Dementia changes over time. Early in the disease, a person with dementia may need no care at all. As the disease progresses, they will need progressively more extensive care. Providing a safe, nurturing environment can help your loved one enjoy their life, keep them safe, and even improve cognition. Some factors to keep in mind when preparing your home for a person with dementia include dementia safety, diet and nutritional issues, psychological support, and stimulation and support.
In some ways, preparing your home for someone with dementia is a lot like babyproofing. Unlike a baby, who becomes more competent with time, your loved one will need a progressively more controlled environment. In the early stages of dementia, you may be able to leave your loved one alone for brief periods. As the disease progresses, a person with dementia must have constant supervision.
Some important things to consider when assessing safety issues include:
- Driving. Is it safe for your loved one to drive? Can you block their access to a car?
- Cooking, electricity, and fires. A failing memory means your loved one might forget to turn off the stove or blow out a candle.
- Nutrition. Your loved one might forget to eat, or forget that they just ate. Help them remember to eat regularly.
- Wandering. In the later stages of dementia, some people begin wandering. This can be especially dangerous in neighborhoods with heavy traffic. Walk together instead, and take proactive steps to prevent wandering. Know that your loved one might even go wandering at night, when everyone is sleeping.
- Aggression and fear. Consider how you might feel if someone you didn’t recognize came into your room, demanded you take off your clothes, and attempted to make you shower. That’s how people with dementia often feel when they can no longer recognize their loved ones. Fear can make your loved one behave erratically, and even aggressively. Be sensitive and patient, and don’t push them to do things unless they’re absolutely necessary. There’s probably no reason your loved one needs a daily shower or a fancy hairstyle.
Diet and Nutritional Issues
The need for good nutrition doesn’t end with dementia. In fact, a poor quality diet can worsen the symptoms of dementia. So it’s important to help your loved one eat a healthy, balanced diet.
Some people with dementia get unusual food cravings. It’s also common for them to crave strong tastes, since dementia can dull the senses. Don’t be surprised if your loved one wants a lot of very spicy or sweet foods. It’s important to choose your battles here. Your loved one is struggling with a terminal illness. So while it’s important to keep them healthy, it’s also important to allow them some small pleasures. Some strategies for good health include:
- Involving your loved one in food preparation.
- Offering a wide variety of healthy foods, but allowing your loved one to choose what they eat.
- Giving a nutritional supplement drink, such as Ensure or Boost.
- Offering nutrient-dense smoothies. Try a protein powder blended with frozen berries, avocado, and a banana. Add some honey for flavor.
As dementia progresses, your loved one may have difficulty swallowing. Dementia can undermine the swallowing reflex, or make it difficult for your loved one to remember to swallow. Some people hide food in their cheeks, choke, or attempt to swallow food whole. Others begin refusing to eat. Consult your loved one’s doctor for help. They may need swallowing therapy. In some cases it’s necessary to switch to a liquid diet.
"Providing a safe, nurturing environment can help your loved one enjoy their life, keep them safe, and even improve cognition."
The fact that your loved one is no longer able to do specific tasks, like driving, will not remove their desire to do those tasks. Likewise, the fact that a person needs more support to explore the world does not mean they no longer want to be a part of that world.
Seniors with dementia are just like everyone else. They have interests and psychological needs, particularly in the early stages of dementia. Try planning outings with your loved one to help them enjoy the activities they once enjoyed alone. Adult daycare, classes at your local senior center, and access to plenty of home-based activities can be helpful.
As your loved one’s cognition declines, they may be less able to do activities they once loved. The avid gardener may now prefer to simply look at or pluck the petals from roses. Try to find ways to incorporate once-beloved activities into your loved one’s life. You might also try some new activities that require fewer cognitive resources. Some great options include:
- Adult coloring books
- Painting, sculpture, and other art forms
- Listening to music
- Listening to the radio or watching TV
- Putting together simple puzzles
- Spending time outside watching the birds
Stimulation and Support
Dementia is painful to watch. It’s even more painful to experience. In the early stages, your loved one may be plagued by anxiety and depression about the future. Consider talking to their doctor about medication that may help. People with dementia may also benefit from therapy and support groups.
As dementia progresses, it’s common to feel isolated and scared. Help your loved ones spend time with family members. Give them lots of affection, and most importantly, follow their lead. If they want to spend time alone, allow them to do so. But if they appear anxious and needy, find ways to give them more affection, support, and time.
Family therapy can help your family find ways to meet your loved one’s needs without draining your family’s emotional resources.
When Is It Time for Senior Care?
Dementia looks different in every senior. Some seniors have a slow decline, and die of something else before end-stage dementia. Others spend many years in a state of severe cognitive decline. Likewise, some families have the emotional, financial, and seasonal resources to provide 24/7 care to the very end. Most don’t.
There is no surefire signal that it’s time for senior care. It’s normal to feel conflicted and uncertain about this decision. To help make the decision, ask yourself two simple questions:
- Am I able to provide the care my loved one needs? If you can’t meet your loved one’s needs, if they are frequently getting injured, or if your home is not safe for a person with dementia, it’s time for a higher level of care.
- Can I care for my loved one without harming myself? Don’t take pride in destroying your own life to care for your loved one. Many families find that their relationship with a loved one actually improves when someone else begins doing the care. Your well-being, your finances, and your family’s health do matter. If you can’t care for your loved one while also caring for yourself and your family—and doing some things you enjoy—it’s time for senior care.