Dementia & Alzheimer’s Support

Dementia / Alzheimer’s Disease presentation

Are you taking care of a person with dementia? Then you bear a great responsibility, because caring requires a huge amount of strength, patience and empathy

Over time, your relative will probably need more help. Live-in-Care (LIC) will assist you with this. In this article you will find, for example, activities that you may implement in everyday life if you live with a person with dementia.

WHAT IS DEMENTIA

Emily Murphy is more and more frequently looking for her glasses. Sometimes she finds them in the fridge or between the towels in the chest of drawers. “You put them there,” her daughter says. She is wondering and anxiously asking herself if her mother suffers from dementia. Age-related dementia, Alzheimer’s or sclerosis – there are many popular names for the diseases that mainly affect the elderly. Behind them are various forms of dementia. The term “dementia” comes from Latin and means “far from the mind.” In fact, dementia is a loss of mental capacity. It occurs due to changes or brain damage, which may occur due to various reasons. As the disease was previously thought to be caused by deposits in the body, people with dementia were also called “sclerosing.”

AGE AS A RISK

The most significant risk factor for dementia is age. The disease affects:

• Only approximately two percent of 65-69 year olds,
• Approximately 15 percent of people over the age of 80,
• More than 30 percent of people over the age of 90.

Source: Alzheimer’s Association

WHAT CAUSES DEMENTIA

Dementia is a basic concept for various diseases, the consequence of which is a mental decline. The most common of these is Alzheimer’s disease. Approximately two-thirds of the people with dementia suffer from the Alzheimer’s disease. This disease is still a mystery to scientists – more than 100 years after it was described by Dr. Alois Alzheimer in 1906. All that is known is that neurons and contacts between them in the brain progressively decrease and protein deposits appear in the affected individuals. The reason for this is unclear and no treatment is currently possible. Only in some of the patients the development of the disease may be delayed. The disease may be recognized by various diagnostic techniques.

• Knowing the disease means helping better.

COURSE OF THE DEMENTIA DISEASE

• Most often, dementia in Alzheimer’s disease begins slowly with small ‘forgets’. The affected person moves objects, looks for the right words during a conversation. If the mental disorders become more striking, a serious illness may be suspected.
• Then obvious symptoms appear: a high degree of memory impairment, close relatives cannot be named by their names, a sense of time and place is lost, speech becomes slurred and meaningless. Sudden mood swings, aggression and depression may occur. Driving must be stopped at this time at the latest. In everyday life, the person needs assistance with personal hygiene and nutrition.
• In the late stage, the patient depends entirely on assistance and care. Many people can no longer walk without assistance or stay in bed. They no longer recognize their relatives and friends, and verbal communication is becoming increasingly difficult.

Source: Alzheimer’s Association

Communication with Dementia / Alzheimer’s suffering person

Understand me!

The word dementia actually means “far from the mind.” However, this does not mean that the patient can no longer communicate. They should be just understood at another level.

It is not always easy to communicate with a person with dementia. But one can learn to speak and communicate with them so that both parties feel good.

MISUNDERSTANDINGS. In the course of the disease, the language loses more and more of its importance as a form of sharing in patients with dementia. They forget what they want to say, they often lose the thread and longer sentences are no longer kept in their memory. When they do not understand what is being said to them, they become uncertain. They feel that something is expected of them and withdraw from the conversation. But this by no means should be understood as we should not talk to the patient, on the contrary: it only means that communication should be adjusted. How you say something becomes more and more important.

TALK BETTER

We may get along with people with dementia mostly through sympathetic talking, and in the advanced stage the touch is often quite pleasant. Experts recommend:

• Establish eye contact
• Do not discuss, for example, statements that you may find absurd
• Discuss with the patients the story of their life and talk about their past
• Speak slowly and clearly
• Make sure your voice is warm and sympathetic
• Use simple words and short sentences
• Add facial expressions to your words
• Announce one thing at a time
• Create closeness by touches
• Avoid background noise and environmental disturbance

ABOUT THE FEELINGS ONLY. Even when mental abilities decline and daily skills become stunted, the patients continue to experience feelings. Persons with dementia often acquire extreme sensitivity to the other person’s feelings. For example, they may “catch” a relative caring for them to be in a hurry to finish the meal or take the patient to bed earlier because he/she has something more important to do. Then they will probably answer, “You want to get rid of me.” Whoever denies this has no serious attitude towards the patient, and they feel very well that the caregiver has little time. It is better to admit, “Yes, I am in a hurry. Next time I will spend more time with you.” In the later stages of dementia, a violent outburst of emotion may follow, but it will quickly resolve. The reason for anger or sadness is often quickly forgotten.

