For most older adults, the idea of aging in place and staying at home for as long as possible is an attractive one.
In fact, a March 2023 survey of 2,000 adults ages 55 and older conducted by U.S. News & World Report found that 93% of respondents felt aging in place was an important goal for them. However, for seniors who’ve been diagnosed with Alzheimer’s or another form of dementia, finding the balance between safety and support at home can be a challenging prospect.
Alzheimer’s and dementia are progressive neurological diseases that slowly rob people of their ability to care for themselves. What may start as forgetfulness or being occasionally tongue-tied can progress to a potentially dangerous situation in which the person needs round-the-clock care.
While many seniors can look forward to at least a few years before they need to consider making a move to an assisted living community or long-term care facility, the journey can often be difficult for caregivers to navigate.
Following are tips for caregivers of Alzheimer’s or dementia patients to help support a loved one at home for as long as possible.
Home Safety Tips: Ensure a Safe Environment at Home
Caring for a loved one at home means starting with a safe environment. Just like you might baby-proof your home when a toddler starts roaming about, adjusting the living space for a senior with dementia is critical to ensuring their safety.
People with dementia or Alzheimer’s disease “require a greater degree of care and supervision than other older individuals,” says Dr. Elizabeth Landsverk, a geriatrician based in the San Francisco area.
There’s a number of reasons why, starting with the fact that people with dementia tend to wander. Wandering and elopement, which refers to when a person with Alzheimer’s or dementia either intentionally or unintentionally leaves the facility or home, can be a normal aspect of the disease. This can be a means of addressing a variety of needs, including alleviating boredom, looking for an item or person or releasing excess energy.
While wandering can be managed in a safe environment, it becomes problematic and dangerous when the senior isn’t being supervised properly.
Nursing home staff are attuned to watch out for problematic wandering and elopement, but the average unpaid family caregiver may not realize the problem or understand how to head it off.
In addition, many homes are filled with potentially dangerous obstacles and hazards that a person with dementia may tangle with unintentionally. From rooms that are too dark to those that are too cluttered, there can be many ways a senior can harm themselves at home without meaning to.
To ameliorate these risks, Moraima Castañeda, the senior director of programs for the Center for Caregiver Advancement in Los Angeles, offers these practical tips:
— Increase lighting to help with visibility. If your home isn’t well lit, finding your way around can be difficult. As you age, your eyesight tends to lose acuity over time.
— Remove rugs. Throw rugs and other decorative floor furnishings might look nice, but they can quickly become dangerous trip hazards, especially for people with dementia. As the disease progresses, your loved one may not be able to lift their feet as well as they once did. If they start shuffling, the corner of a rug can certainly trip them up.
— Declutter the home. Having all sorts of stuff stacked up can also make navigating very difficult. Clear out the clutter to give your loved one enough room to maneuver comfortably.
— Avoid using the front burners of the cooking range. Doing so may reduce accidental burns.
— Install handrails in the bathroom. This can help give your loved one something to hold on to, which can greatly reduce the chances of falling.
— Use outlet covers and drawer and cupboard locks. Keep your loved one from being able to access areas and items they shouldn’t, such as knives and cleaning products, by installing outlet covers and locks on drawers and cupboards.
— Use door alarms. This will alert you if your loved one attempts to leave the home.
— Add an identification bracelet. If your loved one manages to leave the house unsupervised, they can readily be identified and returned home.
[Signs It’s Time for Memory Care]
Everyday Care Tips: Simple Ways to Help With Daily Tasks
People with mild dementia symptoms during the early stages may only need a few changes to their care, such as help following a scheduled routine to aid their memory or clearly labeling where personal items belong.
However, as the disease progresses, individuals with dementia will need increasing help with managing the activities of daily living, including:
— Bathing and personal hygiene.
— Dressing.
— Walking.
— Toileting.
— Eating and preparing meals.
— Household management, including laundry, shopping and paying bills.
When this occurs, a caregiver will need to step in to provide more support, but it’s not always easy. Alzheimer’s and other forms of dementia can cause difficult behaviors, such as changes in personality or combativeness.
As such, it’s important to stay flexible in accommodating the changing needs of a person who has Alzheimer’s or dementia.
Dementia can also alter a person’s sense of time, place and general understanding of the world around them, such as the season, their age, location and other details. While it can be distressing and concerning for you to see that your loved one is disoriented, as a caregiver, it’s better to provide comfort and support than insisting on accuracy.
“Most of these things do not matter and are, therefore, not important to correct,” Castañeda says. “If the person says it’s summer, in a calm voice, you say, ‘I love summertime.’ It doesn’t matter if it’s fall or winter. You do not need to prove this to them.”
[READ Anosognosia vs. Alzheimer’s: Understanding the Key Differences]
Communication and Behavior Tips: Handle Changes in a Better Way
As your loved one loses their language capabilities, communication can become very difficult, so it’s important to approach the patient with patience and kindness.
To do so, Castañeda recommends the following tips:
— Remind yourself it is the disease — not the person — that is being difficult.
