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How to Care for Someone With Dementia

When a cognitively impaired adult needs care, these strategies can help

By Family Caregiver Alliance

Many American families care for an adult with a cognitive impairment brought on by conditions such as Alzheimer's or a stroke.

Cognitively-impaired people have difficulty with one or more of the basic functions of their brain, such as perception, memory, concentration and reasoning skills. Common causes of cognitive impairment include Alzheimer’s disease and related dementias, stroke, Parkinson’s disease, brain injury, brain tumor or HIV-associated dementia. Although each disorder has its own unique features, family members and caregivers often share common problems, situations and strategies.

Each caregiving family faces unique circumstances, but some general strategies can help you navigate the path ahead. As a traveler in new terrain, it is wise to educate yourself as best you can about the landscape and develop a plan accordingly, with the flexibility to accommodate changes along the way. Here are 10 steps to help you set your course.

Step 1. Lay the foundation. Establishing a baseline of information lays the groundwork for making current and future care decisions. Talk with your loved one, family and friends: What was mom “normally” like? How has she changed? How long has she been forgetting to take her medicine? When did she stop paying her bills? Answers to questions such as these help create a picture of what is going on and for how long. This basic information not only gives you a realistic view of the situation, but also provides an important foundation for professionals who may be called in to make a more formal assessment.

Step 2. Get a medical assessment and diagnosis. It’s very important for your loved one to get a comprehensive medical exam from a qualified health care team that reviews both physical and mental health. Many medical conditions can cause dementia-like symptoms, such as depression and medication interactions. Often these conditions can be reversed if they are caught early enough. Additionally, new drug treatments for diseases such as Alzheimer’s and Parkinson’s diseases may be most effective in the early stages of the disease. A confirmed diagnosis is essential in accurately determining treatment options, identifying risks and planning for the future. Take your loved one to a memory disorder clinic, if one exists in your community, to get an accurate diagnosis.

Step 3. Educate yourself, your loved one and your family. Information is empowering. Talk to doctors, health and social service professionals, and people going through similar experiences. Read books and brochures. Do research at the library and on the Inter-net. Learn how the disease progresses, the level of care that will be needed, and what resources may be available to help. Keep a notebook and a file folder of information you collect that you can refer back to when needed. Knowledge will increase your confidence and may reduce the anxiety and fear that many of us feel in the face of the unknown.

Step 4. Determine your loved one’s needs. Care assessment tools include a variety of questionnaires and tests designed to determine the level of assistance someone needs and establishes their personal preferences for care (e.g., bathing in the morning rather than the afternoon). Each situation is different. While one person in the beginning stages of Alzheimer’s may need assistance with grocery shopping and bill paying, another in later stages may have problems with dressing, eating and hygiene.

Assessments usually consider at least the following categories:

  • Personal Care: bathing, eating, dressing, toileting, grooming.
  • Household Care: cooking, cleaning, laundry, shopping, finances.
  • Health Care: medication management, physician's appointments, physical therapy.
  • Emotional Care: companionship, meaningful activities, conversation.
  • Supervision: oversight for safety at home and to prevent wandering.
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  • Fire hazards such as stoves, other appliances, cigarettes, lighters and matches.
  • Sharp objects such as knives, razors and sewing needles.
  • Poisons, medicines, hazardous household products.
  • Loose rugs, furniture and cluttered pathways.
  • Inadequate lighting.
  • Water heater temperature — adjust setting to avoid burns from hot water.
  • Cars — do not allow an impaired person to drive.
  • Items outside that may cause falls, such as hoses, tools, gates.

Be sure to provide:

  • Emergency exits, locks to secure the house, and,if necessary, door alarms or an identification bracelet and a current photo in case your loved one wanders.
  • Bathroom grab bars, non-skid rugs, paper cups rather than glass.
  • Supervision of food and alcohol consumption to ensure proper nutrition and to monitor intake of too much or too little food.
  • Emergency phone numbers and information.
  • Medication monitoring.
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By Family Caregiver Alliance

MissionFamily Caregiver Alliance is a public voice for caregivers, illuminating the daily challenges they face, offering them the assistance they so desperately need and deserve, and championing their cause through education, services, research and advocacy.    Who We Are Founded in 1977, Family Caregiver Alliance was the first community-based nonprofit organization in the country to address the needs of families and friends providing long-term care at home. Long recognized as a pioneer in health services, the alliance offers programs at national, state and local levels to support and sustain caregivers.National, State and Local Programs Uniting research, policy and practice, the alliance established the National Center on Caregiving to advance the development of high-quality, cost effective programs and policies for caregivers in every state in the country. The National Center on Caregiving sponsors the Family Care Navigator to help caregivers locate support services in their communities. Family Caregiver Alliance also oversees Link2Care, an Internet support and information system for clients of California's system of Caregiver Resource Centers and operates the Bay Area Caregiver Resource Center in the six-county San Francisco Bay Area. In that capacity, the alliance's staff social workers work closely with families caring for ill or elderly loved ones. Our services, education programs and publications are developed with their expressed needs in mind, to offer real support, essential information, and tools to manage the complex and demanding tasks of caregiving.

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