Caring for people with dementia at home and in hospital

From this article you will learn:

What is dementia
What are its symptoms and manifestations
How to care for someone with dementia
How does home care for a person with dementia differ from care in a boarding house?

Dementia is an incurable disease that can develop over a long period of time. It changes the life of both the patient and his loved ones. People who suffer from this disease need constant supervision. This places not only an emotional and physical burden on the caregiver, but also a financial one.

Caring for people with dementia usually involves protecting and ensuring their comfort. Often such care is perceived by the patient with aggression and disapproval, since the disease destroys his memory and changes his perception of the world, which does not always allow a person to consciously react to people close to them.

What is dementia

As a result of a malfunction of higher nervous activity, in addition to memory, dementia reduces a person’s ability to learn and contributes to the loss of many knowledge and skills that he acquired during his life.
Elderly people often suffer from forgetfulness, which does not always signal the presence of a more serious illness. But like memory problems, the development of dementia can be caused by numerous factors that affect the brain and nervous system. These include: alcohol or drug use, head injuries, tumors, atherosclerosis, meningitis, Parkinson's disease, encephalitis, Alzheimer's disease and others. Read material on the topic: Mixed dementia - causes, features of diagnosis and treatment

Treating dementia at home

An extremely important factor in home treatment is the environment in which he lives, as well as his activities and lifestyle.

Recommendations for older people with dementia

Follow the regime . It is necessary to strictly follow the diet, rest and activity regimes. It will be useful to do moderate work, but it is not recommended to overwork yourself. It is better to eat a little food up to 6 times a day.
Train and exercise . You need to support both your brain and your body. Moderate physical activity in the form of helping around the house, walking and therapeutic exercises will be useful. You can also use yoga classes.
Effective treatment requires mental development . Reading printed publications, poems, crosswords, memory tests - everything can bring significant benefits. Creative activities have proven themselves to be excellent: hobbies, embroidery and knitting.
A person with dementia should be provided with love and pleasure . Pets, communicating with family members, looking through family photo albums, listening to beautiful music, etc. can help with this.

Causes of senile dementia

As we have already mentioned, older people are susceptible to senile dementia, or dementia, which is directly related to a disorder in the cognitive function of the brain. Not all aspects of the occurrence of this disease are clear, but the following main reasons are identified:

Atrophy of brain tissue due to a failure of the metabolic process and lack of oxygen, all its resources are lost in this situation.
Diseases of the cardiovascular system, as a result of which degenerative changes occur (neurons die), which is why dementia is considered incurable.
Infectious diseases, cancer. They may also underlie senile dementia.

Read the material on the topic: Senile dementia is an enemy that can be successfully fought

Clinical manifestations of dementia

Senile dementia develops gradually, completely unnoticed at first. Dementia is most pronounced in those who suffer from atherosclerosis of the cerebral and coronary vessels and arterial hypertension. As a rule, the deterioration of the situation is facilitated by strokes, after which changes in memory, thinking and behavior are noticeable. The main causes of senile dementia are considered to be Alzheimer's disease and vascular dementia. The first symptom of developing dementia is a slowdown in a person's thought processes. This is expressed in the fact that solving any problems, even the simplest ones, for example, household ones, takes more than the allotted time, and the ability to think quickly and concentrate is reduced.

The character and behavior of a person at the initial stage of development of dementia changes for the worse.
Rudeness, stubbornness, and excessive straightforwardness appear. Such symptoms are attributed to the “selfishness of old age,” since the patient does not notice these changes and believes that this is normal. Forewarned is forearmed. A greater effect will be achieved if dementia prevention is started as early as possible. Properly selected treatment will help slow down destructive processes. Read the material on the topic: Alzheimer's disease

Caring for people with dementia at home

Caring for people with dementia at home is a complex and time-consuming task. Trustees usually become close relatives: spouse, children. The choice depends on the gender of the patient, as well as on which of them has the best living conditions and financial situation. Often the daughters or daughters-in-law of the sick become guardians. Caring for patients with dementia is a huge amount of work associated with extreme stress for all loved ones, which is why the term “caring burden” is recognized internationally and includes not only emotional and physical stress, but also the financial costs of the caregiver. A person caring for someone with dementia must ensure that their physical health and well-being are not neglected. The illness of a loved one can destroy the usual structure of the family and lead to chronic fatigue of its members, their emotional burnout, feelings of guilt and indignation.

