Last updated: April 29, 2015
Even though most dementia
develops from irreversible causes, there is still much that
families can do to help their loved ones continue to function as
well as possible for as long as possible. Creating a safe,
comfortable and supportive environment for someone with dementia
can be achieved through the below standard practices.
General Dementia Care Techniques
Researchers, doctors and eldercare professionals are still
discovering and refining what works and what doesn't when it comes
to dementia care, but the following tactics have proven effective
- Develop a Daily Routine
Assess your day to see if there are routines you can put in place
to help things go more smoothly. Most people like to have a sense
of what's coming next, and a daily rhythm can be especially helpful
for those dealing with general confusion. If there are times of day
when your loved one is less confused or more cooperative, plan
major activities for those times.
- Encourage Independence
Studies have found that a technique called "graded
assistance," combined with daily practice and positive
reinforcement can go a long way to maintaining functional
independence. Graded assistance is a method of helping someone
accomplish a task with the least amount of aid possible, using a
spectrum of assistance from verbal prompts to physical
demonstration, physical guidance, partial physical assistance and
complete physical assistance.
- Use Music
Studies have shown that music soothes and can help reduce problem
behaviors, such as agitation and aggression (especially
during mealtimes and bathing). However, it's important to note that
the music should be something that the person with dementia
prefers, not necessarily what the caregiver thinks would be nice to
listen to. Playing your loved one's favorite types of music is
typically the most effective form of dementia
Here are some more tips from the National Insitute on Aging
- Minimize Distractions: When you're preparing
to have a focused conversation, turn off the TV and radio.
- Get Your Loved One's Attention: Call him by
name, and make sure he's looking at and listening to you before
- Speak Simply and Directly: Choose simple words
and short sentences and use a gentle, calm tone of voice. Make sure
to treat the person with dementia like an adult; avoid taking a
- Be Patient: Allow enough time for a response.
Be careful not to interrupt. If she is truly struggling to find a
word or communicate a thought, gently try to provide the word she
is looking for.
Dementia can make bathing a frightening, confusing experience.
Advance planning can help make bath time better for both of
- Limit Bathing: Try replacing some showers with
sponge baths. Depending on how active your loved one is, he or she
may not need a full shower every day.
- Plan Ahead: Gather everything you need ahead
of time, including a towel and change of clothes. Get the water
going and set to the right temperature.
- Warm the Bathroom: Undressing can be
especially unpleasant when it's cold. Turn up the heat as
- Narrate What's Happening: Tell him what you
are going to do, step by step, and allow him to do as much as
- Minimize Safety Risks: Use a handheld
showerhead, shower bench, grab bars, and nonskid bath mats. Never
leave the person alone in the bath or shower.
For those with dementia, getting dressed presents a series of
challenges, from choosing what to wear, to figuring out how to
properly take things off and put other things on, to manipulating
buttons and zippers. Here are some things you can do to simplify
- Encourage Independent Choice: Allow the person
to choose from a limited selection of outfits. If she has a
favorite outfit, consider buying several identical sets.
- Arrange Clothes in Order: Elimintate the need
for decision-making by laying clothing items out in order they are
to be put on.
- Provide Instructions if Needed: If the person
needs prompting, provide clear, step-by-step instructions.
- Choose Convenient Clothes: Clothing for
dementia patients should be comfortable and easy to get on and off.
Elastic waists and Velcro closures minimize struggles with buttons
- Limit Distractions: Ensure a quiet, calm
atmosphere for eating. Limiting noise and other distractions may
help the person focus on the meal.
- Serve Small Meals and Snacks: Dementia
patients may have limited appetites and attention spans. Plan on
serving small portions and supplementing these with snacks.
- Make Eating Easy: Use straws or cups with lids
to make drinking easier. Serve finger foods if the person has
trouble with utensils. Using bowls instead of plates may also help
encourage independent eating.
- Visit the Dentist Regularly: Maintaining a
healthy mouth and healthy teeth is key to helping dementia patients
Activities & Exercise
Incorporating physical and mental stimulation into daily
routines is important for both caregivers and their charges. Here
are some tips for making regular exercise and other activities a
part of daily life:
- Find Mutually Enjoyable Activites: From daily
strolls around the neighborhood, to game nights and regular
outings, activities should be simple and fun for everyone.