• Think: Everyday life is filled with many good moments. The patient’s smile compensates for everything else.

 THIS MAKES THE CONVERSATION EASIER

• Do not leave any open questions, you better ask questions that may be answered with “yes” or “no”. Instead of “What do you want to eat?” you better ask, “Would you like to have a sandwich?”
• Without correcting or scolding, you better pay attention to the emotional content of the utterance. Do not answer to the words, “Has my husband eaten yet?” with “He passed away”, you better say, “You must miss your husband very much”.
• Do not assess their behavior. Instead of saying “You should not put the bag in the fridge”, you better say “I found your bag, shall I put it on the hanger?”
• Do not show irritation if the patient collects belongings or stores up food, for example in the closet. Just put them back in their usual place.

Evaluation of Dementia Care Situation

Valuable comradeship

You might better understand the world of disoriented people by a special method

The strengthening of the personality and the serious attitude towards the patient are the basis of the so-called “conversation with an emphasis on the personality”. Gerontologist Naomi Fail, for example, has developed a method of communicating, by which the caregiver “gets into the patient’s shoes.” The central point of the evaluation method is to accept the reality of the elderly, confused persons, to show them respect, attention and empathy. “Wrong” statements should not be omitted or diverted. The patient should not confront his/her own reality. It is much more important to go back in time and accept the associated desires and feelings, as well as the patient’s worries and fears.

ACCEPT THE FEELINGS OF THE PERSON SITTING OPPOSITE. Often the relatives need to put aside their own feelings. If an elderly woman really wants to go to the supermarket because she has to buy food for the children, it will not help if you make a note that her daughter has everything.

You should rather look concerned. You may ask her, “Do you take care of your children?”, and also, “Would you like to cook something for them now?” The patient will accept this as sympathy. The worries and feelings are valuable and they will keep their place. Thus, you may relax and not put so much burden on the patient. If these feelings are suppressed or rejected as meaningless, they will intensify and may lead to outbursts of anger, aggression, or deep sadness.

It is really difficult for many people to “lie” to their relatives who suffer from dementia. They consider it their duty to correct them if they want to go “home” – to a house that has long been gone. When the old father says he just talked to mother on the phone, they would like to correct this. However, even if the caregiver does not perceive the patient’s world as real, the relationship with the patient should be based on honesty, because the patient’s feelings at this time are real and require compassion. This also applies to behavior that may cause pain to the caregiver. According to Naomi Fail, sometimes behind this lie unfinished life tasks of the patient, which he/she unconsciously seeks to “finalize”.

ONLY SYMBOLS. A man who may have worked in the banking sector may feel robbed. He may no longer take care of money matters on his own and now suspects those close to him that they are taking advantage of him. For a woman on the other hand, her allegedly stolen jewelry may indicate another painful loss that has not been overcome, but which she cannot express.

Going deep into the world of the other person and appreciating his/her feelings helps relatives as well. Anyone who has realized that confused people often speak with symbols only and that the allegedly stolen ring speaks of painful loss, will not feel attacked and will not defend themselves. Because every behavior has a reason, even when it is surprising to the relatives.

The caregiver should know that the attacks are not intended to affect him/her personally. Then there is no danger of justifying or arguing with the patient with dementia.

LOOK FOR POSITIVE ASPECTS

Do not correct the false delusions of the dementia patient. If they are looking for their parents, it will not help if you tell them that those have been dead for years. Take their longing for protection seriously. The appropriate response would be, “You must miss your parents a lot,” or, “It would be good for you if they could be right here with you.”

