How to Care for Someone With Dementia: 5 Tips for CaregiversFeb. 9, 2022 - Katie McCallum
Being a caregiver to a loved one is an incredibly rewarding experience, yet it's also a difficult one. And if your loved one has dementia, caregiving can be even more challenging.
"Dementia is an all-encompassing word for a general decline in a person's cognitive function," says Dr. Randall Wright, a neurologist at Houston Methodist. "There are different types, including Alzheimer's disease, Lewy body dementia and frontotemporal dementia, just to name a few. Each type of dementia presents with its own unique features. What all types have in common, though, is progressive cognitive impairment that makes day-to-day functioning more and more difficult."
For that reason, people with dementia need a caregiver (or caregivers) who can assist with everyday tasks and personal care, as well as aid in decision-making about health, finances and more.
"Dementia can cause memory issues, impaired decision-making and behavioral changes, so caregiving for someone with dementia can be very mentally and physically challenging," says Dr. Wright. "But it's important to know that you're not alone. There are help and resources out there for you and your loved one."
Here are Dr. Wright's five tips when providing care for someone with dementia.
1. Be open to new ways of interacting and communicating
"It's easy to look at a parent or loved one with dementia and see them as they've always been," says Dr. Wright. "But it's important to realize that, to some degree, he or she is a different person now. They may look the same, but their behaviors are going to be different and you can't return them to normal just through sheer willpower."
Instead, Dr. Wright recommends taking steps to adjust how you perceive, interact and communicate with your loved one.
Being open to seeing them as they are now can help you better engage with them in your day-to-day activities. It can also help you navigate how to effectively respond to the challenging situations that will assuredly arise, such as their asking the same question repeatedly, forgetting something important or doing something inappropriate.
"It's critical for you to give your loved one plenty of grace," recommends Dr. Wright. "If you find yourself getting annoyed or short-tempered, remind yourself that they're not doing these things intentionally. Their actions and behaviors are the result of something they have no control over anymore."
2. Take steps to avoid agitation, stress and conflict
Dementia impairs how effectively the brain handles stress and confusion. As often as possible, help set your loved one up for success by limiting situations that induce confrontation or unnecessary change.
"Tough conversations and circumstances will arise, but avoid needless conflict and try not to exacerbate small everyday issues," says Dr. Wright. "Getting into an argument with your loved one isn't fair to them, so it's best to instead direct your energy toward diffusing these situations."
In addition, know that confusion can be introduced by change in either routine or location.
"The brain likes patterns," Dr. Wright recommends. "The more it recognizes its environment and schedule, the more optimally it can perform. It's important to play toward this strength, not against it, while caring for someone with dementia."
You can accomplish this by maintaining a normal routine as often as possible. In addition, avoid exposing your loved one to new environments frequently or haphazardly. Try to keep them in their usual environment as much as possible.
3. Recognize dangerous situations and implement precautions
Having impaired memory or decision-making can make certain situations unsafe for your loved one. You, as the caregiver, will need to identify safety issues and be quick to enact solutions.
"The specific precautions needed to keep your loved one safe are likely going to be very individualized and depend on the unique features of their dementia," explains Dr. Wright. "There are some common issues to be on the lookout for, though — such as driving a car and using certain kitchen appliances."
Dr. Wright recommends knowing the danger areas in your loved one's home and taking steps to make them safer.
"For those who are forgetful, cooking on the stove can be dangerous, but the microwave may be a little less dangerous," adds Dr. Wright. "For those who get lost easily or have trouble making quick decisions, allowing them to drive or go for a walk alone may now be unsafe."
Because activities like driving and cooking are often tied to our sense of independence, taking them away or limiting them can be challenging. But because safety is a top priority, it is important to address these issues when they arise.
While making these decisions, remind yourself that your loved one can't always perceive what's best for them anymore — but you can.
"For instance, taking the car away may lead to strong emotions, but you must be the voice of reason," says Dr. Wright. "The best thing you can do is initiate the conversation in a non-confrontational way and be sensitive to the emotions and reactions they experience. Remember, give your loved one grace."
4. Be proactive rather than reactive
Dementia is progressive, so you'll want to regularly assess how much support your loved one needs.
"Caregivers need to recognize when a one-off issue is becoming a pattern and be quick to enact a solution," says Dr. Wright. "When caregiving for someone with dementia, it's critical to be proactive, not reactive."
Determining when exactly it's time to make these protective decisions is tough, though.
If you're struggling to determine when your loved one needs more care or what more care even looks like, a home safety evaluation can help you assess:
- Your loved one's risk
- Whether safety concerns exist
- Whether gaps in care exist
- The next steps to take
Managing your parent or loved one's care comes with many legal, financial and medical matters to navigate, too. Getting a head start on these can go a long way.
"It's always more challenging to handle a situation if you wait to enact the solution until after something happens," says Dr. Wright. "Not only could this limit what options are available moving forward, but delaying decision-making could also pose a safety concern to your loved one. I recommend beginning to plan for these medical and financial decisions very early on — ideally as soon as your loved one gets the diagnosis."
Making decisions for someone else is always going to be stressful, but researching your options and making decisions in advance can help limit the amount of stress you ultimately face. This is important since, as a caregiver, you're likely to face a lot of it.
5. Know when to ask for help
When caring for someone with dementia, it's easy to let your own physical and mental health slide. But don't forget about your own self-care.
In particular, one of the best things you can do as a caregiver is allow others to help you, being clear about what help looks like. Maybe that's relying on a grocery delivery service or asking a family member to take your loved one to a doctor's appointment now and then. Use this time away for yourself, filling it with whatever helps you relax and recharge.
"One thing I find that caregivers really struggle with mentally is when to include more people in the caregiving process — particularly, when to let the professionals take over," explains Dr. Wright. "Doing so can feel like it means you're giving up on your loved one, and there are a lot of conflicting emotions that come with that. But, in reality, it's incredibly difficult for someone to care for a loved one alone."
And when it begins to become clear that it's time for a transition of care, continue to remind yourself that you don't have to do this alone.
"Don't feel guilty about letting the professionals care for your loved one when it's time," Dr. Wright adds. "Relying on experts will give you more quality time with your loved one, time spent doing things you enjoy doing with one another rather than you just being there to help complete day-to-day tasks."