Caring for a Relative Who Has Dementia

Last Updated May 2023 | This article was created by familydoctor.org editorial staff and reviewed by Robert "Chuck" Rich, Jr., MD, FAAFP

If your loved one is in the early stages of dementia, they may not require much care. This is a good time for you to learn about your relative’s dementia and what you can expect. Also, it’s a good idea for you, your relative, and your other family members to plan for the future while your loved one can still make sound decisions.

If your loved one is in the middle stages of dementia, keep the environment safe. Stick to a daily routine. Read the tips below for ideas about how to cope with new demands and personality changes associated with dementia.

Path to improved well being

Dementia affects your loved one’s ability to communicate thoughts and emotions. Your loved one may not know how express their needs. They may not understand what you want when you ask a question or make a request. This can be frustrating. Follow these tips to reduce stress and improve communication:

  • Be positive. Keep your tone of voice and body language calm. Control your facial expressions. Speak in a pleasant manner. And use touch to give your loved one affection.
  • Be clear. Get your loved one’s attention. Speak slowly and calmly. Use simple words and phrases. You may have to repeat the information or question multiple times. Don’t get frustrated when this happens. Ask yes or no questions. Avoid giving choices if there are none.
  • Acknowledge feelings. If your loved one is sad, angry, or upset, don’t ignore it. Let them know that you understand as you work to calm them. For example, you might say, “I can see that you are frustrated. Let’s go for a walk.”

Take care of yourself

As the caregiver of a person who has dementia, you must first take care of yourself. If you become too tired and frustrated, you will be less able to help your family member. If you need a break, try the following:

  • Ask for help from relatives, friends, and local community organizations.
  • Look for caregiver support groups. Other people who are dealing with the same problems may have good ideas about how to cope and make it easier.
  • Consider respite care. Respite care is short-term care that is given to a person who has dementia. This provides a brief break for the caregiver. This service may be available through a local senior living group. Also, it may be provided by a social services agency.
  • Consider adult day care centers. These centers can provide your family member with a consistent environment. Also, it gives them a chance to socialize.

Things to consider

Caring for a loved one who has dementia is difficult. They will undergo many changes. These include:

Agitation

Your loved one may be agitated (upset). It may be for many different reasons. A sudden change in surroundings or frustrating situations can cause this. Moving to a new apartment, home, a nursing home, or the hospital can cause agitation. Getting dressed or answering questions incorrectly can cause frustration. There are other causes of agitation, too. These may include being questioned about their confusion. This may include the inability to do things they used to do. Your loved one may cry, become irritable, or try to hurt others in some way. To minimize agitation, try to:

  • Avoid loud noises and overstimulation. A calm, pleasant environment with familiar faces and things helps ease fear and anxiety.
  • Set realistic expectations. Expecting too much of your loved one can frustrate and upset you. Let your loved one help with simple, enjoyable tasks. This includes meal prep, gardening, crafts, and sorting photos. Make other tasks less difficult. For example, instead of having your loved one get dressed alone, just have them do one part of the outfit. It could be a shirt, one shoe, a hat, etc.
  • Limit the frequency of difficult tasks. If bathing or showering is difficult, have your loved one do it every other day. Plan difficult tasks at a time when your loved one is less agitated.
  • Be positive. Frequent praise for your family member will help them feel better. It will help you as well.

Sleep problems

Dementia causes changes in sleep patterns. Your loved one may become restless or awake at night. They may confuse night and day or sleep all day. Or they may be more confused at night in general. Try one or more of the following if your loved one is having trouble sleeping:

  • Establish a routine. Keep morning wake-up and evening bedtimes the same.
  • Make the time of day obvious. Keep curtains or blinds open so they can tell day from night. Place clocks where they can see them.
  • Limit junk food. Control how much caffeine, sugar, and unhealthy food your loved one consumes.
  • Make movement a priority. Make sure your loved one gets exercise every day. Avoid exercising too close to bedtime.
  • Limit napping.Too many naps during the day makes it hard to sleep at night.
  • Make your loved one’s bedroom restful. Make sure the room is quiet at night. Provide a night light at night or leave a dim light on. Total darkness can add to confusion.
  • Relieve pain. Talk to your loved one’s doctor if they have arthritis or another painful condition. This affects sleep quality.

Wandering

Wandering means walking around in the middle of the night. Also, it could mean walking away from home or nursing home without permission. Simple things can help with this problem. It is all right for your loved one to wander in a safe place, such as in a fenced yard. By providing a safe place, you may avoid confrontation. If you can’t provide a safe place for your loved one to wander, try the following:

  • Block doors. Remind your loved one not to go out a certain door. Place a stop sign on it or put a piece of furniture in front of it. A ribbon tied across a door serves as a reminder, too. Try hiding the doorknob by placing a strip of cloth over it. Using child locks may cause frustration and agitation.
  • Use an alarm system. This will alert you that your loved one is trying to leave a certain area. Your alarm system can be professional. Or it can be a few empty cans tied to a string on the doorknob.
  • Install special locks. This might be necessary. However, be aware that this could be dangerous in a house fire. Keep the keys close to the door. Make sure all other family members know where to find the keys. Teach everyone how to open the doors. Don’t use this method if your loved one will be left home alone.
  • Give your loved one an identification bracelet. Make sure they wear it. It should include the person’s name, address, phone number and medical conditions in case of an emergency. Also, this is helpful if your loved one gets lost. Consider purchasing a digital device that uses GPS to track a person’s whereabouts.

Hallucinations

Hallucinations are the experience of seeing something that isn’t really there. If your loved one has hallucinations that are causing fear and anxiety, try the following:

  • Keep rooms well lit. This helps minimize shadows.
  • Keep dangerous items out of reach. This is for your safety and for loved one.
  • Offer simple explanations.To calm a loved one, provide a simple reason why they shouldn’t be afraid. But don’t argue. This adds to their agitation.
  • Distract them. Involving your loved one in a pleasant activity can help reduce fear, anxiety, and frustration.
  • Talk to a doctor. If hallucinations are severe, talk to your loved one’s doctor. Medicine may help.

Questions to ask your doctor

  • What if I can’t afford caregiving?
  • Can being a caregiver impact my health?
  • How do I recognize changes in my loved one?
  • Can a person with dementia be violent?

Resources

Alzheimers.gov: Caregiver Stress: Interventions to Promote Health and Well-being
National Institute on Aging: Managing Personality and Behavior Changes in Alzheimer’s

National Institutes of Health, News in Health: Dealing with Dementia

 

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