Issue 4, June, 2007
FEATURE ARTICLE - Providing For Care of Your Pet in the Event of Your Death or Incapacity | HEALTHLINE - Tai Chi Can Boost Immunity Against Shingles
LEGALLINE - Veterans Benefits - What You Might Not Know
CAREGIVER HELPLINE - Caring For Someone With Dementia (Part 2)

Caring For Someone With Dementia (Part 2)

One of the biggest struggles caregivers face is dealing with the difficult behaviors of the person they are caring for. Dressing, bathing, eating - basic activities of daily living - often become difficult to manage for both the person with AD and the caregiver. Having a plan for getting through the day can help caregivers cope. Many caregivers have found it helpful to use strategies for dealing with difficult and stressful situations. Through trial and error you will find that some of the following tips work, while others do not. Each person with AD is unique and will respond differently, and each person changes over the course of the disease. Do the best that you can, and remind yourself to take breaks.

While some people with AD don't mind bathing, for others it is a frightening, confusing experience. Advance planning can help make bath time better for both of you.

• Plan the bath or shower for the time of day when the person is most calm and agreeable. Be consistent. Try to develope a routine.
• Respect the fact that bathing is scary and uncomfortable for some people with AD. Be gentle and respectful. Be patient and calm.
• Tell the person what you are going to do, step by step, and allow him or her to do as much as possible.
• Prepare in advance. Make sure you have everything you need ready and in the bathroom before beginning. Draw the bath ahead of time.
• Be sensative to the temperature. Warm up the room beforehand if necessary and keep extra towels and a robe nearb y. test the water temperature before beginning the bath or shower.
• Minimize the safety risks by using a handheld showerhead, shower bench, grab bars and nonskid bath mats. Never leave the person alone in the bath or shower.
• Try a sponge bath. bathing may not be necessary every day. A sponge bath can be effective between showers or baths.

Trying to communicate with a person who has AD can be a challenge. Both understanding and being understood may be difficult.

• Choose simple words and short sentances and use a gentle, calm tone of voice.
• Avoid talking to the person with AD like a baby or talking about the person as if he or she weren't there.
• Minimize distractions and noise - such as the television or radio - to help the person focus on what you are saying.
• Call the person by name, making sure you have his or her attention before speaking.
• Allow enough time for a response. Be careful not to interrupt.
• If the person with AD is struggling to find a word or communicate a thought, gently try to provide the word he or she is looking for.
• Try to frame questions and instructions in a positive way.

For someone with AD, getting dressed presents a series of challenges: choosiing what to wear, getting some clothes off and other clothes on and struggling with buttons and zippers. Minimizing the challenges may make a difference.

• Try to have the person get dressed at the same time each day so he or she will come to expect it is part of the daily routine.
• Encourage the person to dress himself or herself to whatever degree possible. Plan to allow extra time so there is no pressure or rush.
• Allow the person to choose from a limited selection of outfits. If he or she has a favorite outfit, consider buying several identical sets.
• Arrange the clothes in the order they are to be put on to help the person move through the process.
• Provide clear, step-by-step instructions if the person needs prompting.
• Choose clothing that is comfortable, easy to get on and off, and easy to care for. Elastic waists and Velcro enclosures minimize struggles with butons and zippers.

Eating can be a challenge. Some people with AD want to eat all the time, while others have to be encouraged to maintain a good diet.

• View mealtimes as opportunities for social interaction and success for the person with AD. Try to be patient and avoid rushing, and be sensitive to confusion and anxiety
• Aim for quiet, calm, reassuring mealtime atmosphere by limiting noise and other distractions.
• Maintain familiar mealtime routines, but adapt to the person's changing needs.
• Give the person food choices, but limit the number of choices. Try to offer appealing foods that have familiar flavors, varied textures and different colors.
• Serve small portions or several small meals throughout the day. Make healthy snacks, finger foods and shakes available. In the earlier stages of dementia, be aware of the possibility of overeaing.
• Choose dishes and eating tools that promote independance. If the person has trouble using utensils, use a bowl instead of a plate, or offer utensils with large or built-up handles. Use straws or cups with lids to make drinking easier.
• Encourage the person to drink plenty of fluids throughout the day to avoid dehydration.
• As the disease progresses, be aware of the increased risk of choking because of chewing andswallowing problems.
• Maintain routine dental checkups and daily oral health care to keep the mouth and teeth healthy.

For Part 3 of this feature, please visit our website to view the August 2007 issue of Lifelines.

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