COURSES FOR DEMENTIA SUPPORT

Behavior with an emphasis on personality cannot be learned quickly. The basic course provides relatives with some techniques. Ask about the course at LIC. The dates of the courses may also be found on www.liveincare.ie

Challenging behavior

Aggression, anger, fear

Dementia changes people’s behavior in a dramatic way. This is often a great challenge for the relatives who are taking care of the patient.

The mother, who has always been gentle and quiet, is now becoming hot-tempered and aggressive. The once so active and confident husband suddenly behaves cowardly. The formerly open-minded wife has rigid views now. The father behaves indecently. It is difficult for family members to accept these changes in personality as symptoms of the disease.

CHANGING BEHAVIOR. The unexpected events, or deviations from the familiar routine are often those that may cause crises and fears in the patient with dementia. Depending on the circumstances, these turn into anxiety, aggression or sadness.

ESCAPE TRENDS. Do not lock the person with dementia if he/she is willing to leave home. This creates unnecessary aggression. He/she is probably looking for something and cannot find it. Distract them with another topic.

The correct reaction:

• Go with him/her and walk together.
• Gently persuade him/her to return home.
• Put on a bracelet on his/her hand with their name, address and telephone number.
• Look for him/her at the neighbors or call the police.

ANXIETY. Many people with dementia develop severe anxiety over the course of the disease. This is expressed, for example, in the fact that they go from room to room in the house. They think they have to do something, but they forget what they wanted to do. They often look as if they are looking for something. In fact, they are looking for something they are familiar with. Because the real world has become alienated to them. Sometimes, their hands are constantly moving and they permanently button and unbutton their jackets. Some of them develop a special attachment that may be very stressful for the caregiver. They follow the caregiver everywhere. He/she can no longer even go to the toilet alone. They keep asking the same questions.

The correct reaction:

• Ensure them enough free space.
• Create a permanent and familiar environment at home.
• Find an activity that suits the patient’s abilities: folding towels or peeling potatoes.

AGGRESSION AND OUTBURSTS OF ANGER

Sometimes the patients become aggressive, both in words and actions. The reason is often a mere trifle. Causes of this aggression may be fears, but also pain. Dementia attacks are not directed at the caregiver’s personality, even when it seems so. Talk to your doctor about these events.

The correct reaction:

• Ignore the aggression or leave the room.
• Stay calm and imperturbable.
• Distract the patient.
• Make sure you are safe.
• Try to find out the cause of the attack.
• Do not provoke the patient, for example by mockery.
• Do not take the accident personally.

HALLUCINATIONS. Sometimes people with dementia suffer from hallucinations or illusions, such as being robbed. Take the patient’s concerns seriously.

The correct reaction:

• Try to distract the patient by talking about things he/she likes.
• Show them that they are in a safe place.
• Contact a psychiatrist or neurologist.

INSOMNIA

In some people with dementia, the rhythm of sleep is disturbed and they wander around at night. You may do the following:

• Make sure your relative gets enough exercise during the day.
• Do not give them stimulant drinks such as coffee or black tea in the evening.
• Place protective grilles on the stairs.
• Secure their routes.
• Make sure that the person with dementia cannot leave the house at night and lock the kitchen or other “dangerous” rooms.
• Some medications may cause a person sleep during the day and stay awake at night. Talk to the doctor!

HERE YOU WILL FIND HELP

Phone for counseling if there are any problems

Counseling service for people who have fallen into a violent or conflict situation during the care of a patient: 0871367766, www.liveincare.ie

Emergency phone number

“Action instead of bullying”: Dublin initiative against adult violence. Consultation and assistance in critical life and health situations: 0871367766

Therapeutic activities

Everyday planning

People with dementia are often still surprisingly mobile. However, they need emotional stimuli.

Everyone enjoys success. If the patients are engaged in various activities, they are less likely to suffer from anxiety and confusion, in which they are often involved if they have nothing to do. Return to the activities that the patient previously enjoyed and that correspond to the stage of the disease. But be careful to not exhaust the patient.

By performing daily activities, the abilities available will be longer preserved. Support them only where necessary. The effective result is not as important as the joy of the activity. Praise and encouragement, even in the absence of success, make much more sense than constant correction.

