appropriately. Sometimes it may seem that person may have been faking it, or that we've been exaggerating the problem when these moments occur. We're not imagining things—they're just having one of those moments, moments to be treasured when they occur.