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Posted: November 29, 2004

Practical Caregiving

Dementia Caregiving in Two Practical Settings

As we grow into adulthood, the idea of having to take care of our parents doesn't even cross our minds. We don't want that to happen and we don't think about it. As a general rule, people don't prepare for the time their parents need help. Our grandparents got old and their minds wandered, but that was our grandparents. In our mind they were always old. Our parents weren't supposed to do that.

Now that you have reached the time when your parent forgets or is confused, just exactly how do you take care of them? That's where I found myself, and I hope to make that transition easier for you.

There are two types of caregiving everyone may encounter - in-home care and residential care. Let's explore both.

In-Home Care

There are several things you can do to make this situation better for both you and your loved one while caring for them in either their home or yours:

  • When you bathe your loved one, check the water temperature with you bare hand instead of a gloved hand.

  • In everything you do with your loved one, take longer and don't rush anything.

  • Don't give them too many choices in food. In fact, don't give them too many choices in anything. Making decisions gets more difficult as the disease progresses.

  • Don't get upset when they can't remember or do something they were able to handle yesterday. That's the way things progress sometimes, depending on the cause of the dementia.

  • Try to include them in your daily activities. They still need to feel needed and welcome, even if they don't remember everything.

  • Before bedtime, create a quiet and peaceful atmosphere. If they like to listen to Lawrence Welk music, tape some shows and play them for an hour before they go to bed.

  • If they wear adult diapers, change them half an hour before bedtime.

  • Have as regular a schedule as possible for everything. Especially important are eating, bathing and bedtime. Someone with dementia needs a regular routine, just like your young children.

  • If your loved one is getting frustrated, try to distract them with something they enjoy.

  • Avoid giving your loved one a project that is too challenging for them. Maybe they could do it yesterday, but if they can't do it today give them something else to do. They may be able to do it again tomorrow.

  • Make your home as safe as possible. (See my previous column on this topic for details.)

  • Don't leave clutter or continually rearrange the furniture. Someone with dementia needs everything to remain the same, if possible.

  • When someone visits who your loved one doesn't recognize, ?introduce? them to your loved one, indicating the relationship they have had over the years. When I first took Mom and Dad to Canada, people often came up to talk with them. They had visited for 17 years and it was like a second home. The women greeted Mom, and then told her who they were and that they had known her for many years. Mom looked at them and replied, ?Oh. That's nice.? The conversation continued from there.

  • If your loved one becomes aggressive, back off a bit. Take more time to get them to do whatever you want them to do. This aggressive behavior quite often is because they are frustrated, but it also may be because they don't feel well and don't know how to tell you. Try to determine the reason before proceeding.

  • When someone with dementia sees things that aren't there, or they ?remember? things that didn't happen, don't argue with them. It is very real to them. Go along with whatever they are saying and don't argue. Mom would ?see? little children on the other side of the room and comment on how cute they were. I just agreed and then she looked a little longer before coming back to reality. She taught kindergarten for many years and her ?visions? seemed to be something related to that.

  • And, of course, visit the doctor and dentist at regular intervals as well as whenever necessary.

Residential Care

When the time comes that you need to find a facility for your loved one with dementia, there are some guidelines to help you choose the right place. You may check out assisted living complexes or skilled nursing care complexes. Some facilities combine both of these, so your loved one can go from one to the other as needed.

The assisted living environment is more like an apartment complex. Operators usually include meals, recreation, transportation and other aspects of care that might be needed. The skilled nursing facility is commonly known as a nursing home. When your loved one needs 24-hour supervision and help, this is the place they need to be. You can refer to an earlier column I wrote for more on nursing homes (and assisted living).

But what should you, the caregiver, do when your loved one no longer lives at home?

  • First of all, remember that you are the one in charge of the care of your loved one. The assisted living facility or nursing home is there to help you take care of your loved one, not to replace you.

  • Visit your loved one as often as possible. Your loved one still needs your love and attention.

  • Try to visit at a time when your loved one is most responsive to your visits. Nighttime might not be a good time to visit.

  • Stay in contact with the staff where your loved one lives. Communication is extremely important. You don't want to phone so often that you irritate them, but often enough that they know you want to be part of your loved one?s care. The decisions should always be in your hands and they need to know they can call you anytime day or night when there is a problem.

  • If your loved one doesn't know you, don't get upset with them. It's part of dementia. Calmly tell them who you are and how you are related (friend or family).

  • If your loved one is angry and says things that are hurtful, remind yourself that it isn't you that is the problem. Something may have happened, either real or imaginary, that upsets them. Because of the dementia, they don't know how to react or handle the situation. They feel very helpless, and in actuality, they are very helpless.

And Now You, the Caregiver

  • Always remember that you are not super-human and can't do everything. Don't feel guilty because you are not perfect, can't make perfect decisions and are unable to be everything to your loved one 24 hours a day.

  • Make decisions based on what is best for your loved one and you, (not just your loved one), then don't look back. You may need to change that decision as the situation with you and your loved one changes, but that doesn't mean your original decision was wrong ? it just needed to be changed at a later date.

  • Make sure you exercise, eat right and take care of yourself. Create time for yourself. If you need to hire someone to make it possible for you to take time off, do it. You could hire a friend or there are organizations that provide this respite care. Many churches have people who enjoy helping the caregiver and will donate their time so the caregiver can get away. You will find that you can take better care of your loved one if you take a break occasionally.

© 2004 Pederson Publishing, Inc. All Rights Reserved.
Commercial use, redistribution or other forms of reuse of this information is strictly prohibited without the prior written permission of Pederson Publishing.

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Please send me your questions, comments and issues regarding the practical side of caregiving at ASKJEAN@caregivershome.com, and remember to take advantage of our professionals and experts in the Ask an Expert section of our website. You'll find it in the left column on our homepage.

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