According to the studies, early mental stimulation may delay the onset of the disease. The main goal is to strengthen the health and improve the quality of life. Games that may be simplified over the course of the disease, such as games for young children, are suitable. Also, light mental tasks are a good workout for the mind. Rhymes, verses or simple audio books are also suitable. Specially developed games and activities for people with dementia are available on the market.

However, you should keep in mind that too much variety may confuse the patient. Those affected by the disease need constant rituals and a structured daily routine.

RITUAL PLANNING. What is being done at the same hours every day and in the same sequence, accompanied by certain words and gestures, gives security to the person with dementia. It takes away the fear of orientation in a world that has become impenetrable. Even slight deviations from the sequence may upset the patient.

This works even where the patient always forgets everything. For example, if the patient asks, “Why are we eating now?”, this does not mean he/she wants to eat at another time. In these circumstances, the patient wants to make sure everything is fine. Rituals can be stronger than words.

• In patients who can no longer express themselves in words, preferences should be observed: for example, singing a favorite song during certain activities.
• In order to make people who can hardly go out experience the seasons, using a table according to the season or the appropriate decoration may be helpful.
• Bedtime rituals indicate that the day is coming to an end: for example, darkening the room, turning on a night light, praying or reading a short text.

MAINTAINING MEMORIES. The experience of something already experienced brings the patients with dementia out of their indifference. We must be oriented in the history of their life and their hobbies.

Melodies known for a long time or old popular tunes evoke memories and create a sense of security. They awaken the vital forces and bring the patient happy moments. Singing is also soothing. Especially the lyrics of children’s and folk songs that are known by heart by many people. In any case, anyone who has never had access to music will not associate anything with it in old age.

ANIMALS AWAKEN VITAL FORCES

Many people with dementia thrive on contact with animals, provided they are not afraid of them. Petting small animals, dogs or cats gives intimacy and warmth. Watching fish is soothing. Animals Help People Association provides contacts between animal owners and patients. Phone: 12345678, website: www.liveincare.ie

GARDENING, WORK, DRAWING

Those who have an occupation retain their abilities longer. Options:

• Simple household activities such as collecting laundry, preparing breakfast, dusting.
• Gardening or watering flowers.
• Sorting items: pencils, buttons, etc.
• Making small things.
• Looking through photo albums together.
• Untangling old knits, this guides the movements.
• Collecting memories and loved items in a “life box” to evoke hidden memories.
• Some patients find painting as a way of expression during their illness.

Everyday life with Dementia Suffering Person

Dealing with everyday life

Dementia also leads to physical limitations or changes in the course of its development.

Relatives need to be prepared that more and more practical abilities, as well as the patient’s control over his/her body will be lost. In the advanced stage, assistance with the personal hygiene, eating or going to bed will be needed.

PERSONAL HYGIENE. In fact, people with dementia often retain their necessary abilities such as bathing or brushing their teeth. However, they should be reminded that bathing is necessary, or shown what soap is for or how a shower works. The aim should be self-bathing and cleaning for as long as possible. You should bear in mind that personal hygiene will not be perfect. If there are no compelling reasons, sometimes “washing like a cat” is enough. As it may turn out that the patient with dementia no longer wants to bathe or brush his/her teeth. Be prepared for this if you follow a certain cleansing ritual or habits.

Be careful when cleaning the patient’s intimate area, because people of the older generation may be quite embarrassed. It may be difficult for women if a man helps them with personal hygiene or vice versa. Maybe it would be better to contact a nursing service.

INCONTINENCE. It is extremely difficult when someone with dementia loses control of their bladder and intestines. In the earlier stage of dementia, the patient simply forgets to go to the toilet or does not find it. During the further development of the disease, the patient can no longer control the urethral sphincter and the sphincter of the colon. The doctor will then prescribe incontinence products. It is not easy for the caregiving relative to convince the patient that he/she needs “diapers”. Information that even younger people sometimes suffer from incontinence and that diapers prevent odors, can help. Other tips:

• Make going to the toilet a lasting and frequent habit of your relative.
• Mark the toilet door and leave it ajar.
• Make them wear clothes that are easy to take off.
• Help your relative put on diapers.
• Put a rubber pad on the patient’s bed.
• You may put faux leather or nylon upholstery on the chairs.

