Information for caregivers of people with Dementia, including daily routines, dignity, independence, positive focus, laughter, safety, communication and health.

Establishing daily routines

A clear routine can decrease confusing decisions for people with Alzheimer's disease (AD). Bringing order to an increasingly chaotic life represents security for anyone feeling confused and disorientated. So, "It's 11.15 - coffee time!" is preferable to, "What would you like to do now?"

Maintaining dignity

The individual needs to contribute to conversations and decisions, and it is best for others never to talk about the person as if he or she is not present, as this can cause feelings of humiliation.

Reinforcing independence

Independence will create self-respect and minimize additional work for caregivers. If others help with an activity, for example, dressing, the helper can start the activity and then allow the individual with AD to complete the task. This will give a sense of achievement.

Separating the person from Alzheimer's disease

Many people become infuriated when the person with AD displays challenging behavior. It is helpful to blame the disease, not the person.

Staying Positive

Conflict causes stress to the caregiver and the person with dementia. It is helpful to avoid focusing on failure, and instead, to highlight any success, or near-success. Becoming upset makes the situation worse.

Sometimes, distraction can solve problems. If the person insists that there is a man in a black cloak nearby, insisting on the truth will cause humiliation. Instead, it can be acknowledged that he or she is seeing the man, but asserted that only the individual can see him – then another subject can be raised. Report hallucinations to a doctor.

Keeping tasks simple

This is achieved by making sure that the individual retains the making of choices - but limiting the choices to avoid confusion. So - instead of saying, "What will you wear today?", the question could be, "Will you wear your blue dress or your green dress today?"

Laughing

Humour can help to relieve stress. If the person is able to laugh at mistakes, this can lighten difficult situations. If caregivers laugh with the person, not at him or her, that can be even better. Other opportunities exist for laughter too - the antics of a pet or a child, a TV program…

Keeping safe

Safety is a high priority. Fire, electricity, water, obstacles and staircases can cause special concern. Information is available from the local support group, fire authorities, electricians etc. on making the home a safer place.

Remaining healthy

It is important to help maintain physical and mental abilities at the highest possible level. The doctor can advise. A healthy diet will benefit the individual. Memory loss for recent events can sometimes mean that the person may eat two meals instead of one - or have too many unhealthy snacks. Keeping to a firm meal routine is helpful.

Try to include some activities that challenge the person's thought processes (perhaps, a daily word puzzle).

Celebrating a person's existing abilities

It is advisable to focus on strengths instead of weaknesses. Some skills can be retained and enjoyed eg. crafts, singing, gardening etc.

Keep communicating

• People need to show warmth and affection.
• The person with AD may express needs through actions.
• Eyesight and hearing should be checked and maintained.
• Others should be aware of their own body language, especially when feeling impatient or cross.

Use aids to help memory

Displaying large clear pictures of relatives and friends can be helpful. So can writing notes on a calendar.

Doors may be labelled with words and bright distinctive colours. Keeping things neat and well organised also helps memory.

There is another important person in this relationship - and that is the caregiver.