A properly organized daily routine should become an important part of the patient’s life. At the same time, it would be good to retain at least some activities related to the person’s past, habitual life. Organization and orderliness will make him feel protected and confident.
Promote greater independence for the patient. This will make your job easier and help maintain the patient's self-respect.
Do not forget that the patient, under any circumstances, remains a person who can be hurt by a careless word or deed. Help in maintaining self-esteem is an important aspect of care and attitude towards the patient. Treat him condescendingly; it is unacceptable to discuss his condition in front of him.
Do not conflict with the patient. Quarrels will only cause unnecessary tension for you and the patient. You need to remain calm in any situation, always remember that it is not the person who is to blame, but his illness.
The patient should always be busy with something. Give him simple tasks. Difficult ones can cause stress and worsen the patient's condition.
The busier the patient is, the better. You must create situations in which the patient can demonstrate his skills and abilities. Constant employment gives his life meaning and increases self-esteem. But be careful, as the disease progresses every day, which means the abilities of your ward are changing. In this case, you just need to change the nature of the activities so as not to cause his irritation and anger.
Think about how to make the patient's stay in the home safe. Due to such manifestations of the disease as memory loss and impaired coordination of movements, the risk of injury to the patient increases.
Make life comfortable for someone with dementia. Have his vision and hearing checked and, if necessary, order a hearing aid or stronger glasses. This will help the person communicate with you or the service staff. This way he won't feel socially isolated.

Bathing and personal hygiene

A person suffering from dementia may forget to wash their face or not remember how to do it. Gently offer him your help, so that the patient manages to maintain his self-esteem.

When washing, try to adhere to the way the patient is used to doing it.
Help him relax, make this process enjoyable for the patient.
Before the procedure, be sure to find out what exactly the patient prefers: take a bath or wash in the shower. Unusual actions may bother him.
If you cannot persuade the patient to swim at the moment, just wait until he changes his mind.
Give the patient the opportunity to do everything he can on his own.
If the patient does not want to completely undress, meet him halfway and leave certain areas of the body covered.
Make the patient's bathing as safe as possible: securely secure handles that you can hold on to, place an anti-slip mat, and additionally place a chair.
If you feel uncomfortable or find it difficult to bathe a patient, ask someone for help.

Recommended articles to read:

Social services for older people
Diseases of old age
Valuable tips on how to choose a boarding house

Dressing

Often people with dementia forget how to dress and why it should be done. In addition, they may dress inappropriately.

Arrange your client's clothes so that they wear them in a certain order.
It is advisable to choose clothes without fasteners; it is better if they have Velcro or a zipper.
Encourage the patient's attempts to dress themselves.
Choose comfortable, loose-fitting, non-slip (preferably rubber-soled) shoes.

Toileting and incontinence

Patients with dementia may forget what it means to “go to the toilet” and stop feeling when to do it.

Praise the patient for going to the toilet.
Develop a toilet routine.
Highlight the toilet door with bright colored letters.
Keep the toilet door open to make it easier for the patient to find it.
Clothes should be easy to remove.
Limit fluids at night within reasonable limits.
Place the chamber pot close to the bed.
When the need arises, use diapers.

Nutrition and cooking

Even eating can be a very difficult process for someone with dementia. Often you have to feed him, because the patient simply forgets how to use cutlery.