IT IS EASIER THIS WAY

• It is better for your relative to take a shower in order to prevent accidents in the bathtub (if he/she does not mind).
• Choose the same time during the day for personal hygiene and the same day for bathing or showering.
• Present the personal hygiene as pleasant as possible: for example, with soft towels and favorite bath salts.
• The favorite music creates a relaxing atmosphere.
• Help in a reserved manner: Sometimes it is enough to just pass the bath sponge and point or show the body.
• If the patient resists your help, hire a caregiver. Help from strangers is sometimes less embarrassing.
• If the patient gets dirty, do not confront him/her because of the situation, but help them understand while cleaning him/her.
• Explain each movement, for example when washing his/her hair, so that your relative knows what will happen and not be afraid.

THE CLOTHES – THE MIRROR OF PERSONALITY

In the course of the disease, it will become more and more difficult for the patient to undress and dress independently. Tips:

• Arrange the patient’s clothes in the order in which they should be worn.
• Respect the patient’s desires regarding clothing, even if you do not like them. However, make sure it is appropriate for the weather.
• Stickers and zippers are better than buttons.
• Use shoes with non-slip patches and soles. Make sure the patient likes them (the color!). Offer a long shoehorn.
• Remove the dirty clothes so that the patient cannot put them on again.

Nutrition

The question of appetite

Patients with dementia also need a complete diet: However, some of them lose weight. In this case, the most important goal is to eat something at all.

Along with the loss of appetite, the taste may also change. While some people with dementia refuse food, others are constantly hungry. Sour dishes are often refused, and sweets are preferred. In addition to trying different dishes, individual preferences from old times should be taken into account. The patient eats only what is tasty or evokes positive childhood memories. It is best to ask the family and friends about the taste preferences. It is also good to involve the patients in the preparation of the food, of course according to their skills, and give them the opportunity to try the food while cooking. Use color contrasts when cooking. Since with age, in addition to the perception of smell and taste, vision also weakens, colorful glasses and plates or foods with many colors may increase their appetite.

WITH EACH BITE TO THE GOAL. If eating with a knife and fork is difficult, small bites that the patient can eat by hand are a good alternative. They increase appetite and allow self-feeding. However, such food often contains little fluid. Therefore, it is important for the patient to drink enough fluids. Older people feel less thirsty. You may offer fluids in the form of watery fruit, compote or ice cream. Soups and thick fluids are delicious also from a glass.

When confused people are constantly wandering around the house, you may put small plates with bites around: This will make the patient eat, passing by.

SWALLOWING PROBLEMS. Mostly at a later stage, the swallowing reflex may be disturbed so that it interferes with drinking. If the patient chokes frequently, fluids are too rare. Pureeing the food or thickening it with a supplement that is sold in pharmacies may help. If swallowing problems get worse, talk to your doctor.

CHEERS! The patient should drink 1.5 liters of fluid per day. But the “You should drink” requirement often doesn’t help. On the other hand, friendliness is a good way to encourage drinking. Sit next to the patient and clink glasses with a loud “Cheers”. Most people drink voluntarily. It is good to distribute water bottles with a glass next to them in the apartment. Colored glasses with drinks are a better solution.

PEG PROBE: YES OR NO

AOK, along with the University of Witten-Herdeke, has developed a solution for artificial nutrition. You may find it on the following website:

www.aok.de > Gesundheit > Gesundheitsinfos > AOK-Entscheidungshilfe

FOLLOW EATING RITUALS

How to eat?

• Eating should always take place in the same place and at the same time.
• Create a calm and pleasant atmosphere.
• Eat together, so the patient could imitate you.
• Large and heavy cutlery may be better gripped.
• Cut the food into chunks in advance.
• Small portions that are appetizingly arranged awaken the appetite.
• Arrange with contrasts: Food should have different color from the plate.
• Do not worry about manners. Eating with fingers is fine.
• Give your relatives as much time to eat as they need. But always remind them to keep eating.
• Too much choice is confusing.