— Try to simplify words and utilize pictures to convey messages.
— If you continue to feel frustrated with difficult behavior, step away.
“Never give up trying,” Castañeda says. “Keep trying a variety of tactics, and don’t be surprised that a variety of tactics is necessary. The dementia makes them change from day to day and moment to moment. Understand it is their disease, not you.”
[READ: New Treatments for Alzheimer’s Disease.]
Healthy Lifestyle Tips: Keep Loved Ones Active and Engaged
People with dementia need to stay actively engaged with people and the world around them.
“Involving the loved one with dementia or Alzheimer’s in daily family activities — like eating together and walking around the block — can help keep them active and socially engaged,” Castañeda says.
To help you with that goal, think about what your loved one liked to do before they were diagnosed, and consider ways you can keep a variation of those activities going. For example:
— Strike up a conversation about their hobbies.
— Listen to their favorite music, and sing along.
— Spend time with a pet, such as a dog or cat.
— Take them outdoors in the sunshine.
Music therapy for dementia patients
Music therapy has been shown to help people with dementia. Because music taps directly into the amygdala, a part of the brain that regulates emotions, music therapy has the power to unlock long-forgotten memories, connect a person to their former self, shift a person’s mood and improve their feeling of well-being.
You can use music to help calm an agitated senior or help them reminisce about days gone by. Use music at the same time every day to help your loved one stay connected and relaxed, or work with a therapist who specializes in using music therapy for dementia patients to build a tailored program.
Self-Care Tips for Caregivers
Far too often, caregivers burn out because they are so consumed with caring for the patient, but practicing self-care can go a long way in avoiding burnout.
Self-care strategies include:
— Getting quality sleep. When you’re overtired, it becomes much more difficult to think clearly and be able to respond appropriately when your loved one needs assistance. Aim for seven to nine hours per night to ensure you’re getting enough quality sleep.
— Eating a healthy diet. Good nutrition will give you more energy to be alert and strong to support your loved one when they need help. Eat a healthy, well-balanced diet that limits ultra-processed foods, and be sure you’re drinking enough water.
— Socializing with friends and family. Being the primary caregiver for a loved one with dementia can be a lonely endeavor. Make time to socialize with family and friends to ensure you’re maintaining the social connections that will support your mental health and overall well-being.
— Staying physically active. Exercise is great for burning off stress and keeping you healthy and focused. The Centers for Disease Control and Prevention recommends adults get 150 minutes of moderate-intensity physical activity each week. That’s just 2 ½ hours, and if you spread it out across the week, that’s a little over 20 minutes a day.
— Joining a support group. Making connections with other caregivers who are facing the same challenges you are can help you feel less alone. A support group may also provide practical, actionable advice that may ease some aspects of caregiving for your loved one.
“If you’re not taken care of, you can’t properly take care of someone else,” Castañeda says.
Preparing for the Future
Alzheimer’s and other forms of dementia are progressive, incurable diseases, so it’s inevitable that your loved one will experience a change in their condition over time.
Prepare yourself for what’s ahead with these tips:
Do your homework about the condition
One of the best ways to support a loved one with dementia is to learn everything you can about their condition.
“Don’t be afraid to ask doctors or specialists questions,” Castañeda says. “The more you know, the better you can plan: good, bad or otherwise.”
Find local aging organizations for support
Your local aging-related organization may provide resources for support, training and respite care. The National Association on Area Agencies on Aging offers online tools to find your local agency.
“Those area organizations on aging can really help you get that local support and piece together the team that’s going to care for your loved one,” says Dr. Rhonda L. Randall, Florida-based executive vice president and chief medical officer, employer and individual, at UnitedHealthcare.
Understand their health insurance benefits
Call your loved one’s health insurance carrier to speak with a case worker who can walk you through their benefits and let you know what resources may be available. For some, this may include VA benefits related to military service, so it’s important to find out what your loved one qualifies for. Medicare and Medicaid services also offer resources.
Look into assisted living or nursing home options
Because Alzheimer’s and other forms of dementia are progressive diseases, there will likely come a time when your loved one must move into an assisted living or nursing home facility that can provide specialized memory care.
“It will be a difficult choice but one that may be necessary,” Castañeda says.
If it’s time to place a loved one in an assisted living or long-term care facility, look for a community that offers more than just the occasional bingo game or chair aerobics class.
“There’s a difference between engagement and entertainment,” says Eleonora Tornatore-Mikesh, chief executive officer of CaringKind, a New York City-based Alzheimer’s and dementia caregiving support organization. “It needs to be what makes every individual tick. That’s when you know the person feels nourished.”
Bottom Line
Ultimately, while Alzheimer’s or dementia is often a challenging journey, it’s important for caregivers to celebrate their loved one’s abilities that they still have.
“Often, caregivers only think about the functions that their loved one has lost, but optimism is contagious, and it will lift your spirit,” Castañeda says.
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Dementia Care: Tips for Home Caregivers originally appeared on usnews.com
Update 04/05/24: This story was published at an earlier date and has been updated with new information.
