Adapting to the Needs of Those Diagnosed with Dementia
Posted by Donna Mae Scheib on November 07, 2016
Adapting to the Needs of Those Diagnosed with Dementia
Although your loved ones may not remember you or might do things that frustrate you, this is the time when they need you the most.
– Angie Nunez Merryman
Memory loss is often a first sign of dementia, and especially with those diagnosed with Alzheimer’s. More than just the “normal forgetfulness” that accompanies the onset of growing older, a deficit in memory, especially short term memory, becomes more pronounced. Although the patient may not be aware or even admit any “problems” with memory, the loss is readily detected by family members and friends and along with it, any number of changes in how the person behaves, feels, and thinks.
Commonalities of Memory Loss
Memory loss is different for everyone affected by dementia. But these are some commonalities:
losing or misplacing items
missing appointments or special events
not remembering to take medications or taking the incorrect dosage
getting lost in usual surroundings or at routine places
forgetting common words and people’s names
struggling to find the correct word to use in conversation
little recall of recent conversations and events
having difficulty with familiar tasks
Steps to Help
What can be done to help those with memory problems so they can retain their confidence and independence as long as possible?
Losing or misplacing items
People with dementia often lose and misplace items. So what can you do?
It may be as simple as trying to keep the items in the same place or labeling a place for each item. You might consider visual clues such as pictures or photos on boxes or drawers of where the item goes. Keep the room(s) clean and have minimal furniture, belongings, etc. This way the items will be easier to find. Make sure there is adequate lighting so lack of visibility does not enhance the deficit. Ask what really is important and if some things that are not that important are in different places, you might choose to leave them as they are. There are also locator devices to help with finding certain lost items. They work by attaching a small electronic tag to each item and then when an item is misplaced, a button on the locator is clicked and the tag beeps. Another idea is to have duplicates of the important items so if they are misplaced, you will have a backup.
Missing appointments or special events
People with dementia may often forget important dates. So what can you do?
Use a corkboard or dry erase board to display appointment cards or arrange for a phone or verbal reminder. A large calendar or clock might be used to help remind the person of important dates. Try to recall how the person kept track of events in the past. Did they use a calendar or a visual display? It might help to duplicate their previous method and continue with this method as they are more comfortable with it and have some type of understanding of its purpose.
Not remembering to take medications or taking the incorrect dosage
People with dementia often get their medicines mixed up or they do not take them consistently. So what can you do?
Use a pill box that clearly designates what needs to be taken. You can mark the medicines a certain way so if the pills get mixed up, they can be more easily sorted. Most pills are white and can cause frustration to the person. Try putting a colored dot or an X on one specific prescription. There are also automatic pill dispensers. However, there most likely will come a time to hire someone to disseminate the medications. Have a list of the medications needed to take with the times/day. The caregiver can check them off when taken.
Getting lost in the usual surroundings or at routine places
A person with dementia may get lost in their house/living facility, neighborhood or beyond. So what can you do?
They may forget where they are and where they were going. It is important that they have some identification with contact numbers. Some people use an emergency identification device like those you see advertised by Medic Alert. There are some mobile phones that are relatively simple to use. You might consider putting a buzzer on entry doors to track the person should they go out and/or having a caregiver take them places to eliminate the incident level of getting lost. Outside their house or living facility, it is helpful to have familiar items to clearly mark where the person lives. This might be certain piece of furniture like a chair or bench, a decorative flag or plant, etc. The address should be easily visible as well. If it is a community living facility, a shadow box or familiar items and photos outside their door and a favorite door hanging are suggestions that may work. When people show confusion of where they reside at the present time, try to anchor this location to something in the past (their favorite color is the same color as the door, the seashell doorstop is from all those summers spent at the beach, the door mat has a black lab on it that looks like the black lab they owned, and so on).
Forgetting common words and people’s names
People with dementia struggle with common words and people’s names. So what can you do?
Try to give tactful prompts and not put the person on the spot. For example, you could say ‘Your friend Bill is here to see you’ or ‘Aunt Clara has come to visit’. You could ask the person to introduce themselves when they speak, too. When naming objects, try using prompts or cues and context clues. For example, they may recognize how something is used or when it is used, yet they can not recall the name of the object. You could have a memory box or a memory book and include photos, drawings or newspaper articles/ads depicting certain objects or information about these so the person with dementia can refer to. Be patient and avoid noisy, large areas that may be distracting and therefore interfere with memory.
Struggling to find the correct word to use in conversation
People with dementia may have difficulties finding the right word in a conversation. So what can you do?
There are lots of things you can to do help with conversation. First of all, allow the person enough time to think of the word, but don’t wait too long to cause embarrassment or too much attention to be thrust on them. Consider the text that the person said and see if you can think of suitable words that fit that can not be remembered. Turn down any background or interfering noises so the conversation can be heard. Ask them if they meant to say so and so? Or if that is not so and so, try to offer prompts or cues. At times, it may be best to change the conversation or activity to try and remove any frustration the person may be feeling. Do this sensitively - it is important not to undermine the person or dismiss their feelings.
Little recall of recent conversations and events
People with memory problems will find it hard to store and recall recent conversations and events. So what can you do?
Try not to tell the person that they heard it before or you just told them the information. Encourage them to use a calendar, diary or journal to record things. Include cues and prompts and put things in context or in ways that are easier to understand. Use reminders like sticky notes or a wall calendar for important things. Consider assistive technology devices like automatic calendar clocks to help the person remember. Focus on one conversation or event at a time. After the information is shared, have them repeat it a few times. Eliminate background noise for easier hearing. Offer them two choices rather than open-ended questions that can be answered with many options and often brings confusion.
Having difficulty with familiar tasks
As dementia progresses, the person may have more and more difficulties with tasks they have done many times before partly because of not remembering the sequence of actions. So what can you do?
Help break down the steps into smaller and easier ones. Put things out in the order in which the person completes the task. Leave the regularly-used items out and put the other items away in drawers that are hand-labeled. Use reminder signs complete with pictures or photos to show the steps involved. Try a motion sensor that has a recorded message to remind people about a task; e.g. the person passes the sensor and the verbal reminder is given.
In Conclusion
It is easier for people with dementia to recall things that happened long ago over things that happened now. Things that they have enjoyed doing or done many, many times are also areas that would lend themselves to an easier discussion for the dementia person. They may also remember something that they have physically done over and over like dance steps or playing the piano. Some important dates or events might be easier remembered if they are linked to a strong emotion (a birth or marriage or death – like the assassination of JFK).They can also be triggered by a certain sense like a smell (baking cookies) or sound (melody of a song). It is interesting that people’s emotional memory usually is affected much later on in dementia. An example would be that they can not recall the exact details of something (when, where, why), but they can remember how they felt about it. Now that’s a powerful thought!
Remember, this is the time dementia patients need you the most. So ask yourself, what can you do?