The level of care given to someone with dementia depends a great deal on the type and degree of their dementia. Some people are still able to live alone with minimal assistance; others can live alone with more active assistance; others may require constant assistance either in their own home or in a care facility.
Caring for their psychological needsAt the point of a diagnosis of dementia, it is not uncommon for there to be a sense of relief that the diagnosis explains recent behaviour. However, from then on, people with dementia can experience a myriad of confusing, fearful thoughts and emotions. Managing their psychological needs is as important as managing their physical needs. Common reactions are feeling fear about the future, anxiety about the confusion and forgetfulness they experience, and concern that their dementia will have an impact on loved ones. Feelings and reactions can range from compartmentalised planning for the future to anxiety and depression. Here are some tips to help with their psychological needs:
- Learn as much as you can about dementia (and the type of dementia your family member/friend has). This will prepare you for what lies ahead
- Talk to other carers of people with dementia – and ask lots of questions
- Be patient with the person with dementia and try to understand how they feel. Learning to judge their moods may take time but will prove worthwhile
- Respect the person with dementia and understand that they are struggling with their condition. Don’t be embarrassed and do not embarrass them
- Always be honest and sincere. Pretence will be noticed and will undermine your relationship
- Do not dismiss a person's concerns. Actively listen to them, engage in conversation and let them know you are there for them
- Enjoy the present – don’t focus too much on the future. Your attitude will extend to the person you are caring for
- Don’t forget to keep a sense of humour and to use it at the right time
- Provide positive reinforcement to the person with dementia whenever you can
- Avoid harsh criticism, snide remarks or negative comments
- If the person you are caring for makes a mistake, be supportive and patient
- Encourage and facilitate social contact for the person you are caring for. You can also help by briefing those in the social circle about what to expect and how to behave
- Be aware of triggers for aggression and stress and try to avoid such triggers occurring
- Allow enough time for regular routines to be undertaken at an unhurried pace.
Caring for their physical needsThe physical needs of people with dementia change as the condition progresses. They may be relatively minor to start with, but can become more onerous, including the need for bathing and toilet assistance. Here are some tips to help with some of their physical needs:
- Let the person with dementia care for their own physical needs as much as possible, even when it would be quicker for you to help. This will help their self-esteem and prolong the time that they still maintain some independence
- Maintain physical closeness as this will help create a sense of security and comfort for the person with dementia
- As it becomes harder for the person to undertake physical tasks, instead of taking over, try demonstrating and then letting them have a go
- Make physical experiences, such as bathing, relaxing and enjoyable rather than burdensome and a chore
- Keep an eye out for wounds or sores that may be a result of a fall or accident when you were not present. The person with dementia may not be able to alert you to them
- If the person you are caring for is male and has always been clean-shaven, continue this look. If it was important to them then, it is important to them now.
Caring for their financial needsIt is critical that someone trustworthy, knowledgeable and reliable keep an eye on the financial situation of someone with dementia. This is for two reasons. First, if the person was still working at the time of the diagnosis, their earning capacity in the future is likely to be short-term and limited. Second, as the dementia worsens, their capacity to understand finances and make decisions is likely to be impaired. Make sure you include the person with dementia in discussions.
Safety in and around the homePeople with dementia are susceptible to accidents and falls. There are a number of things you can do to make their place of residence safer. These include:
- Remove rugs; these can easily be tripped on
- Do not move furniture around and ensure rooms are uncluttered
- Place nightlights in their bedroom, hallways and bathrooms
- Keep cables taped to the bottom of walls, rather than extended along the floor
- Put handrails alongside stairs inside and outside the house
- If their bedroom is upstairs, consider ways to have them move to a room on the ground floor
- Use bath and shower seats, handrails and non-slip mats
- Place handrails next to the toilets
- Reduce the temperature of water from the hot water tap
- Make sure smoke alarms work.
Residential care for someone with dementiaIf you are searching for residential care, do not rush into the first available option. Check various Homes, particularly focussing on those who provide specialist dementia care. CareAbout includes these details on its website. More information can be found in Caring for someone with dementia, Aged care homes with dementia care and Person-centred dementia care.
Looking after yourselfThe person you are caring for needs you to be emotionally, physically and psychologically on your game all the time (or at least as much as is humanly possible). That means looking after yourself. We have extensive advice on looking after yourself.
- Dementia Australia recommends joining a support group, as these groups allow carers to:
- Receive support and meet others in a similar situation
- Receive relevant dementia education and information
- Enjoy the benefits of a social outing
- Share ideas, management tips and techniques with other carers
- Learn about local community services for people with dementia and their carers
- Learn how to cope with issues such as loss and grief, guilt, resentment, anger, relief and other emotions which may arise
- Learn coping mechanisms and techniques such as stress management and relaxation etc.