- Keep Expectations Reasonable: You may need to
modify favorite activities to suit current abilities. Go slowly,
take things step by step, and avoid frustration and
- Take Advantage of Organized Programs: Local
senior centers often offer classes and activities suitable for
those with dementia. You may also want to check into adult day
services, which can be a good source of daily socialization for
those with dementia and relief for caregivers.
As the disease progresses, many people with dementia begin to
incontinence. Sometimes incontinence is due to physical
illness, so be sure to discuss it with the person's doctor. Beyond
that, here are some tips for managing bathroom care:
- Develop a Schedule: Take the person to the
bathroom at regular intervals. Don't wait for her to ask.
- Watch for Signs of Discomfort: Is he unusually
restless or pulling at his clothes? Take him to the bathroom.
- Prevent Accidents When Possible: Take steps
such as avoiding fluids after a certain time of night. If you are
going to be out with the person, plan ahead. Know where restrooms
are located, and have the person wear simple, easy-to-remove
- Stay Calm and Positive: When accidents occur,
minimize embarassment by dealing with them matter-of-factly.
Getting enough rest can help ensure optimal mental functioning
for those with dementia. Try the following techniques to increase
the likihood of everyone getting a good night's sleep:
- Keep Evenings Peaceful: When it's getting
close to bedtime, dim the lights and avoid stimulating activities
such as watching television. You may find that playing soothing
music or reading to your loved one helps him or her relax.
- Make Bedtime Consistent: Help your loved one
develop an effective internal clock by keeping bedtime within 15
minutes of the same time each night.
- Maintain an Exercise Routine: Getting enough
physical activity each day is key to sleeping deeply at night.
- Avoid Caffiene: Limit coffee, tea and soda,
especially after lunch and into the evening.
Hallucinations & Delusions
As the disease progresses, a person with dementia may experience
hallucinations and/or delusions. The following techniques can be
used to help manage episodes:
- Avoid Arguing: Don't disagree with the person
about what she sees or hears. Try to respond to the feelings she is
expressing, and provide reassurance and comfort.
- Offer Distractions: Suggest a change of topic
or activity. Sometimes moving to another room or going outside for
a walk may help.
- Turn Off the TV: Dark, moody or violent
programming can be especially unhelpful for those who have
difficulty distinguishing fantasy from reality.
- Ensure Safety: Make sure the environment is
free of objects that could be used to cause harm.
Home Safety & Wandering
Creating a safe environment is one of the most important aspects
of caregiving and can prevent many stressful and dangerous
situations. Caregivers of people with dementia often have to look
at their homes through new eyes to identify and correct
senior home safety risks.
- Install Locks on Possible
Exits: All windows and doors should be appropriately
secured to prevent wandering. This may involve installing new and
unfamiliar locks, or placing new locks where the person can't reach
- Remove Interior Locks: Avoid allowing your
loved one to lock him- or herself into any room, including the
bathroom. He or she may not remember how to unlock
- Remove Dangerous Objects: This includes
anything that could create a tripping hazzard and anything that
could be used to cause harm.
- Install Childproof Latches: Secure kitchen
cabinets, linen closets and other storage spaces.
- Ensure Proper Identification: Make sure that
the person carries some kind of identification or wears a medical
bracelet. If he gets lost and is unable to communicate adequately,
this will alert others to his identity and medical condition. In
addition, keep a recent photograph or videotape of the person with
dementia on hand.
Driving generally isn't safe for those in all but the earliest
stages of dementia. Here's how you can handle the transition:
- Be Firm: Don't allow your loved one to drive
on "good days" but forbid it on "bad days." Offer sympathy when he
or she expresses unhappiness with the situation, but don't give
- Get a Doctor's Help: The person may view the
doctor as an "authority" and be willing to stop driving.
The doctor also can contact the Department of Motor Vehicles and
request that the person be reevaluated.
- Take the Car Keys: If just having keys is
important to the person, substitute a different set of keys.
- Move the Car: If all else fails, disable the
car or move it to a location where the person cannot see it or gain
access to it.
Visiting the Doctor
Here are some tips for handling medical appointments:
- Schedule Wisely: Try to schedule the
appointment for the person's best time of day. Also, ask the office
staff what time of day the office is least crowded.
- Give Short Notice: Don't tell the person about
the appointment until the day of the visit or even shortly before
it is time to go. Be positive and matter-of-fact.
- Bring Snacks and Activities: Bring along
something for the person to eat and drink and any activity that he
- Bring a Helper: Have a friend or another
family member go with you on the trip, so that one of you can be
with the person while the other speaks with the doctor.