What to eat?

• Offer foods that the patient likes.
• Enrich the diet with lots of fiber, vegetables and fruits.
• The pleasant aroma of the food exacerbates the appetite.
• The feeling of hot and cold is weakened: Make sure the food is with the right temperature.
• Dispose of spoiled food in a timely manner where patients live alone.
• Appetite increases if the patient is involved in the preparation of food – encourage them, for example, to wash the salad or peel the potatoes.
• Fit large napkins with ties to protect clothes, bibs are often perceived as humiliating.

Activity

Carefully increase the activity

When memory and perceptions weaken, people with dementia are often less active. This increases the risk of falling. A targeted training programme can help.

Weakening of the brain leads not only to mental changes, but also to physical impairments. Due to the changed perception of information, patients, for example, change their gait. People with dementia walk unsteadily and with very small steps. Their feet are held back on the floor. Therefore, their gait is generally inharmonious. This increases the risk of falling.

Another problem is that the patient’s attention is not enough to keep on moving and at the same time be mentally stimulated, for example to have a conversation during a walk or to go down the stairs and think about the shopping list. Therefore, motor programmes for people with dementia include exercises training such double challenges (see the box below).

EXERCISE PROGRAMME. Is it possible to make exercises with people with dementia? Research shows that it is possible in mild to moderate dementia. The effects of training are also impressive: Muscle strength and balance visibly increase. The ability for daily activity such as walking, standing up from a chair or climbing stairs is improved by 30 to 50 percent.

Each movement strengthens the muscles and improves the coordination. The brain also benefits from every movement we make.

Sunlight and irritants such as wind, cold or heat awaken the senses. Therefore, it is ideal to take joint walks as often as possible. If this is no longer possible, motor games are an alternative, for example with a balloon. While the patient can still perceive, light balance exercises may help to walk safely. The acceptance of these exercises will also depend on whether the patient has been accustomed to sports. Despite all difficulties: The best protection against falling is movement.

IT IS ALWAYS BETTER WITH MUSIC: It makes some people dance, which vitalizes both their body and spirit. Thanks to the melodies and rhythmic movements of dancing, long-forgotten abilities return. More and more municipalities and nursing homes organize dance sessions where people cared for at home are also welcome. As dancing is another way to get dementia patients out of isolation. Suddenly they feel competent again, during the dances many people relax. And despite the serious illness, they learn that there are always happy moments.

ONLINE TRAINING PROGRAMMES

The University of Heidelberg has developed anti-fall exercises for people with mild to moderate dementia. You will find the training programme on the following website: www.bewegung-bei-demenz.de. The exercises are divided into such for beginners, advanced and professionals. With the use of a fitness test, you may determine which level is appropriate for the patient. More information may be received by phone at +353871367766.

IT IS BETTER THIS WAY

• Show the exercises. Stand in front of the patient.
• Use simple language, such as “Raise your legs”, and always positive wording such as “Stay upright” instead of “Don’t sit down”.
• When correcting, guide the correct movement with your hands.
• The more compliments the more motivation.
• Find only simple and clearly structured exercises.
• Speak pictorially, for example, “We stand stable like a tree”, “We are lifting a box” or “We are climbing the stairs”.
• Rhythmic signals help guide the movement, for example “And…go!” or “Now…lift it high!”

Housing

Secure and protected

A sign of dementia is the difficult orientation even at home

Involvement in the processes and activities will help less frequently in advanced disease. This increases the risk of endangering the patient and other people. For example, improper use of household appliances or if the patient no longer knows that he/she can mix hot and cold water during a shower. Therefore, the home must be tailored to the needs of the patient.

However, you should keep in mind that the news confuses people with dementia. Therefore, if possible, do not change anything at home. Leave the furniture in its usual place. The patient often gets accustomed to them over the years and may not accept the changes. If they have to go from the cupboard to the table and the armchair, this helps avoid falls.

If a change in the environment is necessary for security reasons, we recommend careful and gradual action. The best is the simple and easy to orientate layout at home, which will preserve the usual arrangement of the furniture. Orientation will be facilitated if you reduce irritants in the room, for example, colorful carpets are often interpreted by the patient as an obstacle.

