Caring for someone with dementia; Home care - dementia
Someone with dementia will need support in the home as the disease gets worse. Family members or other caregivers can help by trying to understand how the person with dementia perceives his or her world. Give the person a chance to talk about any challenges and participate in his or her own care.
Ask your health care provider how you can:
Help the person stay calm and oriented
Make dressing and grooming easier
Talk to the person
Help with memory loss
Manage behavior and sleep problems
Tips for reducing confusion in people with dementia include:
Have familiar objects and people around.
Keep lights on at night.
Use reminders, notes, lists of routine tasks, or directions for daily activities.
Stick to a simple activity schedule.
Regular walking with a caregiver or other reliable companion can improve communication skills and prevent wandering.
Calming music may reduce wandering and restlessness, ease anxiety, and improve sleep and behavior.
People with dementia should have their eyes and ears checked. If problems are found, hearing aids, glasses, or cataract surgery may be needed.
Supervised meals can help with feeding. People with dementia often forget to eat and drink, and can become dehydrated as a result. Talk to the health care provider about the need for extra calories due to increased physical activity from restlessness and wandering.
Also talk to the health care providers about:
Watching for risk of choking and what to do if choking occurs
How to increase safety in the home
How to prevent falls
Ways to improve bathroom safety
The Alzheimer's Association's Safe Return Program requires people with dementia to wear an identification bracelet. If they wander, their caregiver can contact the police and the national Safe Return office, where information about them is stored and shared nationwide.
Eventually, people with dementia may need 24-hour monitoring and assistance to provide a safe environment, control aggressive or agitated behavior, and meet their needs. This may include in-home care, nursing homes, or adult day care.
A person with dementia may need monitoring and help at home or in an institution. Possible options include:
Adult day care
Many organizations are available to help you care for a person with dementia. They include:
Adult protective services
Local or state government departments of aging
Visiting nurses or aides
In some communities, dementia-related support groups may be available (See: Elder care - support group). Family counseling can help family members cope with home care.
Advance directives, power of attorney, and other legal actions may make it easier to decide on care for the person with dementia. Seek legal advice early, before the person is unable to make these decisions.
Burns A, Iliffe S. Alzheimer's disease. BMJ. 2009;338:b158.
DeKosky ST, Kaufer DI, Hamilton RL, Wolk DA, Lopez OL. The dementias. In: Bradley WG, Daroff RB, Fenichel GM, Jankovic J, eds. Neurology in Clinical Practice. 5th ed. Philadelphia, Pa: Butterworth-Heinemann Elsevier; 2008:chap 70.
Knopman DS. Alzheimer's disease and other dementias. In: Goldman L, Schafer AI, eds. Cecil Medicine. 24th ed. Philadelphia, Pa: Saunders Elsevier; 2011:chap 409.
David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine. Also reviewed by Luc Jasmin, MD, PhD, Departments of Anatomy and Neurological Surgery, University of California, San Francisco, CA. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.