Every time, tell the patient that it is time to eat.
Feed him something that is easy to handle.
Cut food into small pieces to make it easier for the patient to swallow and prevent choking. In the later stages of the disease, feed him liquid food.
Make sure that the food is warm, as sometimes patients cease to distinguish between cold and hot.
During each meal, remind them to eat slowly.
Do not offer more than one serving to the patient.
Sometimes patients forget how to swallow; consult a doctor, he will tell you about techniques for stimulating this process.
A patient suffering from dementia must eat well. But in the later stages of the disease, he may forget how to prepare food. This is an even more serious problem if the patient lives alone. Poor coordination of movements also leads to injury: a person can cut himself or get burned. Therefore, you, as a guardian, must provide him with ready-made meals.

Read material on the topic: Nutrition in old age: the most important recommendations

Poor sleep of the patient

Another challenge of caring for someone with dementia is that they may not sleep at night. What can be done in this case?

Do not allow the patient to sleep during the day.
Make exercise and daily walks mandatory and regular.
Make sure that the patient feels comfortable when going to bed.

Complaints about lost items

The patient often forgets where he put this or that item, so he can easily accuse you of theft. To avoid such situations, check if your ward has a secluded place where he puts his clothes or personal items.
Make it a rule to keep a bunch of keys or glasses in reserve.
Check your trash can before you throw it away.
Never get irritated in response to patient accusations, be calm and reasonable. Agree that a lost item must be found.

Vagrancy

Often people with dementia develop a tendency to wander; they may wander away or go far from home or get lost. Therefore, the guardian’s task is to ensure that the ward always has a passport or other document with him that will help determine his identity.

The patient must have a note with him with an address and telephone number for contacting relatives or a guardian.
Keep the patient's home safe by locking doors and windows to ensure that your patient does not leave without your knowledge.
If the patient does get lost, do not show your emotions, be calm, when they find him, support him.
Always have a photo of your ward with you in case you need it when searching for him.
Attach unbreakable mirrors to the doors of your apartment or house: your own reflection will distract the patient from the desire to open the door.

Aggressive behavior

The reasons for this behavior of the patient may be:

Stress from mental or physical exertion.
Despair from the fact that others do not understand or do not want to understand his desires.
The likelihood of another disease.

Read material on the topic: Senile insanity

Nurse or hospital? How to make life easier for yourself and your caregiver

Having learned about the difficult condition of their loved one, many relatives, frightened, try to take the patient to the hospital, being absolutely sure that he will be better there. According to Ilya Eremin, this is precisely a huge mistake. Because if in his native walls a person in a state of incipient dementia still has something that his fading memory can still cling to, then in the hospital walls there is absolutely nothing for it to cling to. And there the patient’s condition deteriorates sharply. Therefore, outpatient treatment rather than inpatient treatment is recommended for patients with dementia. But at the same time it is necessary to treat such a patient.

Many relatives of such patients, having experienced the initial shock of learning about their illness, then fall into despair at the prognosis and give up.

“In fact, treatment is not just necessary,” says Ilya Eremin, “It can significantly improve not only the condition of a patient with dementia, but also the life of his loved ones and his care. Although, of course, the necessary drugs can be expensive.”

When taking the medications prescribed by the doctor, the patient will be much less aggressive, calmer and more controllable. Of course, perhaps not all relatives of patients with dementia have yet managed to realize this important fact that life with a more or less calm patient is much easier than if he fights and swears all day, and also protests against the regime, refusing, for example, to wash .

Psychiatrist Ilya Eremin talks about cases from practice when some patients who are not treated have caregivers quit every two days, and, ultimately, finding a patient assistant is much more expensive than purchasing the necessary medications.

In addition, treatment still slows down the progression of the disease, that is, it delays the next stage - after all, caring for a bedridden patient is much more difficult. It is also very important that the treatment preserves the image of the sick relative worthy of respect in the eyes of his loved ones: after all, it is emotionally easier to take care of a person in whom not only aggression and stubbornness are boiling, but who still have favorite traits.

Natalia Demyanova