A situation may arise where care of the sick person is no longer possible in the family. Then another housing option should be found. Moving the patient to a relative’s home or to a sanatorium poses a problem. Getting used to it is easier if the room is furnished with familiar furniture or objects.

More and more alternative forms of housing are being developed, such as living at the caregiver’s place or living together with a group of dementia patients, which offers the patient individual care within a family setting (see the addresses on page 24). LIC will inform you how these outpatient housing groups are being supported.

• By the way: If your doctor diagnoses dementia, you should inform your insurance company. If the patient causes a damage, the insurance company may refuse to pay compensation if you have not previously informed it of the disease.

 SECURE HOUSING

• Choose colors that emphasize the railings and lighting switches.
• Provide bright, shadowless lighting.
• Always keep your home or house tidy.
• Remove the obstacles, such as loose wires and high carpet edges.
• Provide windows, lower railings and stairs.
• Remove the fragile valuables.
• Remove small arches or carpets.
• Install handles in the bathroom and toilet.
• Reduce the boiler temperature. Patients often forget to mix the water.
• Place electrical appliances out of the patient’s reach. Secure the kitchen stove.
• It is best to lock the kitchen if you are not there.
• Label the individual rooms with the appropriate symbols, especially the toilet.
• Lock the medicines, household chemicals and cigarettes.

FIND A NICE PLACE

People with dementia need a clearly structured environment that also offers security. Therefore, when choosing a home you should keep in mind the following:

• Are there smaller homes for people with dementia?
• Are these homes without long corridors and grouped around a living room and dining room?
• Are the rooms comfortably furnished and equipped with familiar objects?
• Can residents actively help in the living room and dining room?
• Is there a garden where disoriented people may be on their own?
• Are there any security systems in place to allow the patient to move freely?

Medicine

Good treatment

The purpose of treatment is to always maintain the quality of life of the dementia patient for as long as possible

To date, no drug has been developed to influence the causes of the disease development and prevent its progress. Drug therapy is only intended to relieve Alzheimer’s symptoms. In any case, it should be left in the hands of the attending physician. And the effect of the frequently recommended herbal preparation ginkgo cannot be proven.

Patients need assistance in taking medication, otherwise they will not take it regularly. If you have no other option, ask your doctor if the tablets or capsules may be added in powder form to the meal. The drug may possibly be sold in drops or completely stopped.

FAMILY DOCTOR. Most often, the patient with dementia is treated by the family doctor. It is good for the GP to know the patient for a long time, then the doctor is at best a trusted person. The doctor should be aware of all the details in order to be familiar with the history of the disease and to assume the relevant leading function. In order to optimally exercise this function, it is important to constantly inform the doctor about the current events, for example, about new prescriptions from the emergency unit or any changes in the wound care from the caregivers. If a visit to the patient’s bed by the doctor is necessary, it is a good idea to clearly describe the symptoms over the phone so that the doctor can bring all the equipment needed for the examination.

Relatives or patients should not be afraid to talk to the doctor about unpleasant things. This is the only way the doctor can build a complete picture.

IN THE HOSPITAL. A hospital stay is almost always a traumatic experience for people with dementia. Along with the pain and problems, they experience a completely different environment and unfamiliar people.

• If possible, choose a clinic with a geriatric ward.
• Visit the patient as often as possible. Talk to the nurses and caregivers about how you may contact them.
• Bring familiar items (pillows, possibly stuffed animals, patient’s own cups and glasses).

HOW TO DEAL WITH PAIN

If people with dementia suffer from another disease, it is often difficult for relatives to establish whether they have pain. In some Alzheimer’s patients, sensitivity to pain is reduced. Others report pain if for some other reason they do not feel well. How do we recognize pain? What can we do against it?

• Observe the body language.
• Find out if the patient takes various positions to relieve the pain.
• Check the speech expressions.
• Make regular appointments with the dentist.
• Aggressive behavior may hide pain.
• If pain is suspected, call a doctor.
• Change the position of the patient in bed frequently.
• Use special pillows and mattresses for decubital ulcers (prescription required)

TRANSFER OF DECISIONS

Patients with advanced dementia can no longer make their own decisions. In this case, family members need a power of attorney. Patients should establish this on time, as the power of attorney is provided with full mental abilities.

