Having dementia is very worrying. The stress leads to upsetting behaviour, and that is the sort of thing that people find hard to deal with at home.
All of them will be solved more easily if there is a relaxed atmosphere at home. If someone is shouting, repeating themselves, refusing to eat, staying cool and tranquil would be a miracle.
So the secret is to put as much in place as possible to keep a stress-free background environment. This means avoiding over-stimulation - and everyone has different things that they find stimulating, so you have to decide for yourself what will work in your situation. Also remember that stress is contagious - a relaxed carer feeling good will help the person with dementia.
Here are some hints for keeping a calm environment:
- Exercise reduces stress and burns off excess energy that could give rise to difficult behaviour. Taking someone with dementia for a nice long walk often reduces the chaos in the home that is created by endless attempts to stop them disappearing out the front door and getting lost. The person with dementia, even after they have started to get lost at times, can go for walks on their own, if you have a suitable tracking device. Friends who are looking for a role might help with this. A dog is a good companion for this sort of work.
- Talking of dogs...research shows that petting an animal can reduce your blood pressure and caring for it gives many benefits. Even if the person with dementia does not speak any more, they can still communicate and the dog knows it is loved, and will come back again and again for scratches and pats. A recent development has been the ‘dementia dog’, which is a trained companion animal for people with dementia. It can do a variety of clever tasks, like remind you to take your pills. But a major benefit arises from the fact that the general public is sentimental about working dogs. The dementia dog, with his smart working coat, invites interaction with other people, and his job is a good subject for conversation. The responsibility and routine of caring for the dog add to the motivation for the owner.
Make sure that you are aware of the situation and use all the knowledge you have about what matters most to the person with dementia.
- If you haven’t got a dog to cuddle, you are just going to have to cuddle each other. Touch is very important. If you are a family that never had much body contact, now is a good time to start. Have big hugs and learn the pleasure of sitting beside your mum, stroking her hair or rubbing some nice cream into her feet and ankles.
- Keep the stimulation level right. This might mean keeping the noise down. It might mean making sure the hearing aids are working so that the person is not frustrated by not being able to hear. There can be too much noise and too little noise and you will know what is best at each time of the day. Try sitting quietly on your own with your eyes shut and just listen to the house...there may be noises of which you were not aware. It is often the case at night, when the person with dementia being disturbed is particularly inconvenient. Gentle music (preferred music, chosen by the person with dementia) can drown out other extraneous noises. If your person with dementia is a heavy metal fan, you’ll possible set them off by playing quiet music. Only you can tell, but make sure that you are aware of the situation and use all the knowledge you have about what matters most to the person with dementia.
Some design ideas for the person with dementia’s home:
- In a familiar environment, change as little as possible.
- In a new environment, make everything as plain and obvious as possible, including signage when needed.
- In both cases increasing the light level can make more difference than the medication for some people. Daylight has the added advantage that it helps set the body clock, the internal mechanism that makes you sleepy at night. Getting out in the daylight can really make it more likely that the person will sleep.
- Sleep is really important in dementia. The condition is crushingly tiring. The design of the bedroom can help. And of course you also need to think about all the common strategies, like plenty of exercise and daylight during the day followed by a bedtime routine. It’s best to keep communication equipment such as televisions and computers out of the bedroom. There is increasing evidence that the light from screens falling on the retina affects the body clock negatively.
- Good design of the kitchen is vital for a person with dementia because eating and drinking are especially important for their health. It is crucial to adapt the kitchen to allow people with dementia to enjoy food as much as possible for as long as possible. Your aim should be that the person is able to continue to make meals for as long as possible, even if they are simple meals. Encourage eating and drinking - you could do this by having a glass fronted fridge or cupboards, so that bright and attractive food and packaging are on display. You can also use a little plug-in electric machine called an Ode, which will release at carefully timed intervals selected food odours that have been shown to encourage appetite.
- Use all the assistive technology that is available to you, and start using it at the earliest possible stage. This will maximise the opportunity for the person with dementia to become familiar with it and for you to learn how to maintain and use it.