• General power of attorney. It authorizes one or more persons to take decisions on all matters.
• Power of attorney for the caregiver. It gives the authorized person many rights, so it should be granted to an absolutely trusted person. It is possible to define the particular competencies and distribute them among more people. When giving the power of attorney, the principal shall have a legal capacity. In the event of hesitation, a certificate issued by a doctor may be required.
• Banking power of attorney. It allows access to accounts and deposit boxes.
• Designation of companion. It determines who will be the legal companion of the patient. He/she will be regularly monitored by the court of trustees, even when the person is a spouse.
• Power of attorney for the doctor. It is issued for the doctor and contains the patient’s desire for medical treatment. If there is no such power of attorney, oral requests are also accepted.

Self-assistance

Help for Dementia Carers

Taking care of a relative with dementia requires a lot of patience and effort from the caregiver. Therefore, we should not be afraid to seek help.

Persons taking round-the-clock care of other persons may reach the limits of their strength. The danger of falling victim to the care of a relative is great. Consequences: The caregiver may become ill.

CAREGIVERS NEED TIME FOR THEMSELVES. Therefore, it is important to look for relief on time and distribute the tasks on someone else’s shoulders. Talk to friends and relatives and find out what they can do to help you on a regular basis. The competent services that offer support are, for example, the counseling services for the elderly, regional self-help groups and Alzheimer’s associations, charity organizations and outpatient offices in the clinics working with patients with dementia. Doctors can also provide you with useful contacts.

FRIENDLY NEIGHBORS. Often the caregiver may hardly leave the house to go shopping or run important errands. During that time, a person who is willing to take care of the patient on an hourly basis may be helpful. Ask the neighbors or friends.

FREE OF CHARGE. There are free projects that offer their services, the so-called low-cost offers, the costs of which are partially covered. They provide a permanent person who may regularly spend some time with the patient. This assistance is often provided for a minimum fee. You may get information from the Alzheimer’s Association or from the regional consulting office.

CONVERSATION CIRCLES. Constant confrontation with the suffering of the sick relative may result in mental burden. Sharing experiences with people in the same position may be relieving.

OUTPATIENT SERVICES. In the later stage of dementia, when the patient’s disability rate needs to be determined, a service provider that may assist with bathing, dressing and other duties may help.

CARE DURING THE DAY AND NIGHT. Caring for a patient in a special day center for dementia patients may relieve you. The patient is taken in the morning and spends the day with others like him/her. There are also incentives, such as music and dancing.

SUBSTITUTES AND SHORT-TERM CARE. LIC may provide you with a substitute for a maximum of 4 weeks a year. If it is not possible to have this at home, you may request short-term care in a sanatorium. The health insurance fund pays up to 1,550 euros a year and also half of the money for care.

DAILY COMPETENCE. Dementia patients cared for at home may also receive benefits with no disability degree or without receiving a disability pension. In milder cases it is up to 100 euros per month, in severe cases – up to 200 euros per month. However, these payments are linked to the intended purpose, such as day care or approved care offers.

HOSPITALIZATION. Those who take care of a person with dementia should ask themselves how much burden they can take without harming themselves. Some conflicts arise not only because of worries. The situation often highlights problems that have existed for many years. Therefore, you should not rule out hospital accommodation. Transferring care to others does not automatically end your relationship. They only change, it is even possible to improve them.

Live-n-Care HELPS

LIC will consult you. In addition, LIC partners will offer you a wide range of health offers:

• detailed care advice
• courses and individual care training, also at home
• conversation circles
• a lot of practical information on the care of patients with dementia in the LIC portal at www.liveincare.ie
• health offers, such as back care courses, yoga or relaxation techniques

The best solution is to get an experienced caregiver at home. We can make you an affordable offer within 24 hours of your inquiry. You need to fill in our questionnaire at: https://liveincare.ie/enquire/ to receive a non-binding offer.